Transcript Folie 1

Quit the shit – An internetbased intervention program
for cannabis users
Bundeszentrale für
gesundheitliche Aufklärung
Peter Tossmann
Benjamin Jonas
Marc Tensil
Peter Lang
Evelin Strüber
Berlin / Cologne, June 2012
Structure of the presentation
1. The programme “quit the shit“
1.1. Basic facts
1.2. Structure & content
2. Evaluation of the programme (RCT)
2.1. Study design
2.2. Results
3. Conclusion
1.1. Basic facts
Development
› “quit the shit” was developed on behalf of the
Federal Centre of Health Education (FCHE / BZgA)
› Start: August 2004
› Embedded in “www.drugcom.de”
Bundeszentrale für
gesundheitliche Aufklärung
Allgemeine Informationen
1.1. Basic facts
Development
› “quit the shit” was developed on behalf of the
Federal Centre of Health Education (FCHE / BZgA)
Bundeszentrale für
gesundheitliche Aufklärung
› Start: August 2004
› Embedded in “www.drugcom.de”
Usage of “quit the shit”
› Until 15 June 2012, 3.900 users (approx. 40 – 50 per month)
Target group
› Cannabis-addicted adolescents and young adults
Aim of the programme
› To reduce cannabis consumption or to quit within 50 days
1.1. Basic facts
Brief intervention
› Clear timeframe (50 days)
› Target oriented approach
Counselling concept
› Social learning theory (Kanfer, 1986): Self-monitoring & self-regulation
› Solution-focussed strategy (Berg & Miller, 2000)
› Motivational Interviewing (Miller & Rollnik, 1999)
Additional Information for the users
› Section title: “How to control cannabis use”
1.2. Structure & content of the programme
1
2
Registration
1.
AdmissionChat
3
ProgrammeParticipation
4
Concluding
Chat
Registration
› Registration questionnaire
› Current use of cannabis & other substances (quantity, frequency,
dependence etc.)
› Mental well-being (life satisfaction, psych. problems, social support etc.)
› Socio-demographics (age, gender, educational & employment status
etc.)
› Registration with E-Mail-Address
› Appointment for the Admission-Chat
1.2. Structure & content of the programme
1
2
Registration
2.
AdmissionChat
3
ProgrammeParticipation
Admission-Chat with trained psychologist
› Where? In the chat-room of “quit the shit”
› Duration: 50 minutes
› Aims:
› Establish a trustful relationship
› Elicit the personal situation of the client
› Define individual goals & coping strategies
4
Concluding
Chat
1.2. Structure & content of the programme
1
2
Registration
3.
AdmissionChat
3
ProgrammeParticipation
4
Concluding
Chat
Programme Participation (I)
› Online diary for 50 days
› Cannabis-use for each day (yes / no):
› If “yes”: When? How much? Situational context? Reasons?
› If “no”: Reasons for abstinence? Which coping strategies?
› Daily resume
› Exercises
› Coping strategies, pleasurable activities & healthy lifestyle, self-efficacy
& problem solving etc.
1.2. Structure & content of the programme
1
2
Registration
3.
AdmissionChat
3
ProgrammeParticipation
4
Concluding
Chat
Programme Participation (II)
› Weekly feedback from the counsellor
› Topics: Substance use, psychosocial situation, progress within the
programme
› Ideas & suggestions, exercises
› Answering questions etc.
1.2. Structure & content of the programme
1
2
Registration
4.
AdmissionChat
3
ProgrammeParticipation
4
Concluding
Chat
Concluding Chat (30 min)
› Where? In the chat-room of “quit the shit”
› Topics:
› Which goals could be obtained? Which ones not?
› Which coping strategies worked? Which ones have to be improved?
› Future perspectives: Is there a need for additional support?
2. Evaluation of the programme
Is “quit the shit” helpful ....
› to reduce cannabis use ?
› to improve psychological well-being ?
2.1. Study design: Randomised Control Trial (RCT)
Structure of the survey
3 Months
Registrationquestionnaire
Participation at QTS
Follow-up
• Socio-demographics
• Cannabis consumption (quantity, freq.)
• Psychological well-being
• etc.
Delay-condition
• Cannabis consumption (quantity, freq.)
• Psychological well-being
• etc.
2.2. Results: Participants
Inclusion criteria fulfilled
(n=1.292)
Randomisation
Waiting Condition
(Control Group) (n=429)
Participation at QTS
(Intervention Group)
(n=863)
Inclusion Programm
(n=360)
response: 35%
response: 39%
Follow-up-data
Follow-up-data
(n=150)
(n=144)
professional help: n=44
Analysed Data
(n=106)
exclusion: n=44
Analysed Data
(n=100)
2.2. Results: Participants
Study population: N=206 participants
Socio-demographic data
•
Significantly more male participants (74%)
•
Average age: 25 yrs. (MD) (youngest: 14 yrs.; oldest: 59 yrs.)
•
Relatively high education: 55% attend Gymnasium (grammar
school) or have reached Abitur (a-levels)
Cannabis: Consumption & dependence
•
On average on 25,5 days (SD=6,1) during the last 30 days
•
On average 20,4 grams (SD=18,1) during the last 30 days
•
95% are addicted to cannabis (DSM IV)
3.2. Results: Days of consumption / past 30 days
30
Abstinence (Follow-up)
26.1
Days of consumption
25
24.9
21.0
20
IG:
32,6%
CG:
5,4%
 Odds Ratio: 8,5 (p<.001)
15
12.4
10
5
CG (n=106)
IG (n=100)
0
Registration
T(187,02)=6,593; p<.001; d = 0.98
Follow up
3.2. Results: Amount (grams) / past 30 days
T(166,969)=5,174; p<.001; d = 0.74
3.2. Results: Anxiety (STAI-T)*
80
70
STAI-T score
60
51,4
50
50,9
40
47,3
42,6
CG (n=99)
30
IG (n=86)
20
Registration
T(183)=3,747; p<.001; d = 0.45
Follow Up
80 = scale max.
20 = scale min.
* State-Trait-Anxiety-Inventory, Trait-Subscale (Laux et al., 1981)
3.2. Results: Depressiveness (ADS-K)*
T(180)=1,907; p=.029; d = 0.26
* Allgemeine Depressions-Skala, Kurzversion (Hautzinger & Bailer, 1993)
3.2. Results: Life satisfaction (SWLS)*
T(195)=-2,683; p=.004; d = 0.29
* Satisfaction with Life Scale (Schumacher, 2003)
4. Summary
“Quit the shit” is one of the first internet-based treatment
programmes for cannabis-related disorders in Europe
It was successfully established in Germany (3.900 users so far)
Extended and optimized continuously
Highly elaborated system (programme, user management)
It has been proven to be effective in reducing cannabis use
and improving psychological well-being
Thank you!