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MOTIVATIONAL/SOLUTION-FOCUSED INTERVENTION FOR REDUCING SCHOOL TRUANCY AMONG ADOLESCENTS

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The objective of this study was to assess the efficiency of a package of motivational stimulation techniques in reducing school truancy rates among adolescents. The program was carried out between March and June 2007 and it comprised 8 group counseling sessions per week, each session lasting one hour. The techniques used combined intrinsic motivational stimulation strategies, motivational interviewing and solution-focused counseling, with strategies focusing on extrinsic methods, such as successive approximation of behavior, behavior contracts and reinforcement techniques. Participants were adolescents, aged 16-17 years, divided into two groups, 19 students in the experimental group, and 19 in the control group. Our data indicated a 61% decrease in truancy rates for the experimental group, a significant difference compared to the control group, where no drops in truancy rates were observed. The results of this non-randomized pilot study suggest that group interventions such as the one described here can prove to be useful in reducing adolescent truancy, and deserve further investigation in controlled randomized studies.

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ADOLESCENT DOSE AND RATINGS OF AN INTERNET-BASED DEPRESSION PREVENTION PROGRAM: A RANDOMIZED TRIAL OF PRIMARY CARE PHYSICIAN BRIEF ADVICE VERSUS A MOTIVATIONAL INTERVIEW

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Internet-based interventions for education and behavior change have proliferated, but most adolescents may not be sufficiently motivated to engage in Internet-based behavior change interventions. We sought to determine how two different forms of primary care physician engagement, brief advice (BA) versus motivational interview (MI), could enhance participation outcomes in an Internet-based depression prevention intervention.

Eighty-three adolescents at risk for developing major depression were recruited by screening in primary care and randomized to two groups: BA (1-2 minutes) + Internet program versus MI (10-15 minutes) + Internet program. We compared measures of participation and satisfaction for the two groups for a minimum of 12 months after enrollment.

Both groups engaged the site actively (MI: 90% versus BA: 78%, p=0.12). MI had significantly higher levels of engagement than BA for measures including total time on site (143.7 minutes versus 100.2 minutes, p=0.03), number of sessions (8.16 versus 6.00, p=0.04), longer duration of session activity on Internet site (46.2 days versus 29.34 days, p=0.04), and with more characters typed into exercises (3532 versus 2004, p=0.01). Adolescents in the MI group reported higher trust in their physician (4.18 versus 3.74, p=0.05) and greater satisfaction with the Internet-based component (7.92 versus 6.66, p=0.01).

Our results indicate that primary care engagement, particularly using motivational interviewing, may increase Internet use dose, and some elements enhance and intensify adolescent use of an Internet-based intervention over a one to two month period. Primary care engagement may be a useful method to facilitate adolescent involvement in preventive mental health interventions.

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