ABOUT iDECIDE

Introduction

iDECIDE (Drug Education Curriculum: Intervention, Diversion, and Empowerment), is a drug education curriculum developed to provide behavioral support and psychoeducation for middle and high school students. The program is designed to serve as a secondary prevention effort for youth at risk for escalation to problematic substance use and as an alternative to suspension, expulsion, and other exclusionary practices for school-based substance use infractions. iDECIDE provides schools and communities the resources to empower students to engage in healthy decision making. iDECIDE is not a cessation program, and is not meant to be used in lieu of treatment.

The objective of iDECIDE is to provide students with:

  • a scientific understanding of the impact of substance use and addiction on the adolescent brain and body;

  • an understanding of the common tactics used by industry to target young people;

  • the ability to identify and respond to personal impulses to use alcohol and other drugs; and

  • a sense of empowerment and a plan to make healthy decisions in line with their core values and future goals.

The Need for Equitable Alternatives to Punishment for Substance Use

  • With an increasing number of students violating school substance use policies, there is an urgent need to establish reasonable, equitable, and effective school responses to substance use infractions.

  • Punitive approaches don’t work as effective deterrents for substance use.1

  • Punitive approaches are associated with increased risk for other negative health,2,1 behavioral3,4,5 and academic outcomes.6,7,8

  • Punitive approaches have a disproportionate negative impact on students of color and students with learning disabilities and/or psychiatric illness…thus may magnify social inequities.9

To address these needs, the Center for Addiction Medicine at Massachusetts General Hospital, in collaboration with the Office of Youth and Young Adult Services at the Massachusetts Department of Public Health and the Institute for Health and Recovery, has designed an alternative to punitive responses to school-based substance use infractions. iDECIDE is a scalable and sustainable best practice education- and skills-based curriculum designed to retain students in school and empower them to make healthy decisions. iDECIDE will also help to improve health equity among students and ensure that responses to substance use infractions at school are effective, age-appropriate and science-based.

Content with footnote10

Multi-Tiered System of Supports (MTSS)

tiers

How does iDECIDE fit within a Multi-Tiered System of Supports?

A multi-tiered system of support (MTSS) is “a comprehensive continuum of evidence-based, systemic practices to support a rapid response to students’ needs, with regular observation to facilitate data-based instructional decision making.”23

The Massachusetts Department of Elementary and Secondary Education (DESE) has extended MTSS beyond academics, to include social emotional and behavioral supports. Students violating school substance use policies may benefit from Tier 2 supports. iDECIDE has been designed to serve as a Tier 2 targeted response. Read more about the details of the MTSS framework within the Massachusetts Department of Elementary and Secondary Education by clicking here to be directed to the Massachusetts Department of Education website.

iDECIDE is not a replacement for Tier 1 prevention strategies, nor is it a replacement for referral to more intensive substance use or mental health evaluation or treatment when clinically indicated.

Mission

iDECIDE promotes education and empowerment, instead of punishment, as an equitable response to adolescent substance use. Providing youth with science-based knowledge and skills, iDECIDE challenges young people to make decisions that align with their core values and future goals to support their own personal well-being.

The following principles are at the core of iDECIDE:

  1. Adolescents are the experts in their own experiences.

  2. Empowerment, strength-building, and factual information change behavior more than punishment.

  3. Long-lasting behavior change is most achievable when goals are aligned with individual core values and fundamental needs.

  4. Cultivating non-judgmental, authentic, and reliable relationships with trusted adults is a powerful protective factor against substance use and its comorbidities.

  5. All adolescents deserve access to science-based information and support, regardless of socioeconomic status, race, color, religion, gender, gender identity or expression, sexual orientation, national origin, or disability. Improving equity has a positive impact on individual outcomes and school culture.

Format

  • iDECIDE is a tier two intervention program; i.e., it is intended for adolescents who have begun to show early signs of problematic substance use behavior. While iDECIDE was designed as an alternative to punishment, it can be used outside of an infraction context as a general drug education curriculum for adolescents experimenting with substances. iDECIDE is not a cessation program and is not meant to be used in lieu of treatment.

  • iDECIDE is agnostic to substance. The curriculum addresses a wide range of substances that are most commonly used by adolescents.

  • iDECIDE consists of 4 core modules, each approximately 75 minutes in length, with the flexibility of being delivered in one, two, or four sessions.

  • The modules are hosted on a learning management system, and utilize videos, structured activities, guided discussions, and at-home activities. Module content covers the neurobiology of addiction and teen brain development, industry tactics, drug effects, risk and protective factors, motivations and triggers for use, realistic and healthy alternatives to alcohol and other drug use, communication strategies, mindfulness and meditation, core values, and goal setting.

  • The curriculum is administered by a trained adult facilitator in either a one-to-one or group format and can be offered in a school or community-based setting.

  • Facilitators do not need to be clinically trained but must get certified by completing the free iDECIDE facilitator training program prior to gaining access to any materials.

  • iDECIDE is ADA-accessible and is available in English and Spanish. Please contact the iDECIDE team with other language requests.

Research

iDECIDE is undergoing continued rigorous research through a large-scale clinical effectiveness trial by the Center for Addiction Medicine at Massachusetts General Hospital. The trial includes over 90 schools throughout Massachusetts.

Program development has been guided by ongoing feedback from students and key school and community stakeholders.

In the fall of 2020, we conducted a statewide survey with school stakeholders to better understand the need for alternatives to punitive approaches for school-based substance use infractions.

key findings

The research of the program is ongoing. If you are a middle or high school student and would like to participate in this research, please contact our clinical research coordinator at (617) 643-4382. Additionally, if you would like to give us feedback regarding your experience with the iDECIDE program, please email us at iDECIDE@mgh.harvard.edu

Leadership

The Development and Evaluation Team

iDECIDE was developed by the Center for Addiction Medicine at Massachusetts General Hospital (MGH) in collaboration with the Massachusetts Department of Public Health (DPH) and the Institute for Health Recovery (IHR). Click on the names below to learn more about the members of the iDECIDE development team.

The Advisory Board

Sharon Levy, MD, MPH

Sharon Levy, MD, MPH


Director, Adolescent Substance Use and Addiction Program

Boston Children’s Hospital

Associate Professor of Pediatrics

Harvard Medical School

John Crocker, M.Ed.

John Crocker, M.Ed.


Founding Director, Massachusetts School Mental Health Consortium

Director, School Mental Health & Behavioral Services

Methuen Public Schools

Eden Evins, MD, MPH

Eden Evins, MD, MPH


Cox Family Professor of Psychiatry, Harvard Medical School

Founding Director, Mass General Hospital Center for Addiction Medicine

Director for Faculty Development, Mass General Hospital Department of Psychiatry

J. Stuart Ablon, Ph.D.

J. Stuart Ablon, Ph.D.


Director, Think Kids,

Massachusetts General Hospital

Thomas G. Stemberg Endowed Chair in Child and Adolescent Psychiatry,

Harvard Medical School

Mark McGovern, PhD

Mark McGovern, PhD


Professor of Psychiatry and Behavioral Sciences,

Stanford University School of Medicine

Co-Chief, Division of Public Mental Health & Population Sciences

Department of Psychiatry

Stanford University School of Medicine

Medical Director, Integrated Behavioral Health, Division of Primary Care and Population Health, Department of Medicine Stanford University School of Medicine

J. Leon Smith, Esq.

J. Leon Smith, Esq.


Executive Director

Citizens for Juvenile Justice

Christine Crawford, MD, MPH

Christine Crawford, MD, MPH


Assistant Professor of Psychiatry,

Boston University School of Medicine

Associate Director, Medical Student Education in Psychiatry,

Boston University School of Medicine

Associate Medical Director,

National Alliance on Mental Illness

Carol Read, M.Ed, CAGS, CPS

Carol Read, M.Ed, CAGS, CPS


Program Manager, Substance Use Prevention Collaborative (SAPC) grant program

Grant manager, Substance Use Prevention & Education - Grant manager, Town of Needham, Public Health Department

David Schoenfeld, Ph.D.

David Schoenfeld, Ph.D.


Investigator, Biostatistics Center

Massachusetts General Hospital

Professor of Medicine

Harvard Medical School

Samantha Graham

Samantha Graham


Substance Use Prevention & Intervention Specialist

Office of Student and Family Support

Massachusetts Department of Elementary and Secondary Education

Past Contributors

Natali Rychik

Natali Rychik

Erin Lamberth

Erin Lamberth

Rose Allocca, MPH

Rose Allocca, MPH

iDECIDE FAQs

What is iDECIDE?

iDECIDE (Drug Education Curriculum: Intervention, Diversion, and Empowerment), is a drug education curriculum developed to provide behavioral support and psychoeducation for middle and high school students. The program is designed to serve as a secondary prevention effort for youth at risk for escalation to problematic substance use and as an alternative to suspension, expulsion, and other exclusionary practices for school-based substance use infractions. iDECIDE provides schools and communities the resources to empower students to engage in healthy decision making. iDECIDE is not a cessation program, and is not meant to be used in lieu of treatment.

Why was iDECIDE developed?

There is an urgent need to define reasonable and effective school responses to student substance use infractions. To work towards this goal, it is essential that responses focus on the mental health and wellbeing of students and not on punishing behavior. Additionally, traditional exclusionary practices disproportionately impact low-income and black students. The iDECIDE curriculum provides an equitable response to infractions and promotes the future success of all students.

Is iDECIDE evidence-based?

The curriculum was developed with close attention to best practices and evidence-based practices in the scientific literature. Over 90 schools in Massachusetts are participating in an evaluation to measure the effectiveness of iDECIDE. Outcomes of this evaluation will be made available on our website and the program will be updated as guided by the data.

Who is developing this program?

This program was developed by the Center for Addiction Medicine at Massachusetts General Hospital (MGH) in collaboration with the Massachusetts Department of Public Health (DPH) and the Institute for Health and Recovery (IHR). Student and school stakeholder feedback was gathered at multiple points during development.

Who is this program being developed for?

iDECIDE was developed for middle and high school students who use substances. The content is not specific to a single substance since some students may use multiple substances and using one substance may increase the risk of using additional substances.

Is iDECIDE relevant for students using all forms of substances?

Yes, iDECIDE is agnostic to the specific substance(s) used by the participant.

What is the structure of the iDECIDE program?

iDECIDE is a 4-session (1 hour each) program that includes videos, discussion, activities, and at-home assignments. The sessions are structured to be conducted in either a group or individual format.

When will this program be available for us to implement?

Please contact the iDECIDE team to determine when this program will be available for your community at iDECIDE@mgh.harvard.edu.

What languages will the program be available in?

Initially, the program is available in English and Spanish. If you have a specific language request, please let us know so we can prioritize it.

Is the website and learning management system disability accessible?

iDECIDE is committed to making our resources available to everyone. Content was developed based on WCAG and ARIA specifications. If you have any questions about our accessibility features or if you are in any need of assistance, please email us at iDECIDE@mgh.harvard.edu, or call us at 617-643-1771.

What are the resources required to be able to implement iDECIDE in our school or community?

iDECIDE was developed with sustainability and scalability in mind to be able to meet the needs of a diverse range of schools and communities. Schools designate someone to be a trained facilitator and once they complete the free training, facilitators will have access to all the resources.

Is there a cost for training to be an iDECIDE facilitator or for bringing iDECIDE to our school.

No. iDECIDE is funded by the Massachusetts Department of Public Health. There is no cost for training or bringing the iDECIDE program to your school.

How will facilitators be trained?

Facilitators can volunteer to sign up or be assigned by their school or community program. The training is one-day, in-person and each site also receives support from an assigned iDECIDE to help with implementation. If you or someone you know might be interested in signing up for facilitator training, please contact us at iDECIDE@mgh.harvard.edu.

Do I need to be a clinician to be an iDECIDE facilitator?

No. The iDECIDE Facilitator Training Program was developed taking all backgrounds into consideration.

Is there a stipend available to facilitate iDECIDE?

At this time, there are limited modest stipends available for schools at early access sites to use at their discretion to offset the costs of training and administering the program. Availability for stipends in other schools or states is contingent upon other funding sources.

What trainings will be offered outside of Massachusetts?

At this time, we do not have any trainings scheduled outside of MA. However, please contact us at iDECIDE@mgh.harvard.edu to inquire further about future virtual trainings.

Who should we contact if we have further questions?

If you have any further questions, please don’t hesitate to reach out to iDECIDE@mgh.harvard.edu.

iDECIDE is funded by a Cooperative Agreement to MGH from the Massachusetts Department of Public Health, Office of Youth & Young Adult Services’ federal award by the Substance Abuse and Mental Health Services Administration.


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Contact Info

101 Merrimac St., Suite 320

Boston, MA 02114