Evidence-based psychosocial treatments for adolescent substance abuse.

Oregon Research Institute, Eugene, OR 97403, USA.
Journal of Clinical Child & Adolescent Psychology (Impact Factor: 1.92). 02/2008; 37(1):238-61. DOI: 10.1080/15374410701820133
Source: PubMed

ABSTRACT This review synthesized findings from 17 studies since 1998 regarding evaluation of outpatient treatments for adolescent substance abuse. These studies represented systematic design advances in adolescent clinical trial science. The research examined 46 different intervention conditions with a total sample of 2,307 adolescents. The sample included 7 individual cognitive behavior therapy (CBT) replications (n = 367), 13 group CBT replications (n = 771), 17 family therapy replications (n = 850) and 9 minimal treatment control conditions (n = 319). The total sample was composed of approximately 75% males, and the ethnic/racial distribution was approximately 45% White, 25% Hispanic, 25% African American, and 5% other groups. Meta-analysis was used to evaluate within-group effect sizes as well as differences between active treatment conditions and the minimal treatment control conditions. Methodological rigor of studies was classified using Nathan and Gorman (2002) criteria, and treatments were classified using criteria for well-established and probably efficacious interventions based on Chambless et al. (1996). Three treatment approaches, multidimensional family therapy, functional family therapy, and group CBT emerged as well-established models for substance abuse treatment. However, a number of other models are probably efficacious, and none of the treatment approaches appeared to be clearly superior to any others in terms of treatment effectiveness for adolescent substance abuse.

Download full-text


Available from: Charles Turner, Mar 20, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Reliable therapist-report methods appear to be an essential component of quality assurance procedures to support adoption of evidence-based practices in usual care, but studies have found weak correspondence between therapist and observer ratings of treatment techniques. This study examined therapist reliability and accuracy in rating intervention target (i.e., session participants) and focus (i.e., session content) in a manual-guided, family-based preventive intervention implemented with 50 inner-city adolescents at risk for substance use. A total of 106 sessions selected from three phases of treatment were rated via post-session self-report by the participating therapist and also via videotape by nonparticipant coders. Both groups estimated the amount of session time devoted to model-prescribed treatment targets (adolescent, parent, conjoint) and foci (family, school, peer, prosocial, drugs). Therapists demonstrated excellent reliability with coders for treatment targets and moderate to high reliability for treatment foci across the sample and within each phase. Also, therapists did not consistently overestimate their degree of activity with targets or foci. Implications of study findings for fidelity assessment in routine settings are discussed.
    Administration and Policy in Mental Health and Mental Health Services Research 09/2013; 41(5). DOI:10.1007/s10488-013-0520-6 · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Abstract: Background: Substance use disorders (SUDs) often begin in adolescence and follow a long relapsing-and-remitting course. Not only are SUDs prevalent, but existing evidence-based treatments for SUDs show a mean within-subject effect size of less than medium magnitude. Emerging research provides support for the use of mindfulness-based treatments to target SUDS in adults, and these treatments could hold promise for adolescents. The practice of mindfulness involves awareness, attentiveness, and acceptance of experiences occurring in the present moment. Method: This article will provide a detailed description of mindfulness, discuss potential mechanisms of action, and review literature that supports the application of mindfulness-based interventions to the treatment of adolescents with SUDs. Conclusions: By facilitating the ability to experience and thus tolerate negative emotions, thoughts, and sensations (including urges or cravings), mindfulness fosters the capacity to respond flexibly and adaptively to internal and external triggers for substance use. Because difficulty tolerating negative affects is a neurodevelopmental aspect of adolescence and a factor in vulnerability to SUDs, mindfulness-based treatments may be particularly appropriate for adolescents with SUDs.
    04/2013; 3(2):172-183. DOI:10.2174/2210676611303020008
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: De acordo com a hipótese da auto-medicação (Khantzian, 1997, 2003), o abuso de substâncias traduz uma forma compensatória de o sujeito modular estados emocionais. Diversos estudos apontam para a relação entre um tipo de vinculação insegura e a toxicodependência. Contudo, a sua associação com categorias específicas evidencia uma grande variabilidade consoante as medidas utilizadas. O presente estudo correlacional procurou analisar a regulação emocional, a diferenciação emocional e a vinculação, numa amostra de 31 toxicodependentes em tratamento. Os resultados indicam que os valores das medidas emocionais estão dentro dos obtidos para a população normativa e a ausência de um script de base segura. Verificou-se uma ausência de correlação significativa entre todas as medidas emocionais e uma correlação positiva entre a reavaliação cognitiva e a vinculação. Os dados sugerem que a teoria da vinculação providencia um enquadramento adequado ao desenvolvimento de programas de tratamento e prevenção no abuso de substâncias. É proposto um modelo integrativo que conceptualize a toxicodependência como um fenómeno multi-factorial. According to Khantzian's self medication hypothesis (1997, 2003), substance abuse functions as a compensatory mean to modulate emotional states. A number of studies reveal the association between an insecure attachment style and drug addiction. However, its association with specific categories or patterns of attachment shows great variability depending on the measurements in use. The goal of the present correlational study is to analyse emotion regulation, emotion differentiation and attachment in a sample of 31 drug addicts undergoing treatment. Results show emotional measures' scores are similar to the normative population and an absence of a secure base script. Results also indicate an absence of correlation between all emotional measures and a positive significant correlation between cognitive re-evaluation and attachment. Data suggests that attachment theory provides an adequate framework from which to develop treatment and prevention programs in substance abuse. Drug addiction understanding requires an integrative model that conceptualizes it as a multifactorial phenomenon.