Challenges and opportunities of group therapy for adolescent substance abuse: A critical review

Alcohol Research Center, Department of Psychiatry, University of Connecticut Health Center, Farmington Connecticut 06030-2103, USA.
Addictive Behaviors (Impact Factor: 2.76). 11/2005; 30(9):1765-74. DOI: 10.1016/j.addbeh.2005.07.002
Source: PubMed


Group intervention has been the most commonly employed treatment modality for adolescents with substance use disorders (SUD). Evidence has been accumulating in support for the efficacy of diverse forms of group therapy that have been utilized with adolescents. It has been argued however, that aggregation of youths who display problem behavior into group interventions may, under some conditions, produce iatrogenic effects on all participants. This assertion known also as "deviancy training" and its presumed effect on treatment outcomes has created a barrier to progress regardless of the fact that it has not been tested or empirically supported in heterogeneous groups of adolescents treated for SUD. It is imperative to optimize group intervention while considering how to prevent, reduce and control, potentially iatrogenic effects associated with the aggregation of antisocial youths in heterogeneous groups. The main objective of this review is to address the challenges and opportunities regarding group treatment of adolescent SUD.

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    • "Another study made a distinction between the type of diversity and found racial diversity to be positively correlated with emotional conflict whereas age diversity is negatively correlated with emotional conflict (Pelled, Eisenhardt, & Xin, 1999). Further, studies have also shown that heterogeneous groups might have a negative impact on adolescents (Kaminer, 2005). However, from a personal perspective, the social workers thought heterogeneity would be ideal. "
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    ABSTRACT: Social workers often are reluctant to use evidence-based prac-tice in group work. Part of this reluctance is because of the perceived rigidity of the process and its emphasis on research. However, social workers can rely on the four cornerstones of evidence-based practice—research, clinical experience, personal views, and client’s perspective—to provide an evidence-based group intervention. In this article, the authors illustrate how social work-ers used the four cornerstones at one alternative high school to provide an evidence-based group intervention. These cornerstones were used from the beginning of the process, which started with choosing the type of intervention, through the end of the process, which concluded with assessing the intervention. In this article, the authors show that it is possible for social workers to provide an evidence-based group intervention, while remaining flexible, thereby contributing to social workers’ knowledge of how to use evidence-based practice with groups.
    Social Work With Groups 02/2015; 38(2). DOI:10.1080/01609513.2014.965871
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    • "The group treatment was a manual-guided intervention based on cognitive– behavioral therapy and motivational interviewing. The features and format were guided by research-supported principles and procedures and combines education, skill training, and social support (Center for Substance Abuse Treatment (CSAT), 1999; Godley, Risberg, Adams , & Sodetz, 2003; Kaminer, 2005; O'Leary et al., 2002). Each session was structured, beginning by goal setting/self monitoring of goal attainment, and followed by didactic/experiential activities, group processing/reflection, and closure. "
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    ABSTRACT: The objective of this article is to examine the effectiveness of 2 theoretically different treatments delivered in juvenile drug court-family therapy represented by multidimensional family therapy (MDFT) and group-based treatment represented by adolescent group therapy (AGT)-on offending and substance use. Intent-to-treat sample included 112 youth enrolled in juvenile drug court (primarily male [88%], and Hispanic [59%] or African American [35%]), average age 16.1 years, randomly assigned to either family therapy (n = 55) or group therapy (n = 57). Participants were assessed at baseline and 6, 12, 18 and 24 months following baseline. During the drug court phase, youth in both treatments showed significant reduction in delinquency (average d = .51), externalizing symptoms (average d = 2.32), rearrests (average d = 1.22), and substance use (average d = 4.42). During the 24-month follow-up, family therapy evidenced greater maintenance of treatment gains than group-based treatment for externalizing symptoms (d = 0.39), commission of serious crimes (d = .38), and felony arrests (d = .96). There was no significant difference between the treatments with respect to substance use or misdemeanor arrests. The results suggest that family therapy enhances juvenile drug court outcomes beyond what can be achieved with a nonfamily based treatment, especially with respect to what is arguably the primary objective of juvenile drug courts: reducing criminal behavior and rearrests. More research is needed on the effectiveness of juvenile drug courts generally and on whether treatment type and family involvement influence outcomes. Trial Registry Name: Clinical, Identified NCT01668303. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Journal of Family Psychology 01/2015; 29(2). DOI:10.1037/fam0000053 · 1.89 Impact Factor
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    • "Iatrogenic or side effects from any psychosocial or pharmacological treatment must be weighed within the context of overall potential benefit (Kaminer, 2005; Macgowan& Wagner, 2005; Moos, 2005). While it is important that more detailed research is conducted in this regard, placing these findings in the context of the empirical evidence regarding the ability of AA and NA to enhance and extend treatment benefits for young people at no cost, our study suggests youth should not be discouraged from attending AA or NA groups due to potential safety concerns. "
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    ABSTRACT: Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have proven to be cost-effective recovery resources for adults and also appear helpful for youth. However, anecdotal concerns about adolescents' safety at meetings have dampened enthusiasm regarding youth participation. Unfortunately, little information exists to evaluate such concerns. Outpatients (N = 127; 24% female) were assessed at intake and at 3, 6, and 12 months regarding perceived safety at AA/NA, experience of negative incidents, and reasons for nonattendance/discontinuation. By 12-month follow-up, 57.5% reported some AA/NA attendance with a combined lifetime exposure of 5,340 meetings. Of these, 21.9% reported at least one negative experience, which was more common among NA than AA attendees. Overall, youth reported feeling very safe at meetings, and ratings did not differ by age or gender. Reasons for discontinuation or nonattendance were unrelated to safety or negative incidents. Weighing risks against documented benefits, these preliminary findings suggest that referral to AA/NA should not be discouraged, but, similar to adults, youth experiences at meetings should be monitored.
    Journal of substance abuse treatment 02/2011; 40(4):419-25. DOI:10.1016/j.jsat.2011.01.004 · 2.90 Impact Factor
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