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Y-SBNT: Family and Social Network Intervention for Young People who Misuse Alcohol and Drugs

The Y-SBNT trial investigated whether a social network intervention, used with adults in the UK called SBNT (social behaviour and network therapy) could be adapted for young people. The study found that Y-SBNT could be delivered, was acceptable to participants, their families and staff, but was more expensive and no more effective than usual treatment in reducing substance use in young people.

Why did we do this research?

Previous research has shown that the family has a considerable impact on young people's drinking and drug use. Interventions involving the family and wider social networks have shown promise in helping young people to deal with substance abuse problems. This study explored whether an adaptation of a family and social network intervention delivered as part of routine practice to young people was clinically and cost effective.

What did we do?

We adapted the social behaviour and network therapy (SBNT) used in the treatment of adults, to produce a purpose-designed therapy manual and associated resources suitable for use with young people. This was achieved by extensive public involvement with young people with experience of services, as well as consultation with treatment professionals working with young people.

To test the delivery of the intervention (called Y-SBNT), we undertook a two-arm randomised controlled open feasibility trial, where young people were randomised to the Y-SBNT intervention or to treatment as usual. We looked at how the intervention was provided and whether young people and their social networks agreed to get involved. The primary outcome was the number of days that the young people used their primary problem substance (either alcohol or a specific drug) over a 3-month period before and after receiving treatment.

Who was involved?

Young people aged 12-18 years with drug or alcohol problems were asked to get involved with this study. In total 53 young people in two treatment services in England were randomised.

We also sought to involve young people with experience of using substance misuse services in the research process.

What did we find?

The adapted intervention could be delivered in young people's services, and qualitative interviews found that Y-SBNT was acceptable to young people, family members and staff. However, Y-SBNT was more expensive than usual treatment and did not appear to work better than usual treatment in reducing the frequency of substance use.

What have we learned? 

Although the findings of this feasibility trial do not support a recommendation for a full trial of the Y-SBNT intervention compared with TAU, they can inform future UK research within routine addiction services.

Engagement of family and network members proved difficult within the intervention and research aspects. The study proved the feasibility of this work in routine services but outcome measurement based on narrow substance use variables may be limited and may fail to capture other important changes in wider areas of functioning for young people.

Validation of the EuroQol-5 Dimensions for young people aged 12-18 years should be considered and flexible models for involvement of young people in research are required to achieve inclusive representation throughout all aspects of the research process.

Publications

• Watson J, Toner P, Day E, Back D, Brady LM, Fairhurst C, et al. Youth social behaviour and network therapy (Y-SBNT): adaptation of a family and social network intervention for young people who misuse alcohol and drugs - a randomised controlled feasibility trial. Health Technol Assess. 2017 Mar;21(15):1-260. https://doi.org/10.3310/hta21150. PMID: 28399988.
• Brady LM, Templeton L, Toner P, Watson J, Evans D, Percy-Smith B, and Copello A. (2018), "Involving young people in drug and alcohol research", Drugs and Alcohol Today, Vol. 18 No. 1, pp. 28-38. https://doi.org/10.1108/DAT-08-2017-0039
• Watson J, Back D, Toner P, LLoyd C, Day E, Brady LM, et al. A randomised controlled feasibility trial of family and social network intervention for young people who misuse alcohol and drugs: study protocol (Y-SBNT). Pilot Feasibility Stud 1, 8 (2015). https://doi.org/10.1186/s40814-015-0004-4 

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