Teen Treatment Programs Need Improvement

By Leslie Quander Wooldridge

Adolescents with substance abuse problems require specially designed treatment programs because they are at vulnerable stages of developmental change. However, a recent SAMHSA-funded study of facilities serving significant adolescent populations indicates that these facilities may not provide comprehensive services for this group, especially when other co-occurring illnesses are involved.

Approximately 2.2 million adolescents (8.9 percent of the total adolescent population) suffered from alcohol and drug abuse in 2003, according to SAMHSA’s National Survey on Drug Use and Health.

Almost all facilities that treat significant numbers of children and adolescents for substance abuse conduct comprehensive substance abuse assessments. However, according to an article, “Characterizing Substance Abuse Programs that Treat Adolescents,” recently published in the Journal of Substance Abuse Treatment, only half of these facilities also conduct comprehensive mental health assessments, which are recommended as part of an integrated treatment approach.

The article was written by researchers from SAMHSA’s Spending Estimates team, Thomson/Medstat, and SAMHSA staff.

To determine if treatment centers were following “best practice” recommendations, researchers compared data from SAMHSA’s 2003 National Survey of Substance Abuse Treatment Services (N-SSATS) with nine key quality elements identified by experts. Best practices, for example, include use of developmentally appropriate programs and continuing care for adolescents.

The study found that substance abuse programs with significant adolescent “volume,” or population, have “room for improvement” to meet quality standards.

“On the positive side, results show that facilities are willing to admit clients with other co-occurring mental or medical conditions,” said Rita Vandivort, M.S.W., a public health analyst in the Division of Services Improvement at SAMHSA’s Center for Substance Abuse Treatment. “But results also reinforce what many have already said: that mental health and substance abuse providers have a way to go to attain truly integrated treatment.”

Areas needing improvement include mental health, medical issues in comprehensive assessments, and curricula to meet the developmental and cultural needs of adolescent clients.

The study found that only half (50.2 percent) of significant adolescent-volume facilities offer special programs for adolescents with co-occurring mental and substance use disorders. Although the programs provide comprehensive assessments of substance abuse needs, researchers found that these programs rarely attend to the mental or other medical health needs that frequently co-occur with adolescent substance abuse.

N-SSATS results show that almost all facilities that treat adolescents are conducting substance abuse assessments (96.6 percent), but far fewer facilities are conducting mental health assessments (50 percent), and even fewer facilities (38.9 percent) are screening for medical conditions such as HIV.

Although lower rates of mental health assessments and medical screenings were reported, researchers did find relatively high rates of other recommended practices among facilities, specifically discharge planning (84.8 percent), aftercare counseling (82.2 percent), and relapse prevention groups (84.4 percent).

Researchers found the relatively high rates of these activities to be encouraging, noting that continuing care must be improved in order to ensure the “best possible outcomes” for treatment.

A total of 2,499 significant adolescent-volume facilities were examined in the study, which was conducted under the SAMHSA Spending Estimates Project.

For more information, visit SAMHSA’s Web site at http://csat.samhsa.gov/IDBSE/index.aspx. 

Citation: Mark T.L., Song X., Vandivort R., Duffy S., Butler J., Coffey R., Shabert V.F. “Characterizing Substance Abuse Programs that Treat Adolescents.” Journal of Substance Abuse Treatment, 2006. 31:59–65.

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