Impulsive Decision Reduction Training for Youth (IDRT-Y) to Promote Adaptive Decision-Making: Results from a Pilot Trial

Decision biases contribute to disruptive behavior, substance use, and other risky behaviors in youth, yet few interventions directly target decision-making processes to promote adaptive outcomes. This study adapted Impulsive Decision Reduction Training for Youth (IDRT-Y) from an adult model to improve adolescent decision-making and reduce risky behaviors. In an open pilot trial, 26 youth (ages 10-17) with frequent, impairing risky behaviors were randomly assigned to either immediate intervention (n = 13) or a 12-week waitlist (n = 13). IDRT-Y involved eight weekly individual sessions with brief caregiver check-ins. Eighty-five percent of youth completed all sessions, with both youth and caregivers rating the program as highly acceptable. Pre- and post-intervention assessments measured decision-making tendencies, impulsivity, and behavioral outcomes. Significant within-person improvements were observed in youth-reported future orientation (p < 0.05), caregiver-reported executive functioning (p < 0.01), youth engagement in risky behaviors (p < 0.05), and caregiver-reported externalizing symptoms (p < 0.001). These findings support IDRT-Y as a feasible, acceptable intervention that engages both decision-making processes and behavioral outcomes. Further research is warranted to assess its efficacy in larger samples and diverse populations.