Behavioral Treatments for Adolescents

Adolescents who abuse and are to drugs have unique treatment needs. Research shows that doctors must modify treatments designed for and tested in adult populations to be effective in adolescents. Family involvement is an important component for interventions targeting youth. Multisystemic therapy addresses the factors associated with serious antisocial behavior in children and adolescents who abuse alcohol and other drugs. These factors include characteristics of the child or adolescent, favorable attitudes toward drug use, family conflicts, parental drug abuse, peers, positive attitudes toward drug use, school dropout, poor performance and neighborhood criminal subculture. When adolescents engage in intensive treatment in natural environments like homes, schools and neighborhood settings, most youth and families complete a full course of treatment. Multisystemic therapy significantly reduces adolescent drug use during treatment and for at least six months after treatment. Fewer incarcerations and out-of-home juvenile placements offset the cost of providing this intensive service and maintaining the low caseloads for clinicians. Multidimensional family therapy for adolescents is an outpatient alcohol and other drug abuse treatment for youth and involves the entire family. Multidimensional family therapy addresses adolescent drug use in terms of a network of influences stemming from the individual, family, peers and community. Multidimensional family therapy suggests that reducing unwanted behavior and increasing desirable behavior occur in multiple ways in different settings.

Drug Treatment Categories

Doctors deliver treatment for drug abuse and addiction in many different settings, using a variety of behavioral and pharmacological approaches. Drug addiction is a complex disorder that can involve virtually every aspect of the functioning of a person in every day life: in the family, at work and school and in the community. Because of the complexity and pervasive consequences of addiction, drug addiction treatment must involve many components. Some of those components focus directly on the individual and drug use. Others, like employment training, focus on restoring the addicted individual to productive membership in the family and society and enable the recovered addict to experience the rewards associated with abstinence. Doctors deliver treatment for drug abuse and addiction in many different settings using a variety of behavioral and pharmacological approaches. In the United States, more than 13,000 specialized drug treatment facilities offer counseling, behavioral therapy, medication, case management and other types of services to persons with substance use disorders. Along with specialized drug treatment facilities, drug abuse and addiction can seek help in the office of a physician and in mental health clinics from a variety of providers, including counselors, physicians, psychiatrists, psychologists, nurses and social workers. Specialists deliver treatment in outpatient, inpatient and residential settings. Although there are some specific treatment approaches that occur in particular treatment settings, a variety of therapeutic interventions or services can be included in any given setting. Because drug abuse and addiction are major public health problems, local, State and Federal governments fund a large portion of drug treatment. Private and subsidized health plans also may provide coverage for treatment of addiction and its medical consequences. Unfortunately, managed care results in shorter stays on average. An historical lack of or insufficient coverage for substance abuse treatment curtails the number of operational programs. The recent passage of parity for insurance coverage of mental health and substance abuse problems will improve this state of affairs.

Health Services Criminal Abusers

One of the goals of treatment planning is to match interventions to individual needs at each stage of drug treatment. Over time, individuals may need various combinations of treatment services. Evidence-based interventions include: cognitive behavioral therapy to help participants learn positive social and coping skills; contingency management approaches to reinforce positive behavioral change; and motivational enhancement to increase treatment engagement and retention. In those addicted to opioid drugs, agonist or partial agonist medications can also help normalize brain function and antagonist medications can facilitate abstinence. For juvenile offenders, treatments that involve the family and other aspects of the drug abuser environment show efficacy.
Drug abuse treatment plans for incarcerated offenders can anticipate the eventual return of the individual to the community by incorporating relevant transition plans and services. Drug abuser treatment often includes mental and physical health services; family counseling; parenting, educational and vocational services, and is crucial components of successful treatment. Case management approaches provide assistance in obtaining drug abuse treatment and community services.

Offender Treatment Duration

While individuals progress through drug abuse treatment at different rates, one of the most reliable findings in treatment research is that length of treatment relates directly to lasting reductions in criminal activity and drug abuse. Generally, better outcomes occur from treatment lasting longer than 90 days, with the greatest reductions in drug abuse and criminal behavior accruing to those who complete treatment. Again, legal pressure can improve retention rates.
A longer continuum of treatment is best for individuals with severe or multiple problems. Research shows that participation in a therapeutic community in prison followed by treatment in the community after prison release can reduce the risk of recidivism to criminal behavior as well as relapse to drug use.