Treatment Outcome Research

Considering all the modalities and characteristics of adolescent treatment, it is important to note that as with many other medical conditions, treatment does not ensure a “cure.” The efficacy of treatment can be quite difficult to measure due to unique patient characteristics that may play a role in that person’s treatment experience. However, recent research has greatly advanced the statistical and clinical efforts in determining which program characteristics and modalities have the most successful outcomes for adolescents.

Unfortunately, a return to drug use (or relapse) is a fairly common occurrence among adolescents. Among youth treated for alcohol or drug problems, one third to one half are likely to return to some drug use at least once within 12 months following treatment. The aforementioned therapeutic elements and modalities can greatly affect the efficacy of treatment, but additional variables also have been shown to impact continued recovery and reduce the risk of relapse.

Programs need to contain key essential elements of effective treatment for adolescents which
include: 


  • Screening and comprehensive assessment to ensure understanding of the full range of issues the youth and family are experiencing. 


  • Comprehensive services to address the adolescent’s substance abuse problem as well as any medical, mental health, familial, or education problems. 


  • Family involvement. Parents’ involvement in their adolescent’s treatment and recovery increases the likelihood of a successful treatment experience. 


  • Developmentally appropriate services and therapies offered address the different needs and capabilities of adolescents. 


  • Strategies to engage and keep adolescents in treatment to help adolescents recognize the value of getting help for their problems. 


  • Qualified staff: staff should have knowledge of and experience working with adolescents/young adults with substance abuse problems and their families. 


  • Cultural and gender differences: programs should consider and address cultural and gender differences within their population. 


  • Aftercare support: effective programs plan for care after the formal treatment program is completed to ensure support and successful recovery.  


  • Data gathering to measure outcomes and success of the program.



Current literature on adolescent relapse risk focuses largely on two classifications of variables: treatment variables and individual variables. Treatment variables include factors specific to the adolescent’s treatment experience, such as discharge status, counselor rapport, and aftercare attendance. One of the most powerful predictors of treatment outcome in the general addiction field is the quality of the alliance between therapist and client. Continuing care, or aftercare, for adolescents also has been repeatedly shown to reduce the likelihood of relapse and enhance the maintenance of treatment gains.

Individual variables, as the name suggests, refer to unique factors specific to the individual adolescent. Such variables that have been shown to be associated with relapse include psychiatric comorbidity, lack of family involvement, continuing influence with drug-using peers, and poor coping skills.

Our overarching conceptual view of the role of this constellation of treatment and individual factors is that they interact to influence the adolescent’s decision making. Thus, if too many relapse factors are present, decisions to use drugs go unchallenged and are strengthened, yet if few or no relapse factors are present, the youth’s decision making is more likely to steer him/her toward a drug-free lifestyle.