Exposure to Adolescent Community Reinforcement Approach treatment procedures as a mediator of the relationship between adolescent substance abuse treatment retention and outcome

Abstract

Data from 399 adolescents, who participated in one of four randomly controlled trials of the A-CRA intervention, were used to examine the extent to which exposure to Adolescent Community Reinforcement Approach (A-CRA) procedures mediated the relationship between treatment retention and outcomes. Although zero-order correlations indicated that retention in treatment was a significant predictor of AOD use (r = -.18, p < .001), this relationship was reduced to non-significance (p = .39) when exposure to A-CRA procedures was included in the model. Overall, the final model evidenced a very good fit (RMSEA=.00; NFI = .99; CFI = 1.00), and explained 29% and 43% of the variance in adolescents’ post-treatment AOD use and AOD-related problems, respectively. Additionally, CHAID analysis was used to derive a target level of A-CRA exposure, which was found to be significantly related to being in recovery at follow-up. The current findings are useful, as little research to date has identified significant mediators of the relationship between retention and treatment outcomes or identified target thresholds of treatment exposure.

Current Expectations and Existing Deficits among Addiction Specialists

“…In addition to the model's success in adolescent substance abuse treatment, it was also recently found to be a mediating factor in treatment retention and outcome (Garner et al, 2008). The approach is family centered and based on the premise that supportive family members and other adults are integral to an adolescent's success following formalized treatment (Godley, Godley, Karvinen, Sloan, & Wright, 2006).…”

The Effects of Interventions to Prevent Substance Use Among Adolescents: A Systematic Review

“…However, one study ) that was categorized under combined intervention was also explained in family-based intervention and schoolbased intervention. Five studies were based on the individual approach for reducing substance use Garner et al, 2009;Grenard et al, 2007;Myers & Prochaska, 2008;Schwinn, Schinke, & Di Noia, 2010). Moreover, four studies were based on community-based intervention Edelen, Slaughter, McCaffrey, Becker, & Morral, 2010;Jones & Rossiter, 2009;Tebes et al, 2007).…”

Examining the relationship between self-control and adolescent TC treatment completion

“…This is an important factor as treatment completion is associated with reduced substance use and criminal behavior for adolescents (Faw et al, 2005;Jainchill et al, 2000Jainchill et al, , 2005 and other positive outcomes (Garner et al, 2009;Jainchill et al, 2000Jainchill et al, , 2005. Furthermore, the TC treatment philosophy has never been clearly tied to a criminological theory to explain why certain client characteristics are related to treatment retention and post-treatment outcomes .…”