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

72 Participants Needed

Trial Summary

What is the purpose of this trial?

Parents with substance use disorders are disproportionately more likely to engage in harsh physical discipline, which can lead to serious clinical outcomes, including child maltreatment and the intergenerational transmission of addictive disorders. One mechanism linking substance use and maladaptive parenting strategies is parental delay discounting, or the tendency to value smaller, immediate rewards (such as stopping children's misbehavior via physical punishment) relative to larger, but delayed rewards (like shaping adaptive child behaviors over time). This study will examine the effectiveness of a brief, episodic future thinking (EFT) intervention in a substance use treatment setting to increase parents' focus on positive, future events associated with enhancing the parent-child relationship. This study will inform broader public health efforts aimed at reducing child maltreatment and interrupting intergenerational cycles of substance abuse in traditionally underserved communities.

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 data supports the effectiveness of the treatment Episodic Future Thinking (EFT)?

Research shows that Episodic Future Thinking (EFT) can help reduce unhealthy behaviors and improve outcomes in areas like weight loss and substance use. Studies have found that EFT helps people focus on future goals, which can lead to healthier choices and behaviors. ^{1 2 3 4 5}

Is Episodic Future Thinking (EFT) safe for humans?

The research does not report any safety concerns or adverse effects related to Episodic Future Thinking (EFT) in humans. ^{2 3 5 6 7}

How is the treatment Episodic Future Thinking (EFT) different from other treatments for health behaviors?

Episodic Future Thinking (EFT) is unique because it involves imagining future events to help make better long-term decisions, unlike other treatments that may not focus on future-oriented thinking. This approach has shown promise in reducing impulsive decisions and promoting healthier behaviors by making future consequences more vivid and relevant. ^{1 2 3 4 8}

Eligibility Criteria

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

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

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

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

A Pilot Goal-Oriented Episodic Future Thinking Weight Loss Intervention for Low-Income Overweight or Obese Young Mothers. [2023]

2. Switzerland 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. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Psychopathology and episodic future thinking: A systematic review and meta-analysis of specificity and episodic detail. [2019]

4. United States 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. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Translating episodic future thinking manipulations for clinical use: Development of a clinical control. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Mothers' DASH diet adherence and food purchases after week-long episodic future thinking intervention. [2021]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Can episodic future thinking affect food choices? [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Promoting farsighted decisions via episodic future thinking: A meta-analysis. [2022]