Adolescent substance abuse treatment outcome: The role of substance abuse problem severity, psychosocial, and treatment factors.

Abstract

A structural equation model incorporating substance abuse problem severity, psychosocial risk and protection, and treatment variables examined adolescent drug abuse treatment outcome pathways across 6- and 12-month follow-up points. Findings on resiliency factors and an empirical method adapted from previous research were used to select and assign 10 psychosocial factors to either a multiple protective factor index or a risk factor index. Gender, substance abuse problem severity, treatment modality, treatment length, and aftercare participation were also examined as outcome predictors. The findings suggest that treatment intensity decisions may be better informed by pretreatment psychosocial risk level rather than by substance abuse problem severity. The present study also suggests that drug-abusing adolescents who receive sufficiently long treatment, participate in aftercare, and possess at least 1 individual or interpersonal protective factor during their recovery process have the best chance to maintain gains made during treatment.

Challenges and Opportunities in the Treatment of Adolescents with Substance Use Disorder and Suicidal Behavior

“…Having substance abusing and deviant peers has been linked clearly to adolescents' substance use (45,46) and predicts negative treatment outcome (47). Similarly, youth may learn about suicide risk behaviors through peers and engage in these behaviors, in part, to fit in with an unhealthy peer group and/or to avoid peer rejection.…”

Internalizing and externalizing behaviors and their association with the treatment of adolescents with substance use disorder

“…This focus does not minimize the importance of understanding mediating and moderating variables that impact treatment outcome, such as aftercare treatment variables and other environmental factors unrelated to treatment (Institute of Medicine, 1990). The adolescent outcome research literature points to the importance of the interrelationships of patient and contextual variables because they pertain to posttreatment outcome (Friedman, Glickman, & Morrissey, 1986;Latimer et al, 2000;Winters, Lee, Stinchfield, & Latimer, in press). …”

“…The significance of this gap in the addictions literature is highlighted by recent studies suggesting that 7% to 17% of school-based youth require treatment for psychoactive substance use disorders (SUDs; Harrison, Fulkerson, & Beebe, 1998;Hartwell, Ungemack, & Babor, 1996). Studies suggest that a range of treatment approaches, including 12-Step, cognitive-behavioral, and family-based interventions, work for drug-abusing youth (Kaminer, Burleson, Blitz, Sussman, & Rounsaville, 1998;Latimer, Newcomb, Winters, & Stinchfield, 2000;Surgeon General, 1988;Winters, Latimer, & Stinchfield, 1999). However, sample size limitations characterizing extant studies have generally precluded a thorough examination of factors that explain why treatments work for some but not for others (Catalano, Hawkins, Wells, & Miller, 1991;Winters, 1999).…”

Substance use treatment outcomes for youth: Integrating personal and environmental predictors

“…Background variables focus on demographic characteristics like age, gender, ethnicity, and socio-economic status (SES). While studies have shown that girls are at less risk for post-treatment substance use than boys (Catalano et al, 1991;Latimer et al, 2000a), less consistent evidence has been found for the impact of age, ethnicity and SES (e.g., Brown et al, 1994;Jainchill et al, 1997). Pretreatment substance use has been implicated in adult substance treatment outcomes (Shuckit et al, 1998;Scott et al, 2003), but studies have shown that pretreatment substance use characteristics alone have not been predictive of relapse patterns up to 1 year following treatment (Brown et al, 1989;Richter et al, 1991;Latimer et al, 2000a).…”