Adolescent Substance Abuse Research and Clinical Advances 1st Edition by Howard Liddle, Cynthia Rowe – Ebook PDF Instant Download/Delivery: 0521823587, 9780521823586
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ISBN 10: 0521823587
ISBN 13: 9780521823586
Author: Howard A. Liddle, Cynthia L. Rowe
This book was first published in 2006. Adolescent drug abuse is one of the most challenging disorders to treat. It impacts on schools, community-based programs, mental health and medical facilities, and juvenile justice settings. This book provides practitioners, program developers and policy makers with practical information for improving outcomes in adolescent substance abuse. The authors cover a range of issues, including empirically based treatment development protocols, how to incorporate innovative treatment models into diverse clinical settings; research advances; interventions with special populations, culturally based intervention guidelines, and recommendations for practice and policy.
Adolescent Substance Abuse Research and Clinical Advances 1st Table of contents:
1 Treating adolescent substance abuse: state of the science
A brief history of adolescent substance abuse treatment research
Theoretical, empirical, and methodological foundations for research
Practice and policy trends in treatment for adolescent substance abuse
Comprehensive assessment and integrative treatment planning with adolescent substance abusers
Empirically based interventions for adolescent substance abuse: research and practice implications
Culturally based treatment development for adolescent substance abusers
Next steps in adolescent substance abuse treatment research
References
Part I Theoretical, empirical, and methodological foundations for research into treatment of adolesc
2 The developmental context for adolescent substance abuse intervention
The developmental model
The influence of each domain
The childhood domain
The adolescent personality domain
The family relations domain
Parent-adolescent mutual attachment
Parental discipline
The parental drug use and personality domain
The marital relationship domain
The peer domain
The larger context
Ethnicity
The biological domain
Interactions of individual, family, peer, and environmental factors
Risk/protective interactions
Individual characteristics as buffers
Ethnic identity as a protective factor
Familial factors as buffers
Environmental factors as buffers
Protective/protective interactions
Individual characteristics as enhancers of protective factors
Ethnic identity as an enhancer of protective factors
Familial factors as enhancers of protective factors
Peer factors as enhancers of protective factors
Implications for prevention and treatment
Individual treatment
Family treatment
Group treatments
Large group/community approaches
Conclusions
Acknowledgements
References
3 Recent methodological and statistical advances: a latent variable growth modeling framework
A latent variable approach to growth curve modeling
Typical approaches to studying change
Toward an integrated developmental model
Specification of the latent variable growth model
Intercept
Slope
Representing the shape of growth over time
Including predictors and sequelae of change
Multivariate and higher-order extensions
Analyzing treatment effectiveness: modeling between-subjects effects
Added growth models
Alternative approaches to analyzing treatment effects: interrupted time series models
Incorporating effects of the social context: hierarchical or multilevel designs
Full information maximum likelihood
Limited information multilevel latent growth modeling
Modeling unobserved heterogeneity: treatment audience profiling
Growth mixture modeling
Conclusions
Advantages of the latent variable growth model
Incorporating missing data in latent variable growth models
Design issues: sample size selection and power estimation
Limitations of the latent variable growth model
Summary
Acknowledgements
References
4 Clinical course of youth following treatment for alcohol and drug problems
Adolescent relapse patterns following drug and alcohol treatment: treatment outcome studies
The process of relapse for adolescents
Factors that predict success for adolescents following drug and alcohol treatment
Self-help group attendance
Personal/environmental characteristics
Alternative pathways to success
Special challenges youth face in controlling drug and alcohol use after treatment
Comorbidity
Neurocognitive factors
Developmental transitions
Conclusions
References
5 Cannabis Youth Treatment intervention: preliminary findings and implications
Treatments and their rationale
Motivational enhancement treatment/cognitive-behavior therapy 5 sessions
Motivational enhancement treatment/cognitive-behavior therapy 12 sessions
Family Support Network
The adolescent community reinforcement approach (ACRA)
Multidimensional family therapy
Overview of field trials
Highlights of findings
Co-occurring problems are the norm
Problem recognition and low motivation are endemic
Common subtypes are related to changes in substance use and problems
Treatment participation was high
Treatments reduced use and problems
Trial 1
Trial 2
Treatments are affordable
Therapists overall reacted positively to treatment manuals
Implications and next steps
Why were retention rates so high?
Why were the clinical outcomes so similar?
If treatments were effective, why was there a need for continuing care?
Would therapists in the community accept and/or use manual-guided therapies?
Would the level of therapist supervision utilized in the program be realistic or even necessary in a
Why have reactions to the Cannabis Youth Treatment experiments been mixed?
What is happening with the manuals?
What are our plans for the future?
References
Part II Practice and policy trends in treatment for adolescent substance abuse
6 Epidemiological trends and clinical implications of adolescent substance abuse in Europe
Prevalence of substance use
Across Europe
European Schools Project on Alcohol and other Drugs
The Health Behaviour in School-aged Children Survey
European Monitoring Centre for Drugs and Drug Addiction
Specific European countries
United Kingdom
Germany
Austria
Switzerland
Finland
Prevalence of substance abuse and dependence
The Netherlands and Spain
Germany
Finland
Summary
Comorbidity and temporal sequences of disorders
Risk factors
Socioenvironmental factors (e.g., age and gender)
Substance-related factors (e.g., attitudes toward drug use and peer drug use)
Intrapersonal factors
Interpersonal factors
Political implications of adolescent substance abuse: a response from the European Union
Clinical implications of adolescent substance abuse: response from Germany
Conclusions
References
7 The Drug Abuse Treatment Outcomes Studies: outcomes with adolescent substance abusers
Drug Abuse Reporting Program
Characteristics of the youth admissions
Treatment retention and posttreatment outcomes
Treatment Outcomes Prospective Study
Youth characteristics
In-treatment services provided to youth
Treatment retention and post-treatment outcomes
The Drug Abuse Treatment Outcome Studies
Characteristics of programs in the youth study
Residential treatment programs
Outpatient drug-free programs
Short-term inpatient programs
Youth characteristics
Demographic characteristics
Drug use
Mental disorders
Criminal involvement
Comparison of the Treatment Outcome Perspectives Study and the Drug Abuse Treatment Outcomes Studies
Changes in characteristics of adolescents in TOPS & DATOS-A
Changes in treatment service profiles
Treatment processes
Motivation and engagement
Services received
Retention
Treatment outcomes among patients in the Drug Abuse Treatment Outcome Studies for Adolescents
Drug use
Alcohol use
Outcomes for youth with comorbid mental disorders
Criminal activity
Risk of infection with human immunodeficiency virus
Differences by ethnicity
Differences by gender
Conclusions
Acknowledgements
References
8 Adolescent treatment services: the context of care
Background
Systems of care: the existing system
The optimal system
Providers of care
Financing mechanisms and funding streams
Technology transfer and treatment quality
Conclusions and recommendations
References
9 The principles of service organization and practice in England
The legal framework in England
Recent policy initiatives
The Health Advisory Service
Aims, objectives and principles of the Substance of Young Needs 2001 Review
A Strategic Framework
Tier 1
Tier 2
Tier 3
Tier 4
Links between tiers
Example of tiers of service
Links of the framework with evidence
Achievements
Conclusions
References
10 Health services with drug-abusing adolescents: the next frontier of research
Effective
Patient Centered
Timing
Efficient
Equitable
Redesign
Note
References
Part III Comprehensive assessment and integrative treatment planning with adolescent substance abuse
11 Clinical perspectives on the assessment of adolescent drug abuse
Assessment model
Print resources
Public access internet sites
Developmental considerations
Method
Client self-report
Diagnostic interviews
Timeline follow-back
Self-report questionnaires
Validity of self-report
Data other than client self-report
Clinical implications of data sources
Source
Parents
Peers
Archival records
Clinical implications of data from other sources
Content
Drug use history
Abuse and dependence diagnostic symptoms
Family functioning and parenting practices
Peer drug involvement
Educational status
Coexisting psychopathology
Clinical implications of content factors
Bridging assessment and referral decisions
Conclusions and future directions
Acknowledgement
References
12 Psychopharmacology of adolescents with substance use disorders: using diagnostic-specific treatme
Current status of pharmacotherapy
Lessons from the adult literature
Pharmacological treatment studies in adolescents
Withdrawal treatment
Substitution therapy
Craving reduction and blocking strategies
Aversive therapy
Tobacco cessation
The pharmacological treatment of comorbid disorders in adolescents
Importance of comorbidity in adolescents
Mood disorders
Attention-deficit hyperactivity disorder
The current status of pharamacotherapy in adolescents with substance use disorders
Future directions in research
Training of investigators
Extension of the adult literature on agents for withdrawal, substitution, craving, or blocking
Studies of adolescents with specific comorbid psychiatric disorders, using specific agents
The use of multicenter trials
The use of common, salient variables among studies
Studies of safety, abuse, and diversion
Studies of compliance and the development of motivational strategies to improve compliance
Multimodal studies using a combination of pharmacotherapy and psychosocial intervention modalities
Acknowledgement
References
13 Developmentally informed diagnostic and treatment considerations in comorbid conditions
Developmental context and bidirectional impact of substance use and comorbid psychiatric disorders
The role of psychiatric comorbidity
Disruptive behavior disorders
Internalizing disorders
Integrated clinical assessment of adolescent substance abuse and comorbidity
A clinical approach to integrating treatment of substance abuse and comorbidity
1. Initiating treatment
2. Assessing suitability for pharmacotherapy
3. Pharmacotherapy principles
4. Choosing specific medications for comorbidity
5. Evaluating improvement
6. Dealing with relapse
Conclusions
Acknowledgements
References
14 Prevention of infection with human immunodeficiency virus in adolescent substance abusers
Structure and message of the chapter
Co-occurring patterns of HIV risk and substance use in adolescents
Levels of intervention
Individual-level interventions: prevention counseling
Prevention case management
Small-group interventions
Accounting for the effectiveness of group interventions
Limitations of group interventions
Intervening at the family level
Community-level interventions
Future as context: research to advance prevention of HIV infection and substance abuse in adolescent
References
Part IV Empirically based interventions for adolescent substance abuse: research and practical impli
15 Adolescent therapeutic communities: future directions for practice and research
Background and history
The empirical basis for the therapeutic community approach
Outcome studies
The prototypical adolescent therapeutic community
Treatment protocol
The role of family
Continuity of care/after-care
Adolescent therapeutic communities in the twenty-first century
Methodological issues
Clinical issues
Client issues
Treatment issues
Policy issues
Conclusions
References
16 School-based group treatment for adolescent substance abuse
Why use schools for delivery of substance abuse treatment
What is known about effective school-based treatments?
The student assistance program
The Teen Intervention Project
Development of a standardized Westchester model student assistance program
Study design and preliminary results
Mechanisms of change in group counseling
Conclusions and future directions
Acknowledgements
References
17 Profiles of change in behavioral and family interventions for adolescent substance abuse and depe
Classifying patterns of change
An examination of differences in individual outcomes
Cluster analysis procedures
Individual profiles of change
Predictors of profiles
Profiles of change associated with family therapy
Implications for treatment
Conclusions
References
18 Behavioral management approaches for adolescent substance abuse
Behavior analysis
Principles of contingency management for the treatment of substance abuse
Contingency management for the treatment of adolescent substance abuse
Implementation issues
Concerns
Conclusions
Acknowledgements
References
19 Evidence-based cognitive?behavioral therapies for adolescent substance use disorders: application
Theoretical models underlying cognitive?behavioral intervention approaches
Randomized clinical trials for adolescent substance abuse treatment
Cognitive?behavioral therapy for common comorbid psychiatric disorders
Depression
Anxiety disorders
Post-traumatic stress disorder
Conduct disorders/antisocial behavior
Client?treatment matching
Treatment modality: group or individual intervention
Mechanisms of change in cognitive?behavioral therapy for substance abuse disorders
Clinical implications and future research directions
Acknowledgements
References
Part V Culturally based treatment development for adolescent substance abusers
20 Family-centered treatment for American Indian adolescent substance abuse: toward a culturally and
American Indian communities
Toward a family-centered inpatient treatment
Effectiveness and enhancement research
Pilot research
Enhancement research
Evaluation model
The enhancement condition
Analysis of outcomes
Conclusions
Acknowledgements
References
21 Using treatment development methods to enhance the family-based treatment of Hispanic adolescents
Empirically supported treatments and Hispanics
Shortcomings of current efforts to ensure ??cultural competence??
Utilizing basic research and treatment development mechanisms to enhance a family treatment
Development of an integrative family therapy for Hispanic adolescents
Developing a draft manual
Adolescent developmental literature
Family process and treatment of adolescent drug abuse
Culture-related variables and processes
Acculturation and externalizing behavior
Acculturation and parenting practices
Immigration-related experiences and parent-adolescent attachment
Hispanic values and family processes
Designing interventions to integrate the relevant literature
Creating thematic modules
Creation of a manual with a flexible design
Integration of individual treatment
Pilot cases to refine the interventions
A basic research study to investigate empirically the links between culture-related factors and fami
A small randomized trial to test the efficacy of the intervention
Conclusions and implications for blending research and practice
References
Part VI Building the future
22 The road ahead: achievements and challenges for research into the treatment of adolescent substan
Remaining gaps and future directions
Policy: learning how to use science to improve practice
A call to action: policy development to address the research?practice gap
Doing our homework
Creating a policy plan
The advocacy vacuum
Action items: recommendations to conceptualize and launch policy work
Fact-finding
Political strategy 101: build coalitions
Plan strategically
Link to other initiatives
Train the next generation
Seek more funding
The road ahead: policy as the missing link between research and practice
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