Combining Motivational Interviewing and Cognitive Bias Modification Training for Substances in Detained Youth

Objective: Motivation is considered a key factor in successful treatment. Unfortunately, detained youth typically show lower motivation for treatment and behavioral change. This pilot study examined the effects of a brief Motivational Interviewing (MI) protocol in conjunction with a Cognitive Bias Modification (CBM) intervention aimed at reducing substance use in detained youth. Method: An MI protocol for adult parolees was adapted for adolescents. A total of 52 detained youth received the MI intervention, aimed at enhancing their insights into their substance use and its potential relation with their offenses, plus substance use treatment. These youth were matched with controls from similar populations who received the same CBM without MI. Results: Changes in motivation over time were examined with a repeated-measures analysis of variance. Results showed no change in motivation over time, nor a significant effect of condition (MI vs no MI). Conclusion: Although application of the MI protocol was feasible, no effect was found on motivation, in contrast to the original adult-focused protocol. Certain core facets of the original protocol, such as client reflection on their history of substance use, may be less applicable to detained youth whose use history is relatively brief. The severity of their substance use behavior should also be taken into account in any future applications. Plain language summary: Motivational interviewing (MI) is an evidence-based method to increase behavioral change and treatment engagement. In this study, 52 detained youth received a 6 session MI protocol in addition to a cognitive bias modification (CBM) intervention targeting substance use, and they were matched with controls from a prior study where youth received CBM only. Neither group showed a change in motivation. These findings suggest that future MI-based interventions should consider the needs and developmental stages of youths with substance use.