Recovery among adolescents: Models for post-treatment gains in drug abuse treatments

• Published in: Journal of substance abuse treatment 2014-03, Vol.46 (3), p.362-373
• Main Authors: Joe, George W., Ed.D, Kalling Knight, Danica, Ph.D, Becan, Jennifer E., Ph.D, Flynn, Patrick M., Ph.D
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adolescent; Adolescents; Adult and adolescent clinical studies; Biological and medical sciences; Condoms; Counseling; Demographics; Desintoxication. Drug withdrawal; Drug abuse; Drug addiction; Female; Follow-up outcomes; Follow-Up Studies; Humans; Male; Medical sciences; Miscellaneous; Motivation; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Recovery; Retention; Substance abuse; Substance abuse treatment; Substance-Related Disorders - psychology; Substance-Related Disorders - therapy; Teenagers; Therapeutic alliances; Therapeutic relationships; Treatment process; Treatments
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2013.10.007

Abstract Recovery among adolescents undergoing substance abuse treatment was modeled in terms of pre-treatment motivation, therapeutic relationships, psychological functioning, treatment retention, legal pressures, DSM diagnoses, and client demographics. To address between program differences, a within-covariance matrix, based on 547 youth, was used. Applicability of the results across treatment modalities was also examined. The data were from the NIDA-sponsored DATOS Adolescent study. Results from structural equation models (estimated using Mplus) indicated that higher pre-treatment motivation predicted stronger counselor and in-treatment peer relationships, better counselor relationships and retention predicted less illegal drug use at follow-up, and DSM diagnosis was important in the treatment process. Overall, illegal drug use at follow-up was associated with post-treatment alcohol consumption, cigarette use, condom nonuse, psychological distress, criminality, and school non-attendance. The results document the importance of motivation and therapeutic relationships on recovery, even when taking into account the relative effects of legal pressures, DSM diagnoses, and demographics.