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29 Open-pilot of an ed-based multi-session remote therapy intervention (rti) for violence
  1. Patrick Carter1,
  2. Jessica Roche1,
  3. Maureen Walton2,
  4. Rebecca Cunningham1
  1. 1University of MIchigan Injury Centre
  2. 2University of Michigan School of Medicine


Statement-of-Purpose Violence is a leading cause of death for urban youth. This pilot evaluated the feasibility of a remote therapy intervention (RTI) for violence and substance use among drug-using youth seeking Emergency Department (ED) care for assault.

Methods Youth (age:14–24) with assault-injury were approached in the ED; those screening positive for past 6 month drug use were enrolled in an open pilot. The 8-session RTI combined elements of motivational interviewing and cognitive behavioural therapy for substance use/violence (e.g., refusal skills, conflict resolution, anger management), and strengths-based care management to link youth with community resources. The RTI was delivered in-person by a therapist during the ED visit (~35 min) and remotely (e.g., phone) in the 12 weeks following the visit. Computerised assessments were completed at baseline,~weekly prior to sessions, and at a 4 month follow-up. Results were analysed descriptively and with paired tests (baseline, follow-up).

Results 20-youth were enrolled in the pilot [M age=21; 55% female; 60% African-American; 70% public assistance; 90% past 2 month marijuana use]. The RTI was acceptable and feasible, with 91% enrollment of eligible youth, 100% of enrolled youth completing the in-person ED session, 70% completing 5 remote sessions, and >80% completing the 4 month follow-up. Participants rated sessions highly, with 80% reporting that it was very/extremely helpful to have post-ED phone sessions. Paired comparisons demonstrated a decrease in violence (aggression/victimisation) prevalence (90%-vs.-20%;p<0.01), and non-significant decreases in drug use frequency (2.61.6-vs.-2.52.3), violence frequency (6.23.5-vs.-2.75.9), and the frequency of drug (9.97.1-vs.-7.97.1), and violence (2.32.2-vs.-0.91.3) consequences.

Conclusion A multi-session violence intervention delivered remotely is acceptable and feasible.

Significance/Contribution Effective individual- and community-based interventions are urgently needed to decrease youth violence. Based on our initial pilot, the RTI is a promising theory-based individual-level intervention for high-risk assault-injured ED youth. Further study is needed to determine intervention efficacy on violence outcomes (e.g., violent re-injury, arrests).

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