NCJ Number
206547
Journal
Journal of Child & Adolescent Substance Abuse Volume: 13 Issue: 4 Dated: 2004 Pages: 13-31
Date Published
2004
Length
19 pages
Annotation
This study examined the effects of comorbid mental disorders on treatment processes and posttreatment abstinence among adolescents in drug treatment programs.
Abstract
Treatment approaches designed specifically for substance-abusing adolescents are relatively new and only a few studies have explored the impact of treatment processes on treatment outcomes for adolescents. It is unclear whether adolescents experiencing comorbidity differ in their degree of therapeutic engagement and also whether treatment processes affect treatment outcomes for this group. The authors analyzed data from the Drug Abuse Treatment Outcomes Studies for Adolescents (DATOS-A) in order to examine the relationship between treatment processes and posttreatment abstinence. The hypothesis stated that youth with comorbid mental disorders would have higher levels of service needs but lower levels of treatment engagement. It was also hypothesized that higher levels of treatment engagement, along with parental involvement in treatment and greater number of services received while in treatment, would be positively related to posttreatment abstinence among both comorbid and non-comorbid youth. Participants were 810 patients who completed intake, 1 month in-treatment, and follow-up interviews. Of the participants, 62 percent had at least one comorbid mental disorder, most often conduct disorder. Variables under consideration included demographic information, mental disorder history, drug and alcohol use and severity, service needs, treatment services received, counselor rapport, treatment commitment, treatment retention, treatment effectiveness, and abstinence from drug or alcohol use during the 12-month posttreatment follow-up. Results of statistical analyses indicated that comorbid youth had greater service needs and received a greater number of services compared with non-comorbid youth. Significant differences were noted in service delivery by type of treatment modality. The strongest predictor of abstinence was participation in 12-step groups during treatment; comorbid youth who participated in these programs increased their likelihood of abstinence by three times. Contrary to expectations, number of services received was not independently associated with posttreatment abstinence and no differences were noted in treatment engagement between the two groups of youth. Limitations of the current research include problems with generalizability given the high level of study attrition. Future research should focus on specifying types of approaches and program characteristics associated with positive treatment outcomes among adolescents. Tables, note, references