Impulsive Decision Reduction Training for Youth With a Patterned History of Making Risky and Impulsive Decisions: A Case Report

Impulsive, risky decision-making has been associated with harmful behaviors and negative outcomes across the lifespan. Targeting maladaptive decision-making during adolescence could prevent adverse consequences in adulthood. However, few interventions directly address decision-making biases and promote adaptive decision-making skills in youth. Impulsive Decision Reduction Training for Youth (IDRT-Y) was developed to address this need by adapting an existing adult intervention. IDRT-Y is an 8-session, manualized cognitive behavioral therapy approach in which youth learn to change their maladaptive decision-making habits, increase their future orientation when making decisions, and learn more adaptive decision-making strategies to reduce risky, impulsive decisions. This article describes IDRT-Y and its application by presenting a case study of a 16-year-old boy with a history of impulsive and risky decision-making patterns who was treated with IDRT-Y. Pretreatment, posttreatment, and 24-week follow-up assessments were conducted. Both the youth and parent reported high satisfaction with IDRT-Y. The youth demonstrated reductions in impulsivity, substance use, internalizing and externalizing symptoms, and improvement in his consideration of future consequences when making decisions. The case study illustrates how IDRT-Y is delivered and shows IDRT-Y was an acceptable and effective intervention for addressing risky, impulsive decision-making in this adolescent. We discuss the implications of these findings and future directions to study the acceptability and effectiveness of IDRT-Y in larger youth samples.