The Seven Challenges®

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Seven Challenges® has been rated by the CEBC in the area of: Substance Abuse Treatment (Adolescent).

Target Population: Adolescents and young adults who have drug problems, co-occurring mental health issues, trauma, and family issues

For children/adolescents ages: 13 – 25

Brief Description

The Seven Challenges® program, specifically for young people with drug problems, is designed to motivate a decision and commitment to change and to support success in implementing the desired changes. The program simultaneously aims to help young people address their drug problems as well as their co-occurring life skill deficits, situational problems, and psychological problems. The challenges provide a framework for helping youth think through their own decisions about their lives and their use of alcohol and other drugs. Counselors use the program to teach youth to identify and work on the issues most relevant to them. In sessions, as youth discuss the issues that matter most, counselors seamlessly integrate The Seven Challenges® as part of the conversation.

The Seven Challenges® are:

  • We decided to open up and talk honestly about ourselves and about alcohol and other drugs.
  • We looked at what we liked about alcohol and other drugs, and why we were using them.
  • We looked at our use of alcohol or other drugs to see if it has caused harm or could cause harm.
  • We looked at our responsibility and the responsibility of others for our problems.
  • We thought about where we seemed to be headed, where we wanted to go, and what we wanted to accomplish.
  • We made thoughtful decisions about our lives and about our use of alcohol and other drugs.
  • We followed through on our decisions about our lives and drug use. If we saw problems, we went back to earlier challenges and mastered them.

Program Goals:

The goals of The Seven Challenges® program are:

  • Decrease drug use
  • Improve overall mental health
  • Improve relationships
  • Improve school/work performance
  • Increase awareness of past and present issues and how they relate to societal issues (discrimination, etc.) to help young people put their problems into a societal context and then take control of their lives and move past problems

Essential Components

The essential components of The Seven Challenges® program include:

  • Group (up to 10 youth) and/or individual sessions
  • Adaptable for any service level (residential, outpatient, school, home, etc.)
  • Sessions that are not prescripted psychosocial modules
  • Counselors with counseling experience
  • Easy for mental health and substance abuse counselors to learn
  • Flexible implementation, ongoing support and monitoring from the developers
  • Clinical supervisor trained and able to train new staff when there is agency turnover
  • Published materials for counselors and youth help build a framework:
    • Manual
    • Training DVD
    • Activity book
    • Book of readings
    • Youth journals
    • Posters for use during sessions
    • Numerous supporting documents for counselors and clinical supervisors

Child/Adolescent Services

The Seven Challenges® directly provides services to children/adolescents and addresses the following:

  • Drug problems, co-occurring mental health issues, trauma, life skills deficits, family issues
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Parental/family support person(s) involvement is required whenever possible and counselors/agencies can make decisions about the involvement – counseling, multi-family groups, activities, etc.

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Community Agency
  • Community Daily Living Settings
  • Foster/Kinship Care
  • Hospital
  • Outpatient Clinic
  • Residential Care Facility
  • Residential Treatment Center
  • School
  • Juvenile detention/justice facility
  • Courtroom

Homework

This program does not include a homework component.

Languages

The Seven Challenges® has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Experienced counselors, counseling setting, published program materials

Minimum Provider Qualifications

Counselors must be experienced working with young people but there is no degree requirement. Weekly clinical supervision must be provided by a specially trained, Master’s level clinical supervisor who is referred to as The Seven Challenges Leader in the program materials.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

Training for counselors is provided onsite.

Number of days/hours:

3 days, 18 hours total

Implementation Information

Since The Seven Challenges® is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for The Seven Challenges® as listed below:

Multiple interviews and open forums for questions are utilized with each agency.

Formal Support for Implementation

There is formal support available for implementation of The Seven Challenges® as listed below:

Program training staff facilitate regular support calls, annual site visits, and support/assistance as needed outside scheduled measures.

Fidelity Measures

There are fidelity measures for The Seven Challenges® as listed below:

The fidelity instrument is available to clinical supervisors.

Implementation Guides or Manuals

There are implementation guides or manuals for The Seven Challenges® as listed below:

There is a counselor’s manual, a training DVD, and an activity book with over 70 activities included – all published items available to organizations implementing the program. Multiple documents to assist with implementation and fidelity monitoring including the basic scripting of beginning sessions to help new counselors get started.

Research on How to Implement the Program

Research has not been conducted on how to implement The Seven Challenges®.

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Smith, D. C., Hall, J. A., Williams, J. K., An, H., & Gotman, N. (2006). Comparative efficacy of family and group treatment for adolescent substance abuse. The American Journal on Addictions, 15, 131-136.

Type of Study: Randomized controlled trial
Number of Participants: 98

Population:

  • Age — 12-18 years
  • Race/Ethnicity — 24% Non-Caucasian
  • Gender — 71% Male and 29% Female
  • Status — Participants were youth referred to adolescent outpatient treatment for substance abuse with the majority experiencing current juvenile justice system involvement.

Location/Institution: In collaboration with the Mid-Eastern Council on Chemical Abuse (MECCA) treatment center

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the efficacy of Strengths-Oriented Family Therapy (SOFT) and The Seven Challenges® in a subset of subjects from a larger longitudinal study. Data was examined for subjects who had completed both baseline and six-month assessments. Adolescents who qualified for outpatient treatment and agreed to participate in the study were randomly assigned to one of the two treatments and assessed at 3 and 6-months following baseline. Typically, all SOFT sessions were provided within the first three months following baseline, and The Seven Challenges participants received approximately 25 hours within the first three months. Measures used included two Global Appraisal of Individual Needs (GAIN) scales: the Substance Frequency Scale (SFS) and Substance Problem Scale (SPS). Using a two-part, random-effects model, the study examined the odds of achieving abstinence or full symptom remission between treatments and over time. Both SOFT and The Seven Challenges participants experienced significantly reduced odds of continued use (SFS) and substance-related problems (SPS) at months 3 and 6 following baseline, but outcomes did not differ between groups. Limitations included treatment manuals finalized during the initial months of the study, the intervention format was modified for rural clients, adolescents met in open groups with non-study participants, results may not generalized due to limited insurance eligibility, and it was difficult to adequately assess therapist effects.

Length of postintervention follow-up: 3 months.

Stevens, S. J., Schwebel, R., & Ruiz, B. (2007). The Seven Challenges: An effective treatment for adolescents with co-occurring substance abuse and mental health problems. Journal of Social Work Practice in the Addictions, 7(3), 29-49.

Type of Study: One group pretest/posttest design
Number of Participants: 36

Population:

  • Age — 13-17 years
  • Race/Ethnicity — 53% Caucasian, 31% Latino, and 17% Bi-racial
  • Gender — 75% Male and 25% Female
  • Status — Participants were enrolled in an intensive outpatient substance abuse treatment program for drug and alcohol abuse and were in clinical range for general mental distress.

Location/Institution: Providence Service Corporation

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study examined mental health outcomes (substance-related issues and mental health issues) for adolescents participating in The Seven Challenges® program over 2 months at an intensive outpatient substance abuse treatment center. Measures were conducted during interviews and included two Global Appraisal of Individual Needs (GAIN) scales: the Substance Frequency Scale (SFS) and Substance Problem Scale (SPS), as well as the Treatment Motivation Index (TMI), General Mental Stress Index (GMSI), Depressive Symptom Index (DSI), and the Anxiety Symptom Index (ASI). The computed variables were used to conduct paired sample t-tests from baseline to 3 months and baseline to 6 months. Results indicated that the two substance-related variables (SPS and SFS) showed significant decreases in scores at 3 and 6 months. The TMI also demonstrated a significant reduction at 3 and 6 months. All three variables (GMSI, DSI, and ASI) reflected significant reductions in scores from baseline to 3 and 6 months. Limitations included small sample size and a reliance on self-report data regarding substance use, as opposed to direct tests.

Length of postintervention follow-up: 1 and 4 months.

Korchmaros, J. D., & Stevens, S. J. (2014). Examination of the role of therapeutic alliance, treatment dose, and treatment completion in the effectiveness of The Seven Challenges. Child and Adolescent Social Work Journal, 31(1), 1-24.

Type of Study: One group pretest/posttest design
Number of Participants: 89

Population:

  • Age — 13-17 years
  • Race/Ethnicity — 50.6% White, 30.3% Hispanic, 2.2% Native American, 9.0% Mixed, and 7.9% Unknown
  • Gender — 72 Male and 17 Female
  • Status — Participants were adolescents who were enrolled in an intensive outpatient substance abuse treatment program for drug and alcohol abuse and were in clinical range for general mental distress.

Location/Institution: Providence Service Corporation

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This longitudinal study examines the effectiveness of The Seven Challenges® in reducing adolescent substance use and mental health problems, as well as the process by which it is effective. Measures utilized include the Seven Challenges Survey, the Relationship with Counselor Assessment, and the Global Appraisal of Individual Needs (GAIN-Short Screener). Participants were adolescents enrolled in a 3-month intensive outpatient adolescent substance abuse treatment program using The Seven Challenges and who provided self-report data at pre- and post-treatment. Results indicated that The Seven Challenges was effective at increasing the number of days refrained from using alcohol and other drugs (AOD), reducing use of tetrahydrocannabinol (THC) and other drugs, and reducing substance use problems and internal mental distress. Results also indicated that The Seven Challenges drug counselors effectively established and maintained therapeutic alliance but this seems to not play a role in the effectiveness of The Seven Challenges. Both treatment dose and completion played a role in the effectiveness of The Seven Challenges; they were both positively related to post-treatment days refrained from AOD use, and negatively related to days of THC use, substance use problems, and internal mental distress. However, the strength of the influence of treatment completion was stronger when treatment dose was low than when it was high. Limitations included the relatively small sample size, length of follow-up, and a reliance on self-report data regarding substance use, as opposed to direct tests.

Length of postintervention follow-up: 3 months.

References

Schwebel, R. (2004). The Seven Challenges manual. Viva Press: Tucson, AZ

Schwebel, R. (2000). The Seven Challenges journals. Viva Press: Tucson, AZ

Schwebel, R. (1995). The Seven Challenges: Challenging ourselves to make wise decisions about alcohol and other drugs. Viva Press: Tucson, AZ.

Contact Information

Name: Sharon Conner
Title: Director of Program Services
Agency/Affiliation: The Seven Challenges, LLC
Website: www.sevenchallenges.com
Email:
Phone: (520) 405-4559

Date Research Evidence Last Reviewed by CEBC: January 2015

Date Program Content Last Reviewed by Program Staff: October 2016

Date Program Originally Loaded onto CEBC: January 2011