Treatment Effectiveness With Dually Diagnosed Adolescents: A Systematic Review

Abstract

The treatment of dually diagnosed adolescents is challenging for many reasons, including complex treatment needs, poor treatment engagement and retention, and a lack of sustainable treatment outcomes. Although a large percentage of adolescents are diagnosed with both substance abuse and mental health diagnoses, research is only beginning to identify effective treatments for this population. The current study systematically reviews randomized clinical trials of interventions for dually diagnosed adolescents. Results examining both between-group effect sizes and within group changes indicate the efficacy of several treatment modalities in improving specific aspects of treatment needs but highlight family behavior therapy and individual cognitive problemsolving therapy as showing large effect sizes across externalizing, internalizing, and substance-abuse outcomes in dually diagnosed youth. The study further discusses the complexities of systematically evaluating the currently limited state of research on dually diagnosed youth. Finally, preliminary guidelines for treating dually diagnosed adolescents are derived from a review of those treatments shown to be most effective. [Brief Treatment and Crisis Intervention 6:177-205 (2006)]

The Empirical Status of Treatments for Children and Youth With Conduct Problems

“…Nine meta-analytic reviews (35%) were classified under the category of multimodal (Bender, Springer, & Kim, 2006;Garrett, 1985;Lipsey, 1992;Lipsey & Wilson, 1998;Reitzell & Carbonell, 2006;Stage & Quiroz, 1997;Vaughn & Howard, 2004;S. J. Wilson, Lipsey, & Derzon, 2003;S.…”

“…Effect sizes within this category ranged from d = -0.24 to d = 1.13, with a majority of effect sizes falling into a small to medium range. Bender et al (2006) completed a systematic review of six studies that assessed treatments that utilized randomized controlled designs for dually diagnosed adolescents. The largest effect size of d = 1.13 was found for familybased therapy on the outcome of substance abuse.…”

Effet d'un traitement de l'abus de substances psychotropes sur la détresse psychologique et le fonctionnement exécutif autorégulateur, chez des adolescents présentant une problématique de consommation /

“…Or, les niveaux de motivation et d'engagement dans le processus thérapeutique sont des facteurs de réussite du traitement (Bender, Springer, & Kim, 2006;Breda & Heflinger, 2007;Hawke, Hennen, & Gallione, 2005;Riggs et al, 2007).…”

Assessing Covariates of Drug Use Trajectories Among Adolescents Admitted to a Drug Addiction Center: Mental Health Problems, Therapeutic Alliance, and Treatment Persistence

“…Outcomes of studies of adults cannot be systematically applied to adolescents because of the unique developmental period, which youth are going through (Bender, Springer, & Kim, 2006). Due to the limited number of studies on this topic, it is difficult to draw conclusions regarding factors that enhance recovery among adolescents in treatment for substance abuse, and even more so for those who have mental health issues (Pagey, Deering, & Sellman, 2010).…”

“…Specific individual or personal characteristics, such as concomitant mental health problems, can also influence therapeutic outcomes (Asay & Lambert, 1999;Bender et al, 2006;Health Canada, 2001;Pagey et al, 2010). Following recommendations outlined in "best practices" guides, mental health problems must be considered when planning adolescent substance use interventions (Bender, et al, 2006;Bertrand, Beaumont, Durand, & Massicotte, 2006;Health Canada, 2001).…”