Practice Goals/Target Population
In 2020 an estimated 1.6 million youths ages 12 to 17 experienced a substance use disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) standards (SAMHSA 2021). This number includes various substances, such as alcohol, marijuana, and opioids. However, treatment of adolescent substance use is low. About 12 percent of youths who meet the criteria for substance use disorder actually participate in treatment (Haughwout et al. 2016). Treatment seeking and the use of treatment programs can be affected by many factors, such as the severity of the problem, family influence, and other mental health diagnoses.
The primary goal of substance use treatment is to reduce or treat substance use among adolescents, regardless of whether they meet the criteria for substance use disorder.
Practice Components
There are several different types of treatment modalities that can be used in substance use treatment for adolescents. Tanner–Smith and colleagues (2016) define these treatment modalities as the following:
- Assertive continuing care programs provide integrated and coordinated case management services for youth after discharge from outpatient or inpatient treatment, including home visits, client advocacy for support services, and integrated social support services.
- Behavioral or contingency management programs are based on operant behavioral principles that use incentives (e.g., gift certificates) to reward abstinence and/or treatment compliance.
- Cognitive–behavioral therapy (CBT) programs are based on theories of classical conditioning and focus on teaching adolescents coping skills, problem-solving skills, and cognitive restructuring techniques for dealing with stimuli that trigger substance use or cravings.
- Family therapy programs are based on ecological approaches that actively involve family members in treatment and address issues of family functioning, parenting skills, and family communication skills.
- Motivational enhancement therapy (MET) programs use supportive and nonconfrontational therapeutic techniques to encourage motivation to change based on clients’ readiness to change and self-efficacy for behavior change.
- MET/CBT programs use a combination of motivational enhancement and cognitive–behavioral therapy techniques.
- Multiservice package programs use a combination of behavioral, CBT, family therapy, MET, pharmacological, psychoeducational therapy (PET), and/or group and mixed counseling in a comprehensive package. [Tanner–Smith et al. 2016, 3–4]