Broadening Thinking Skills Training and Improved Psychosocial Outcomes in High-Risk Adolescents

Background: Broadening thinking skills training is considered an effective approach for preventing and treating addiction in adolescents. Objectives: The present study aimed to investigate the effect of teaching broadening thinking skills on moral development, altruism, cognitive flexibility, and sexual rights in adolescents with high-risk behaviors such as addiction. Patients and Methods: A quasi-experimental design with control and intervention groups was employed. Twenty-six male high school students with identified high-risk behaviors were randomly assigned to either the intervention group (n = 13) or the control group (n = 13). Participants were 26 male high school students, aged 15 - 18, with identified high-risk behaviors including substance use, risky sexual behaviors, and a history of school behavior problems, and without a history of severe psychiatric disorders. Randomization was conducted using simple random assignment. Due to the nature of the intervention, blinding was not feasible. The primary outcome was the change in cognitive flexibility from baseline to post-intervention. Secondary outcomes included changes in moral development, altruism, and sexual rights. The intervention group received five weeks of broadening thinking skills training, based on Edward de Bono's six thinking hats, and conducted by trained facilitators in a school setting. The Cognitive Flexibility Questionnaire (CFQ), Moral Development and Altruism Questionnaire (MDAQ), and Halbert Sexual Assertion Questionnaire (HISA) were administered at pre-intervention and post-intervention. Data were analyzed using ANCOVA and MANCOVA. Results: Broadening thinking skills training significantly improved cognitive flexibility, moral development, altruism, and reduced problematic sexual rights (P < 0.05). Specifically, in the intervention group: Cognitive flexibility increased from 43.92 (SD = 2.69) to 51.15 (SD = 1.62); moral development/altruism increased from 37.76 (SD = 3.29) to 39.00 (SD = 1.91); and sexual rights decreased from 53.92 (SD = 2.98) to 46.69 (SD = 5.25). The results indicated that the educational intervention had a significant impact on participants’ cognitive flexibility, moral/altruistic development, and sexual rights. Specifically: 1. Cognitive flexibility: Mean difference 7.23, 95% CI: 4.12 - 10.34, P < 0.001. 2. Moral/altruistic development: Mean difference 1.24, 95% CI: 0.11 - 2.37, P = 0.03. 3. Sexual rights: Mean difference -7.23, 95% CI: -10.98 to -3.48, P < 0.001. These results suggest that the educational intervention led to an increase in cognitive flexibility and moral/altruistic development, and a decrease in negative attitudes towards sexual rights among the participants. Conclusions: Broadening thinking skills training effectively improves moral development, altruism, and cognitive flexibility, and reduces problematic sexual rights in adolescents with high-risk behaviors, such as addiction. These results are consistent with previous studies demonstrating the efficacy of cognitive skills training in improving psychological functioning in adolescents. However, limitations related to the small sample size and lack of blinding limit the generalizability of the findings and highlight the need for future studies with larger sample sizes and more rigorous designs.