Comparative Efficacy of Family and Group Treatment for Adolescent Substance Abuse

Department of Pediatrics, University of Iowa, Iowa City, Iowa, United States
American Journal on Addictions (Impact Factor: 1.74). 11/2006; 15(s1):s131 - s136. DOI: 10.1080/10550490601006253


Due to the continuing prevalence of adolescent substance abuse, promising treatment models need to be developed and evaluated. Thus, the purpose of this study was to evaluate the efficacy of two promising models, Strengths Oriented Family Therapy (SOFT) and The Seven Challenges® (7C). Adolescents who qualified for outpatient treatment and agreed to participate in our study were randomly assigned to one of the two treatments and assessed at 3 and 6-months following baseline. Using a two-part, random-effects model, we examined the odds of achieving abstinence or full symptom remission between treatments and over time. For those not achieving full abstinence or full problem remission, we investigated whether frequency of use or symptom severity were reduced at follow-up. Participants in both SOFT and 7C demonstrated significant reductions in substance use and related problems, but treatments did not differ at 3 and 6 months following baseline. Overall, treatment services were delivered as planned. Both SOFT and 7C were efficacious with adolescents who abuse substances, as participants in both conditions were significantly more likely to be in symptom remission or abstinent at follow-up interviews versus at baseline. Replication studies are needed that address this study's limitations.

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    • "A longitudinal study of adolescent clients (Stevens et al. 2007) showed that The Seven Challenges was effective at reducing substance use and related problems, increasing treatment motivation, and decreasing mental health-related problems through 6 months post-intake into treatment. Another longitudinal study re-examined the effectiveness of The Seven Challenges through 6 months post-intake comparing it to another adolescent treatment program (Smith et al. 2006). The results showed that The Seven Challenges was effective at reducing substance use and related problems in adolescents and was as effective as the comparison program, Strengths Oriented Family Therapy. "
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    ABSTRACT: Adolescent alcohol and illicit drug (AOD) use is a major public health concern. This longitudinal study examines the effectiveness of The Seven Challenges in reducing adolescent substance use and mental health problems, as well as the process by which it is effective. Participants were 89 adolescents (72 male, 17 female) enrolled in a 3 month intensive outpatient adolescent substance abuse treatment program using The Seven Challenges and who provided self-report data at pre- and post-treatment. Results indicated that The Seven Challenges was effective at increasing the number of days refrained from using AOD, reducing use of tetrahydrocannabinol (THC) and other drugs, and reducing substance use problems and internal mental distress. Results also indicated that The Seven Challenges drug counselors effectively established and maintained therapeutic alliance but this seems to not play a role in the effectiveness of The Seven Challenges. Both treatment dose and completion played a role in the effectiveness of The Seven Challenges; they were both positively related to post-treatment days refrained from AOD use, and negatively related to days of THC use, substance use problems, and internal mental distress. However, the strength of the influence of treatment completion was stronger when treatment dose was low than when it was high. Despite a small sample and other limitations, findings add to existing literature that suggests that The Seven Challenges is an effective substance abuse treatment for adolescents. Furthermore, findings suggest that adolescent substance abuse treatment should focus on clients meeting pre-determined program goals as well as on dose.
    Child and Adolescent Social Work Journal 02/2014; 31(1). DOI:10.1007/s10560-013-0307-3
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    • "Our experience was that parental attendance was the rule rather than the exception. Families, on average, completed about 60% of the group content in our SOFT intervention , but, consistent with other published reports on high overall dropout in substance abuse treatment, completion by our families was highly variable (Smith et al., 2006). Our completion rate reflects some dropout but also how some youth were unable to come to group due to competing prosocial activities on their schedules (i.e., sports, vacations). "
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    ABSTRACT: Agencies that provide adolescent drug treatment services have reported increased demand to treat multiple families in groups. However, little attention has been paid to the challenges associated with implementing multiple-family group interventions for adolescent substance abusers. To address this gap in the literature, the authors discuss the implementation of multiple-family groups embedded within a promising multimodal intervention called Strengths-Oriented Family Therapy (SOFT). We provide a brief description of the system of care within which the SOFT multiple-family groups were developed and outline the process of implementation. The authors discuss challenges they faced implementing multiple-family groups in their partnership with a not-for-profit agency using Gotham's (200611. Gotham , H. J. 2006 . Advancing the implementation of evidence-based practices into clinical practice: How do we get there from here? . Clinical Psychology: Research and Practice , 37 ( 6 ) : 606 – 613 . [CrossRef], [Web of Science ®]View all references) conceptual framework for the transfer of evidence-based models into community practice. The challenges included meeting state licensure standards, providing services in rural areas, supervising the multiple-family groups, and addressing therapist's concerns and assumptions about the model. The authors conclude with practical recommendations for others that are developing or implementing multifamily groups as adolescent substance abuse treatment models.
    Social Work With Groups 04/2010; 33(2-2-3):122-138. DOI:10.1080/01609510903366236
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    • "First, some adolescents may have underreported drug use frequency or drug problems. Despite the CYT and SCY findings that few false negatives existed for self-reported drug use (i.e., negative self-report with positive urinalysis), adolescents still could have minimized the amount of use or the scope of problems associated with such use at intake (Dennis, Godley, et al., 2004; Fendrich & Xu, 1994; Smith et al., 2006). Future research with this data set could rule out issues of validity with self-report by investigating whether these results hold after eliminating adolescents with discrepant urinalysis results. "
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    ABSTRACT: The purpose of this study was to evaluate the association between authoritative, authoritarian, indulgent, and neglectful parenting, and clinical severity of adolescent substance abuse. Data were examined from 2 substance abuse treatment outcome studies: the Cannabis Youth Treatment (CYT) study and Project Iowa SCY. In both studies, authoritative parenting was associated with less parent-reported substance problem severity compared to neglectful parenting. In CYT, authoritative parenting was also associated with lower conduct disorder severity when compared to authoritarian and neglectful parenting. Findings were not replicated with adolescent-reported outcomes. Lower level of care recommendations are made for authoritatively parented youth when compared to those from authoritarian and neglectful homes. Additional research should rule out shared method variance explanations and investigate whether changes in parenting practices predict substance abuse treatment outcomes.
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