Motivational Enhancement Therapy and Cognitive Behavioral Therapy - 5 Sessions (MET/CBT5)

Note: MET/CBT5 declined to participate in the CEBC review process. The following information was obtained from publicly available sources (website, articles, etc.).

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5

Relevance to Child Welfare Rating:
2
Medium
See scale of 1-3

Child Welfare Outcomes: Child and Family Well-Being

Brief Description:

Motivational Enhancement Therapy and Cognitive Behavioral Therapy - 5 Sessions (MET/CBT5) has been rated by the CEBC in the area of Substance Abuse Treatment (Adolescent). MET/CBT5 is a brief treatment approach for adolescents with cannabis use disorders, consists of two individual motivational enhancement therapy (MET) sessions, followed by three group cognitive behavioral therapy (CBT) sessions. The two initial individual MET sessions are primarily intended to enhance adolescents' motivation to address their marijuana use and to prepare the clients for the group sessions, with an introduction to functional analysis and the concept of triggers. The purpose of the three group sessions is to assist clients in the development of skills useful for stopping or reducing marijuana use. The CBT sessions focus on the following skills:

Learning basic skills for refusing offers of marijuana
Developing a plan for pleasant drug-free activities
Establishing a social network that will support recovery
Coping with high-risk situations

Recovering from a relapse, should one occur.

Manual and Training section:
The publicly available information indicates that there is a manual and training available for MET/CBT5. Please contact Randolph D. Muck, M.Ed., Phone: 240-276-1576, Email: Randy.Muck@samhsa.hhs.gov for more details.

Relevant Published, Peer-Reviewed Research:
Motivational Enhancement Therapy and Cognitive Behavioral Therapy - 5 Sessions (MET/CBT5) is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. For more information on the rating of a "3 - Promising Research Evidence," please see the Scientific Rating Scale.

Dennis, M. L., Godley, S. H., Diamond, G. S., Tims, F. M., Babor, T., Donaldson, J., … Funk, R. R. (2004). The Cannabis Youth Treatment (CYT) study: Main findings from two randomized trials. Journal of Substance Abuse Treatment, 27, 197-213.

Type of Study: Randomized controlled trial
Number of participants: 600
Population:

Age Range: 13-18 years
Race/Ethnicity: 61% Caucasian/White, 30% African American/Black, 4% Hispanic/Latino, 6% Other/Mixed
Status (e.g., foster care, CW): Adolescents and their families were recruited from sequential admissions to 4 treatment sites.

Location/Institution: Farmington, CT/University of Connecticut Health Center, Madison County, IL/Chestnut Health Systems, Philadelphia, PA/Children's Hospital of Philadelphia, and St. Petersburg, FL/Operation PAR.
Summary: (To include comparison groups, outcomes, measures, notable limitations) This article presents the main outcome findings from two inter-related randomized trials conducted at 4 sites to evaluate the effectiveness of 5 short-term outpatient interventions for adolescents with cannabis use disorders. Trial 1 compared Motivational Enhancement Therapy and Cognitive Behavioral Therapy - 5 Sessions (MET/CBT5) with a 12-session regimen of MET and CBT (MET/CBT12) and another that included family education and therapy components (Family Support Network [FSN]). Trial II compared the Motivational Enhancement Therapy and Cognitive Behavioral Therapy - 5 Sessions (MET/CBT5) with the Adolescent Community Reinforcement Approach (A-CRA) and Multidimensional Family Therapy (MDFT). All 5 Cannabis Youth Treatment (CYT) interventions demonstrated significant pre-post treatment improvements during the 12 months after random assignment to a treatment intervention in the 2 main outcomes: Days of abstinence, as measured by self-reports using Global Appraisal of Individual Needs (GAIN) (a standardized semi-structured interview), and the percent of adolescents in recovery (no use or abuse/dependence problems and living in the community). Overall, the clinical outcomes were very similar across sites and conditions. Two notable limitations of the study are its reliance on participant self-report and the lack of a no-treatment control group.
Length of post-intervention follow-up: 38-46 weeks post-intervention (Treatment length 6-14 weeks, with 3, 6, 9, and 12-month follow-ups after intake).

Mason, M., & Posner, M. (2009). Brief substance abuse treatment with urban adolescents: A translational research study. Journal of Child & Adolescent Substance Abuse, 18(2), 193-206.

Type of Study: Non-randomized comparison study
Number of participants: 102
Population:

Age Range: 13-20 years
Gender: 80% male, 20% female
Race/Ethnicity: 44% white, 36% African American, 9% Hispanic, 11% mixed/other
Status (e.g., foster care, CW): Participants were enrolled in a brief, manualized substance abuse treatment program between January 2004 and September 2006 and were referred by health care providers, schools, and the juvenile justice system.

Location/Institution: Philadelphia, PA
Summary: (To include comparison groups, outcomes, measures, notable limitations) The purpose of this translational research study was to test a brief, manualized adolescent substance abuse treatment - Motivational Enhancement Therapy and Cognitive Behavioral Therapy - 5 Sessions (MET/CBT5) - protocol's effects in an urban community setting compared to a sample in an experimental study from which the treatment was first employed (Cannabis Youth Treatment, CYT, Study; Dennis et al., 2004). Participants in the community group were adolescents who were treated with MET/CBT5 and followed for six months post-intake. Comparison group data were drawn from participants in the Cannabis Youth Treatment (CYT) Study (Dennis et al., 2004), a randomized trial testing adolescent substance abuse treatment with 600 participating youth; this comparison sample also received MET/CBT5. The Global Appraisal of Individual Needs (GAIN) assessment was used to measure substance use and mental health. Results showed that, by month 6, alcohol use for the comparison (CYT Study) group increased 0.72 days while alcohol use for the community group decreased 0.58 days. Limitations include the nature of adolescents' self-reports of substance use, as well as the lack of randomization and an alternative-treatment control group.
Length of post-intervention follow-up: 3 & 6 months post-intake.

References:
Dennis, M., Titus, J. C., Diamond, G., Donaldson, J., Godley, S. H., Tims, F. M., …Scott, C. K. (2002). The cannabis youth treatment experiment: rationale, study design and analysis plans. Addiction, 97(Suppl 1),16-34.

Sampl, S., & Kadden, R. (2001). MET and CBT for adolescent cannabis users: 5 sessions, CYT series, volume 1. (BKD384). Rockville, MD: CSAT, SAMHSA. Retrieved on April 1, 2010, from kap.samhsa.gov/products/manuals/cyt/

Contact Information
Contact name (and Degree): Randolph D. Muck, M.Ed., Chief
Affiliation/Agency: Targeted Populations Branch, Division of Services Improvement, Center for Substance Abuse Treatment
E-mail: Randy.Muck@samhsa.hhs.gov
Phone: 240-276-1576
Fax: 240-276-2970
Website: evidencebasedpracticenetwork.net/MET_CBT_5.aspx

Date review compiled: April 2010