Moderators of brief motivation-enhancing treatments for alcohol-positive adolescents presenting to the emergency department

• A 2011 trial of alcohol-positive adolescents presenting to the emergency department (ED) found that adolescent + parent motivational enhancement therapy (MET) reduced high volume drinking better than adolescent MET only.
• Seven variables were tested as potential predictors or moderators of high volume drinking at 3 months post-treatment.
• Older adolescents (age 16–18) had worse drinking outcomes than younger adolescents (age 13–15) in both MET conditions.
• Adolescents whose parents screened positive for problematic alcohol use had worse drinking outcomes with adolescent + parent MET than adolescent MET only.
• Alcohol-positive adolescents presenting to the ED may respond better to MET if they are under the age of 16 and involving parents with problematic alcohol use in MET may have negative effects on adolescent high volume drinking.

A 2011 randomized controlled trial compared the effectiveness of two brief motivation-enhancing therapy (MET) models among alcohol-positive adolescents in an urban emergency department: adolescent MET-only versus MET + Family Check-Up (FCU), a parent MET model. Results indicated that among the 97 adolescents completing the 3-month assessment, both conditions were associated with reduced drinking and MET + FCU was associated with lower rates of high volume drinking than adolescent MET-only. The goal of this study was to identify predictors and moderators of high volume drinking in the original trial. Seven candidate variables were evaluated as moderators across three domains: demographic characteristics, psychological factors, and socio-contextual factors. Analyses of covariance models identified one significant predictor and one significant moderator of outcome. Older adolescents had significantly worse drinking outcomes than younger adolescents regardless of MET condition. Adolescents whose parents screened positive for problematic alcohol use at baseline had significantly worse drinking outcomes in the MET + FCU condition than the MET-only condition. Results indicate that alcohol-positive adolescents presenting to the emergency department may respond better to MET models if they are under the age of 16. Involving parents who have problematic alcohol use in a parent-focused MET may have negative effects on adolescent high volume drinking.