Finally, it is also recommended that new adaptations are first piloted with high-risk youth, who are then asked about their experiences with the intervention. According to one qualitative evaluation of adolescents’ reactions to interventions, they report that, for them, the most important components of the intervention are learning cognitive–behavioural strategies and that such skill development during personality-targeted interventions was key to positive behavioural change [73•]. Importantly, youth-generated information regarding their intervention experiences independently accounted for 12–25 % of the variance in change in alcohol use and mental health symptoms over 12 months. By contrast, very little variance in substance use outcomes could be predicted using investigator-selected quantitative measures of cognitive–behavioural processes, suggesting that mixed-method approaches, particularly those that allow for youth perspectives to be communicated, are extremely important in the adaptation process.
