Continuing Care for Adolescents in Treatment for Substance Use Disorders

Abstract

Summary Research shows that many adolescents who enter treatment for substance use do not complete the recommended program, and after discharge, do not connect with continuing care services. Furthermore, the majority of adolescents will return to some level of substance use either during or after participation in treatment. Our review found 10 outcome studies of continuing care treatment for adolescents. Five of six studies with randomized designs resulted in significant clinical improvement for youth receiving the experimental continuing care approaches. Key findings of these trials are that more assertive approaches can increase continuing care initiation rates and that rapid initiation of continuing care made a difference in reducing substance use. Findings suggest that continuing care is not only appropriate for those who successfully complete treatment but also for many individuals who do not. Although there are no randomized controlled studies of adolescent participation in mutual aid groups, evidence is accumulating suggesting that matching adolescents to age-appropriate 12-step and other mutual aid groups can support recovery. Research employing adaptive treatment designs holds promise for establishing decision rules as to which adolescents need low-intensity continuing care services and which need more intensive care.

Testing the Feasibility of Measuring Recovery in Adolescent Participants of an Alternative Peer Group: Lessons Learned and Next Steps

“…Adolescents generally do not attend treatment willingly and return to substance use more quickly after treatment than their adult counterparts (Dennis, Scott, & Laudet, 2014; Winters & Kaminer, 2011). Family-based treatments seem to produce the best outcomes, and research shows that completion of any evidence-based treatment leads to significant reductions in adolescents’ substance use (Hogue, Henderson, Ozechowski, & Robbins, 2014; Passetti, Godley, & Kaminer, 2016). However, effect sizes are small, and treatment gains fade relatively quickly (Black & Chung, 2014; Buckheit, Moskal, Spinola, & Maisto, 2018).…”

Goal commitment predicts treatment outcome for adolescents with alcohol use disorder

“…Significant progress has been made over the past twenty years in the development of evidence-based practice treatment protocols for youth with alcohol and other substance use disorders (AOSUD; Dennis & Kaminer, 2006; Passetti et al, 2016). Most interventions have been provided in outpatient settings where the vast majority of adolescents are treated.…”

Who attends recovery high schools after substance use treatment? A descriptive analysis of school aged youth

“…RHSs therefore seek to improve adolescents’ academic and behavioral adjustment by fostering social connectedness and social capital among supportive peers (Karakos, 2014), and can serve as a form of continuing care support for youth discharged from substance use treatment. Given high relapse rates after substance use treatment (Chung & Maisto, 2006; Dennis et al, 2004a; GAIN Coordinating Center, 2013a), and increasing recognition of addiction as a chronic relapsing condition (ASAM, 2011), continuing care services can be crucial for supporting adolescents’ recovery process after treatment (Passetti, Godley, & Kaminer, 2016).…”