Co-Occurring Disorders in the Adolescent Mental Health and Substance Abuse Treatment Systems

Turner, Win C; Muck, Randolph D.; Muck, Rebekah J; Stephens, Robert L.; Sukumar, Bhuvana

doi:10.1080/02791072.2004.10524428

Cited by 54 publications

(41 citation statements)

References 23 publications

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“…This article reviews the evidence base on outpatient behavioral treatments for adolescent substance use (Turner, Muck, Muck, Stephens, & Sukumar, 2004). Because practice guidelines in behavioral healthcare now favor on-site treatment over referral for comorbid disorders (see Sacks et al, 2013), behavioral therapists should be fully prepared to manage common ASU problems that present as a secondary reason for referral or an emergent treatment issue.…”

Section: Introductionmentioning

confidence: 99%

“…Approximately 125,000 adolescents enroll annually in outpatient ASU treatment nationwide (Substance Abuse and Mental Health Services Administration, 2007). Moreover, of the approximately 2.8 million adolescents annually enrolled in outpatient mental health services (Substance Abuse and Mental Health Services Administration, 2009), as much as 20% have a co-occurring ASU problem (Turner, Muck, Muck, Stephens, & Sukumar, 2004). Because practice guidelines in behavioral healthcare now favor on-site treatment over referral for comorbid disorders (see Sacks et al, 2013), behavioral therapists should be fully prepared to manage common ASU problems that present as a secondary reason for referral or an emergent treatment issue.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Hogue

Henderson

Ozechowski

et al. 2014

Journal of Clinical Child & Adolescent Psychology

146

120

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This article updates the evidence base on outpatient behavioral treatments for adolescent substance use (ASU) since publication of the previous review completed for this journal by Waldron and Turner (2008). It first summarizes the Waldron and Turner findings as well as those from more recent literature reviews and meta-analytic studies of ASU treatment. It then presents study design and methods criteria used to select 19 comparative studies subjected to Journal of Clinical Child & Adolescent Psychology level of support evaluation. These 19 studies are grouped by study category (efficacy or effectiveness) and described for sample characteristics, methodological quality, and substance use outcomes. Cumulative level of support designations are then made for each identified treatment approach: ecological family-based treatment, group cognitive-behavioral therapy, and individual cognitive-behavioral therapy are deemed Well Established; behavioral family-based treatment and motivational interviewing are deemed Probably Efficacious; drug counseling is deemed Possibly Efficacious; and four integrated treatment models combining more than one approach are deemed Well Established or Probably Efficacious. The remainder of the article (a) articulates fidelity, mediator, and moderator effects reported for evidence-based approaches since 2008 and (b) recommends four enhancements to the prevailing business model of ASU outpatient services to accelerate penetration of evidence-based approaches into the underserved consumer base: pursue partnerships with influential governmental systems, utilize web-based technology to extend reach and control costs, adapt effective methods for linking services across sectors of care, and promote uptake and sustainability by emphasizing return on investment. INTRODUCTIONThis article reviews the evidence base on outpatient behavioral treatments for adolescent substance use (Turner, Muck, Muck, Stephens, & Sukumar, 2004). Because practice guidelines in behavioral healthcare now favor on-site treatment over referral for comorbid disorders (see Sacks et al., 2013), behavioral therapists should be fully prepared to manage common ASU problems that present as a secondary reason for referral or an emergent treatment issue. Thus for behavioral health providers who serve teenage populations in a variety of settings, identifying effective treatments for ASU remains a top priority.The following two sections specify the area of intervention science surveyed in this update and recap the Waldron and Turner (2008) findings that are the launching point for review. The remainder of the article summarizes findings from other literature reviews and meta-analytic studies of ASU treatment published since 2008 and introduces the main contributions of the current review; defines the search parameters and inclusion criteria for identifying the final pool of 19 comparative studies subjected to the JCCAP evidence-based treatment evaluation criteria (Southam-Gerow & Prinstein, 2014); describes the main findings of these ...

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Hogue

Henderson

Ozechowski

et al. 2014

Journal of Clinical Child & Adolescent Psychology

146

120

View full text Add to dashboard Cite

show abstract

“…[10][11][12] However, certain groups of adolescents remain at higher risk of pregnancy, including minority groups and those with family and/or economic instability. 10,13,14 Adolescent girls with major mental illnesses, including major depression, bipolar disorder, and psychotic disorders such as schizophrenia, have several risk factors associated with teenage pregnancy, including poverty and early childhood trauma, [15][16][17][18] but trends in fertility rates among adolescent girls with mental illness diagnosed before pregnancy have not been documented.…”

Section: Discussionmentioning

confidence: 99%

Fertility Rate Trends Among Adolescent Girls With Major Mental Illness: A Population-Based Study

et al. 2014

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OBJECTIVE: Fertility rates among adolescents have decreased substantially in recent years, yet fertility rates among adolescent girls with mental illness have not been studied. We examined temporal trends in fertility rates among adolescent girls with major mental illness. METHODS: We conducted a repeated annual cross-sectional study of fertility rates among girls aged 15 to 19 years in Ontario, Canada (1999–2009). Girls with major mental illness were identified through administrative health data indicating the presence of a psychotic, bipolar, or major depressive disorder within 5 years preceding pregnancy (60 228 person-years). The remaining girls were classified into the comparison group (4 496 317 person-years). The age-specific fertility rate (number of live births per 1000 girls) was calculated annually and by using 3-year moving averages for both groups. RESULTS: The incidence of births to girls with major mental illness was 1 in 25. The age-specific fertility rate for girls with major mental illness was 44.9 per 1000 (95% confidence interval [CI]: 43.3–46.7) compared with 15.2 per 1000 (95% CI: 15.1–15.3) in unaffected girls (rate ratio: 2.95; 95% CI: 2.84–3.07). Over time, girls with major mental illness had a smaller reduction in fertility rate (relative rate: 0.86; 95% CI: 0.78–0.96) than did unaffected girls (relative rate: 0.78; 95% CI: 0.76–0.79). CONCLUSIONS: These results have key clinical and public policy implications. Our findings highlight the importance of considering major mental illness in the design and implementation of pregnancy prevention programs as well as in targeted antenatal and postnatal programs to ensure maternal and child well-being.

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“…With regard to youth seeking behavioral treatment, not only is ADHD a leading reason for referral among children age 3–12 (Pelham & Fabiano, 2008), it is also highly prevalent among adolescents, affecting between 18–48% of those enrolled in mental health and substance use services (Tims et al, 2002; Turner et al, 2004; Wu et al, 2011). These are conservative estimates of clinical prevalence given that ADHD is significantly underdiagnosed in adolescent samples (Sibley et al, 2012; Todd, Huang, & Henderson, 2008) and is frequently undetected when it co-occurs with other chronic psychiatric disorders for which teens are typically referred: oppositional defiant and conduct disorder, anxiety, depression, and substance use (see Merikangas et al, 2011).…”

Section: Overview Of Adhd-related Morbidity In Adolescents Enrolled Imentioning

confidence: 99%

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

Hogue¹,

Bobek²,

Tau³

et al. 2014

Child & Family Behavior Therapy

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Attention-Deficit/Hyperactivity Disorder (ADHD) is highly prevalent among adolescents enrolled in behavioral health services but remains undertreated in this age group. Also the first-line treatment for adolescent ADHD, stimulant medication, is underutilized in routine practice. This article briefly describes three behavioral interventions designed to promote stronger integration of medication interventions into treatment planning for adolescent ADHD: family ADHD psychoeducation, family-based medication decision-making, and behavior therapist leadership in coordinating medication integration. It then introduces the Medication Integration Protocol (MIP), which incorporates all three interventions into a five-task protocol: ADHD Assessment and Medication Consult; ADHD Psychoeducation and Client Acceptance; ADHD Symptoms and Family Relations; ADHD Medication and Family Decision-Making; and Medication Management and Integration Planning. The article concludes by highlighting what behavior therapists should know about best practices for medication integration across diverse settings and populations: integrating medication interventions into primary care, managing medication priorities and polypharmacy issues for adolescents with multiple diagnoses, providing ADHD medications to adolescent substance users, and the compatibility of MIP intervention strategies with everyday practice conditions.

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Co-Occurring Disorders in the Adolescent Mental Health and Substance Abuse Treatment Systems

Cited by 54 publications

References 23 publications

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Evidence Base on Outpatient Behavioral Treatments for Adolescent Substance Use: Updates and Recommendations 2007–2013

Fertility Rate Trends Among Adolescent Girls With Major Mental Illness: A Population-Based Study

Clinical Strategies for Integrating Medication Interventions Into Behavioral Treatment for Adolescent ADHD: The Medication Integration Protocol

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