Future Thinking for Health Behaviors

Overseen By Ashley Kucera, MPH

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Henry Ford Health System

Disqualifiers: Suicidality, Bipolar, Schizophrenia, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how a brief intervention called Episodic Future Thinking (EFT) can help parents with substance use disorders improve their relationship with their children. The aim is to reduce harsh discipline by encouraging parents to focus on positive future events instead of immediate reactions. Participants meet with peer recovery coaches to imagine future milestones with their children and receive daily check-ins for two weeks to reinforce this thinking. The trial seeks parents who are currently receiving substance use treatment and have regular contact with a child aged 6-10. As an unphased trial, this study offers a unique opportunity for parents to explore innovative ways to strengthen family bonds.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this episodic future thinking intervention is safe for parents with substance use disorders?

Research has shown that Episodic Future Thinking (EFT) is generally safe and may assist individuals with substance use issues. Studies suggest that EFT can facilitate choosing long-term benefits over immediate rewards, potentially aiding in better decision-making for the future.

No reports of serious side effects from EFT exist. As a behavioral method, not a medication, it involves imagining future events to enhance decision-making. Since EFT doesn't involve drugs or invasive procedures, it typically carries a low risk of negative effects.

For those considering joining an EFT trial, this approach is designed to be safe and straightforward, aiming to help individuals make better choices for their future. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how Episodic Future Thinking (EFT) could help parents in substance use disorder (SUD) treatment. Unlike standard therapies that often focus on immediate past experiences or current behaviors, EFT encourages parents to visualize positive future milestones with their children, helping to motivate change. This approach is unique as it uses vivid imagination to foster long-term goals and strengthen the parent-child bond, potentially offering a novel way to support recovery and enhance family dynamics. The trial also compares this with Episodic Recent Thinking (ERT), which focuses on recent past events, providing insights into how different time-focused strategies may aid in SUD recovery.

What evidence suggests that this trial's treatments could be effective for improving parenting behaviors in parents with substance use disorders?

Research has shown that Episodic Future Thinking (EFT), which participants in this trial may receive, can help individuals with substance use problems make better decisions. Studies indicate that EFT reduces impulsive choices by encouraging thoughts about positive future events. For instance, EFT assisted individuals with cocaine use disorder by decreasing their tendency to choose immediate rewards over larger, future ones. This shift in thinking was linked to better recovery outcomes. Overall, EFT offers a promising approach for improving decision-making in people facing substance use challenges. ^{4 5 6 7 8}

Are You a Good Fit for This Trial?

This trial is for parents of children aged 6-10 who are currently receiving services at Flint or Saginaw Odyssey House. Participants must be able to engage in English-written assessments and interventions, consent legally for their child's participation, and commit to follow-up check-ins. Parents with more than one child in the study, or those with bipolar disorder, schizophrenia, psychosis, or active suicidality/homicidality cannot participate.

Inclusion Criteria

Are receiving services at Flint or Saginaw Odyssey House (Odyssey House)

I can read, write, and speak English well enough to participate in studies.

I am willing to receive follow-up check-ins for two weeks after the treatment.

Exclusion Criteria

Self-disclosed current bipolar disorder, schizophrenia, or psychosis

Self-disclosed active suicidality/homicidality

Study enrollment with more than 1 child

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive either Episodic Future Thinking (EFT) or Episodic Recent Thinking (ERT) intervention, with daily check-ins over two weeks

2 weeks

Daily check-ins (virtual or in-person)

Follow-up

Participants are monitored for changes in delay discounting and parenting behaviors

12 weeks

Assessments at Week 2, Week 4, and Week 14

What Are the Treatments Tested in This Trial?

Interventions

• Episodic Future Thinking (EFT)

Trial Overview The study tests a brief intervention called Episodic Future Thinking (EFT) aimed at helping parents with substance use disorders improve their parenting by focusing on positive future events rather than immediate rewards like harsh discipline. It compares EFT against Episodic Recent Thinking (ERT) to see which better enhances parent-child relationships.

How Is the Trial Designed?

Group I: Episodic Future Thinking (EFT) Experimental Treatment 1 Intervention

Parents who are receiving residential substance use disorder (SUD) treatment will receive an adapted episodic future thinking focused condition. Parents will meet with peer recovery coaches (PRCs) who will administer the intervention, focused on generating future, pleasant milestones with their children. The participant will also be allowed to draw or write about the scene, to help them envision it, which they will keep to refer to if they choose. After the intervention session, PRCs will check-in with parents daily over the course of two weeks to practice episodic future thinking (EFT) intervention by asking participants to further elaborate on the milestones they identified in the intervention to prompt these episodes in vivid detail.

Group II: Episodic Recent Thinking (ERT) Active Control 1 Intervention

Parents who are receiving residential substance use disorder (SUD) treatment will receive an adapted episodic recent thinking intervention. Parents will meet with peer recovery coaches (PRCs) who will administer the intervention. During the intervention, the participant will be asked to describe in detail two things they struggled with and two things that went well that occurred during the last few days. The participant will also be allowed to draw or write about the scene, to help them envision it, which they will keep to refer to if they choose. After the intervention session, or present-oriented thinking (in the comparison condition, by asking participants to discuss an event that happened that day PRCs will check-in with parents daily over the course of two weeks to practice episodic future thinking (EFT) intervention by asking participants to further elaborate on the milestones they identified in the intervention to prompt these episodes in vivid detail.

Who Is Running the Clinical Trial?

Henry Ford Health System

Lead Sponsor

Trials

334

Recruited

2,197,000+

University of Kansas

Collaborator

Trials

157

Recruited

332,000+

University of Maryland, College Park

Collaborator

Trials

163

Recruited

46,800+

Published Research Related to This Trial

Episodic Future Thinking (EFT) was found to significantly reduce delay discounting, which is the tendency to devalue future rewards, compared to a novel control group using health information thinking (HIT) in a study of 254 participants.

The study suggests that while EFT is effective in reducing maladaptive health behaviors, further research is needed to establish the HIT procedure as a reliable control for other outcomes in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Translating episodic future thinking manipulations for clinical use: Development of a clinical control. Rung, JM., Epstein, LH.[2023]

Individuals with psychiatric disorders show significant deficits in episodic future thinking (EFT), with an overall effect size of g = -0.84, indicating less specific and detailed future event simulations compared to control groups.

Subgroup analyses revealed that these deficits are particularly pronounced in depression, bipolar disorder, and schizophrenia, suggesting that these conditions may impair the ability to mentally simulate future experiences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Psychopathology and episodic future thinking: A systematic review and meta-analysis of specificity and episodic detail. Hallford, DJ., Austin, DW., Takano, K., et al.[2019]

Episodic future thinking (EFT) shows promise as an intervention for reducing problematic substance use and substance use disorders, based on a systematic review of 16 studies that demonstrated benefits in self-reported and task-based outcomes.

The review highlights the need for further research to assess the feasibility, generalizability, and long-term effects of EFT, as well as to identify factors that influence its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Imagining the future can shape the present: A systematic review of the impact of episodic future thinking on substance use outcomes. Collado, A., Stokes, A.[2023]

The pilot goal-oriented episodic future thinking (GoEFT) intervention was well-accepted by low-income overweight or obese mothers, with participants appreciating the structured approach to setting and evaluating goals.

The intervention demonstrated significant efficacy in promoting weight loss, increasing fruit and vegetable intake, and improving emotional control, along with reducing fat and sugar intake and alleviating stress, indicating its potential as an effective weight management strategy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Pilot Goal-Oriented Episodic Future Thinking Weight Loss Intervention for Low-Income Overweight or Obese Young Mothers. Chang, MW., Tan, A., Wegener, DT., et al.[2023]

Episodic future thinking (EFT) is a promising behavioral intervention that can help reduce delay discounting and improve health behaviors, but there is significant variability in how EFT is implemented across studies.

The review highlights the need for standardized methods in generating EFT cues and suggests best practices, while also identifying gaps in research that need to be addressed to enhance the efficacy and effectiveness of EFT as an intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Putting prospection into practice: Methodological considerations in the use of episodic future thinking to reduce delay discounting and maladaptive health behaviors. Brown, JM., Stein, JS.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8062282/

Evaluating effects of episodic future thinking on valuation ... These preliminary findings suggest that EFT can reduce impulsive decision-making in cocaine use disorder and may therefore have therapeutic value.

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0740547220303020

Acute and extended exposure to episodic future thinking in ... These disorders are associated with substantial negative outcomes, including negative health consequences, interpersonal problems, legal problems, and negative ...

3. jsatjournal.com jsatjournal.com/article/S2949-8759(23)00307-7/fulltext

Art-delivered episodic future thinking reduces delay ... Lower rates of DD predict better treatment outcomes, and thus strategies that reduce DD may support SUD recovery. The process of vividly ...

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37307365/

A systematic review of the impact of episodic future thinking on ... The systematic review examines EFT as a potentially efficacious intervention for problematic substance use and SUD.

5. sciencedirect.com sciencedirect.com/science/article/pii/S2352853223000408

Patients with cocaine use disorder exhibit reductions in ... Episodic future thinking (EFT) has been shown to reduce impulsive decision-making. · This EFT effect has previously been demonstrated in substance use disorders ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9669959/

Methodological considerations in the use of episodic future ... In recent years, episodic future thinking (EFT) has emerged as a promising behavioral intervention to reduce delay discounting or maladaptive health behaviors.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT04125238

Study Details | NCT04125238 | Increasing the Temporal ... These trials gather additional information about a drug's safety, efficacy, or optimal use. ... Episodic future thinking (EFT) is based on the new science of ...

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S2352250X24000666

A focus on depression and suicide risk Episodic future thinking (EFT), the ability to imagine future autobiographical events, is both an everyday and clinically significant cognitive process.