An Overview of Outpatient Treatment of Adolescent Substance Abuse (original) (raw)
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Advances in Adolescent Substance Abuse Treatment
Current Psychiatry Reports, 2011
Alcohol and other drug use among adolescents has been a public health problem for decades. Although some substance use may be developmentally routine, a concerning number of adolescents meet criteria for a substance use disorder and could greatly benefit from a quality treatment experience. However, parents and health care providers want evidence of the efficacy of adolescent-specific treatment programs. This review summarizes four factors surrounding the efficacy of current adolescent treatment programs: 1) adolescent-specific treatment services; 2) the variety of therapeutic modalities; 3) relapse and recovery rates; and 4) the need for evidence-based, quality assessments and research. Current adolescent treatment efforts are summarized, and the recent literature regarding the efficacy of adolescent treatment and recovery rates is discussed.
Treating Adolescents for Substance Abuse and Comorbid Psychiatric Disorders
Science & Practice Perspectives, 2003
Treating Adolescents for Substance Abuse and Comorbid Psychiatric Disorders A A dolescents who abuse drugs possess special characteristics that include behavioral problems, skills deficits, academic difficulties, family problems, and mental health problems that generally have been shaped by environmental adversities and biological vulnerabilities that began in early childhood. Developmental studies have yielded an inventory of the risks, difficulties, and typical problems that most often mark the developmental path of adolescents who develop substance use disorder (SUD) (Tarter, 2002; Tims et al., 2002). Developmental research has also informed the creation of behavioral and family-based interventions that integrate the treatment of adolescent drug abuse with efforts to address other problems associated with adolescent SUD; these interventions have been captured in manuals to guide treatment providers (Drug Strategies, 2002). A growing research and clinical consensus indicates that treatment for adolescents is most effective when it attends to the patients' many psychosocial problems and mental health needs in addition to their drug abuse. There is also evidence that an increasing number of community-based treatment programs are successfully implementing integrated treatment services (Drug Strategies, 2002; National Institute on Drug Abuse, 1999). Despite these advances, integrated treatment of comorbid psychiatric disorders in drug treatment programs for adolescents has trailed other integrated treatment services because of clinical and systemic barriers. These include a critical shortage of child/adolescent psychiatrists with training in addictions, poor Recent research has identified a cluster of standardized approaches that effectively treat adolescents with substance abuse disorders. Many of these approaches share elements that may be adopted to improve outcomes in substance treatment programs. In adolescents, treatment goals should be informed by a comprehensive assessment that includes the adolescent patient's developmental history and evaluation of psychiatric comorbidity. Treatment for behavioral, psychosocial, and psychiatric problems should be integrated with substance abuse interventions. The author describes practical clinical guidelines, grounded in current research, for providing integrated treatment services. Special emphasis is given to strategies for integrating the treatment of comorbid psychiatric disorders with substance use disorders in adolescents.
Psychosocial Treatment of Substance Use Disorders in Adolescents
… of Indian Association for Child and …, 2005
Psychosocial treatment for substance use disorders is a broad" umbrella" term that brings under its folds a diverse array of non-pharmacological interventions for effective and global management of drug abuse. The common thread underlying these interventions is ...
Treating adolescent substance abuse: state of the science
Research and Clinical Advances, 2006
The conference objective was to characterize and articulate the developmental status of the research specialty in adolescent drug abuse treatment. Specifically, we aimed to explore the specialty's readiness to adopt or adapt existing treatment development models, and to develop new empirical and clinical frameworks. A broader function of the conference was to disseminate the latest research-based work on a range of core topics in adolescent substance abuse treatment to a diverse audience. With a diversity of research and clinical interests, viewpoints, and settings represented, we hoped that the conference would facilitate dialogue and specify unanswered empirical questions and points of controversy. In addition, if issues of this kind could be addressed successfully, additional advances in the adolescent substance abuse treatment research specialty could occur. In the weeks after the terrorist attacks, amidst threats of continued violence, fears of flying, and the anthrax outbreak only miles from the conference venue, serious questions emerged: could the conference proceed at all, and if it did, would more than a handful of participants attend? We held the meeting and the participants turned up. We were relieved and amazed to see that there was standing room only throughout the 2-day event, and that participants and presenters came from across the USA to attend. The conference exceeded all expectations. The capacity turnout and enthusiastic discussions following the presentations testified to the fact that research on adolescent substance abuse treatment had come of age and had taken its place in the substance abuse field. There was a sense of looking back, reviewing progress, and taking stock of where we had come as a field in our
Adolescent Treatment: Implications for Assessment, Practice Guidelines, and Outcome Management
Pediatric Clinics of North America, 1995
The inevitable question regarding treatment for substance addiction is, "Does it work?" As with most complex questions, simple answers are more likely to lead one astray than to provide any understanding. Human behavior, especially during the formative developmental stages, is a highly complex phenomenon influenced by a wide range of seemingly unrelated factors. Internal variables plus a myriad of external influences must be considered in any attempt to understand the dynamic. Many adolescents meeting diagnostic criteria for abuse or dependence have been able to achieve abstinence from alcohol and other mood-altering drugs, and many more adolescents have been able to reduce their levels of abuse as a result of a treatment experience. For treatment to provide benefits, however, adolescents who are chemically dependent or who are abusing alcohol and other drugs must be identified and referred to appropriate services, which necessarily requires the resources and abilities to appropriately screen, diagnose, refer, place, and treat the adolescent as early as possible. Physicians must appreciate their key role in both the referral and recovery processes if they are to provide the best care for their adolescent patients. To present both a historical perspective and some insights driven by empirical findings, this article provides a brief review of the literature on the treatment of chemical dependency and substance abuse in adolescents. Using an extensive treatment outcome database, this article also
Characterizing substance abuse programs that treat adolescents
Journal of Substance Abuse Treatment, 2006
Few systematic studies have examined the characteristics of substance abuse treatment programs serving adolescents. An expert panel recently identified nine key elements of effective adolescent substance abuse treatment. We measured the percentage of treatment programs in the United States with at least 10 adolescent clients on a given day that reported these elements using data from the 2003 National Survey of Substance Abuse Treatment Services. This first look into the characteristics of facilities serving significant numbers of adolescents indicates that many facilities may be lacking in components considered important. The most significant measured potential areas for improvement occurred in the areas of including mental health as well as medical issues in comprehensive assessments and developing curricula to meet the developmental and cultural needs of clients. On a more encouraging note, many facilities were conducting discharge planning and providing aftercare, although the specifics of these services were not determined. D
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Treatment of Adolescent Substance Use Disorders
Current Treatment Options in Psychiatry, 2014
Significant progress has been made in development and dissemination of evidence-based behavioral interventions for adolescents with substance use disorders (SUD). Medications have also shown promise in reducing substance use when used in conjunction with psychosocial treatment for adolescents with SUD, even in the context of co-occurring psychopathology. Although the efficacy or "probable efficacy" of the behavioral interventions discussed in this review have been established based on at least two randomized controlled trials, they produce relatively low abstinence rates and modest reductions in substance use that attenuate over time. Research has shown that abstinence rates may increase with the addition of abstinence-based incentives; however, post-treatment relapse rates remain high, with few treated adolescents sustaining abstinence one year post-treatment. This may be due to the paucity of continuing care, or post-treatment recovery support services, and the lack of integrated or concurrent treatment for co-occurring psychiatric conditions that contribute to poorer treatment outcomes. Thus, despite significant progress, there is clearly room for the improvement of existing treatment for adolescents with SUD. There is also a critical need to increase the availability of, and access to, substance and behavioral health treatment services for adolescents. Although 10-15 % of U.S. high school students would currently meet diagnostic criteria for at least one SUD, only 10 % of those who could benefit from substance treatment receive it. Five-year trends, showing significant increases in the use of marijuana and nonmedical prescription drugs among U. S. high school students, are evidence of the shortcomings of existing school-based interventions, and poor access to community-based substance treatment for non-juvenile-justice involved youth. There is clearly a need to adapt or develop more effective prevention, early interventions, and treatment for youth who are "at risk," as well as the increasing number of adolescents who have progressed to more serious substance involvement.