The prevalence of substance addiction among adolescents is ever increasing. There are many social and psychological factors that contribute to this problem, but the question that interests the families with inflicted adolescents most is how to overcome the addiction and return to a normal life. Winters, Botzet and Fahnhorst have provided a detailed overview of modern non-confrontational approaches to substance abuse treatment in adolescents in their 2011 article “Advances in Adolescent Substance Abuse Treatment”, which can be accessed at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3166985/.
The article compares different approaches to substance abuse treatment, evaluating their efficacy and providing directions for future research. Nowadays, there is a wide variety of orientations and techniques that counselors and clinicians can use with this population within five levels of care in Addiction Medicine. The authors observe that, whatever therapeutic model is used, the prevalent approaches today are cognitive-behavioral treatment, brief intervention/ motivational interviewing and contingency management reinforcement. Referring to comparative studies, they claim that cognitive behavioral therapy, motivational enhancement and family therapy have demonstrated the best outcomes in substance abuse among treatment adolescents. The authors argue that treatment efficiency of these approaches could be enhanced with the incorporation of adolescent-specific elements, such as family involvement, aftercare support, cultural and gender differences, comprehensive assessment with the consideration for mental health and education issues. They also emphasize the need to minimize the risk of relapse by manipulating both individual and treatment variables. The article argues that, despite large advances in substance abuse treatment, more research is necessary on the specific factors that influence its efficacy with adolescents.
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At present, there are so many approaches to substance abuse treatment that both counselors and parents can get confused about which one they should choose. While there is a vast body of research that celebrates the positive outcomes of cognitive-behavioral approach and family therapy, there are numerous individual factors that have to be considered in the choice of approach. Particularly, it is important to identify potential comorbidity issues that may affect the therapeutic rapport and treatment outcomes. For example, if an adolescent exhibits antisocial traits, he is likely to be unresponsive and even opposed to family therapy, and it will be counter-productive to insist on it. Cognitive-behavioral therapy, used as the only treatment method, can be inefficient in case of severe chemical dependency. Moreover, to achieve long-term results, cognitive-behavioral therapy has to be complemented with establishing alternatives to the sense of belonging that was previously formed by the substance use culture (McHugh, Hearon & Otto, 2010). This way, adolescents in treatment should be offered a new social group to belong to, whether it be a volunteering society or a sports club. The desperate need of adolescents to be be a part of community is often underestimated in addiction counseling, which results in relapses or development of new addictions.
In the overall, empirical research has shown integration of different treatment modalities is the most efficient to reach positive outcomes in the treatment of substance abuse, especially when it is accompanied with co-morbid psychiatric issues (Bukstein et al., 2005). Thus, despite all the advances of psychological approaches to substance abuse, counselors and clinicians should not neglect pharmacotherapy when there are reasons to believe that it will reinforce the positive effects of the main method applied. Moreover, when dealing with adolescents, it is of crucial importance to to provide thorough aftercare, as this population is more likely to relapse than adults.
- Bukstein, O., et al. (2005). Practice parameter for the assessment and treatment of children and adolescents with substance use disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 44(6): 609-621.
- McHugh, R.K., Hearon, B.A. & Otto, M.W. (2010).Cognitive-Behavioral Therapy for Substance Use Disorders. Psychiatric Clinics of North America, 33(3): 511-525.
- Winters, K., Botzet, A.M., & Fahnhorst, T. (2011). Advances in Adolescent Substance Abuse Treatment. Current Psychiatry Report, 13(5): 416-421.
