Substance Use, Education, Employment, and Criminal Activity Outcomes of Adolescents in Outpatient Chemical Dependency Programs

Abstract

Although the primary outcome of interest in clinical evaluations of addiction treatment programs is usually abstinence, participation in these programs can have a wide range of consequences. This study evaluated the effects of treatment initiation on substance use, school attendance, employment, and involvement in criminal activity at 12 months post-admission for 419 adolescents (aged 12 to 18) enrolled in chemical dependency recovery programs in a large managed care health plan. Instrumental variables estimation methods were used to account for unobserved selection into treatment by jointly modeling the likelihood of participation in treatment and the odds of attaining a certain outcome or level of an outcome. Treatment initiation significantly increased the likelihood of attending school, promoted abstinence, and decreased the probability of adolescent employment, but it did not significantly affect participation in criminal activity at the 12-month follow-up. These findings highlight the need to address selection in a non-experimental study and demonstrate the importance of considering multiple outcomes when assessing the effectiveness of adolescent treatment.

Self-Control as a Predictor of Relapse and Recidivism in Adolescent Therapeutic Community Treatment

“…Substance use has led to a number of concerns such as an increased risk of physical or mental health problems, negative social consequences, or involvement in other types of delinquency (Balsa, Homer, French, & Weisner, 2009;Gordon, Kinlock, & Battjes, 2004;Knudsen, 2009;Sussman, Skara, & Ames, 2008). Adolescents, for example, who are engaged in fighting, or other delinquent behaviors, are more likely to have used illicit substances in the past month (SAMHSA, 2011).…”

Los Angeles County Juvenile Justice Crime Prevention Act: Fiscal Year 2015--2016 Report

“…Programs must also employ empirically validated therapies and address co-occurring conditions, such as learning disabilities and other mental health disorders. Balsa et al, 2009, found that adolescent drug treatment "significantly increased the likelihood of attending school, promoted abstinence, and decreased the probability of adolescent employment" (p. 2).…”

Adolescent Substance Use Treatment: The Moderating Effects of Psychopathology on Treatment Outcomes

“…29 More recent studies place greater emphasis on other functional outcome measures such as sober support, attending school, and employment or criminal involvement. [30][31][32] Of particular interest in the current study are recovery-based variables, such as building informal sober social support networks through family and friends 33 and participating in other activities related to recovery (i.e., AA, referral follow-through). 32 Prior research has identified that increased functioning, including increased engagement in educational/vocational activities and reductions in the severity of comorbid mental health, can occur independent of abstinence.…”