Substance Abuse Treatment (Adolescent)

MDFT is a family-based treatment for adolescent substance use, delinquency, and other behavioral and emotional problems. Therapists work simultaneously in four interdependent domains: the adolescent, parent, family, and community. Therapy sessions are held alone with the youth, alone with the parents, and with youth and parents together. Once a therapeutic alliance is established and youth and parent motivation is enhanced, the MDFT therapist focuses on facilitating behavioral and interactional change. The final stage of MDFT works to solidify behavioral and relational changes and launch the family successfully so that treatment gains are maintained.

Multisystemic Therapy (MST) is an intensive family and community-based treatment for serious juvenile offenders with possible substance abuse issues and their families. The primary goals of MST are to decrease youth criminal behavior and out-of-home placements. Critical features of MST include: (a) integration of empirically based treatment approaches to address a comprehensive range of risk factors across family, peer, school, and community contexts; (b) promotion of behavior change in the youth's natural environment, with the overriding goal of empowering caregivers; and (c) rigorous quality assurance mechanisms that focus on achieving outcomes through maintaining treatment fidelity and developing strategies to overcome barriers to behavior change.

A-CRA is a behavioral intervention that seeks to increase the family, social, and educational/vocational reinforcers of an adolescent to support recovery from substance abuse and dependence. The manual outlines an outpatient program that targets youth 12-25 years old with Diagnostic and Statistical Manual of Mental Disorders (DSM-5) cannabis, alcohol, and/or other substance use disorders. A-CRA also has been implemented in intensive outpatient and residential treatment settings. A-CRA includes guidelines for three types of sessions: adolescents alone, caregivers alone, and adolescents and caregivers together. According to the adolescent's needs and self-assessment of happiness in multiple areas of functioning, therapists choose from among 17 A-CRA procedures that address, for example, problem-solving skills to cope with stressors, communication skills, and participation in positive social and recreational activities with the goal of improving life satisfaction and eliminating substance use problems. The adult model, Community Reinforcement Approach (CRA), has also been rated by the CEBC.

Adolescent FBT includes more than a dozen treatments including treatment planning, behavioral goals, contingency contracting/Level System, communication skills training, job-getting skills training, self-control, stimulus control, and tele-therapy to improve session attendance. Therapies are consumer-driven and culturally sensitive. Adolescent FBT‘s goal is to result in positive outcomes in such areas as alcohol and drug use, depression, conduct problems, family dysfunction, and days absent from work/school. Adolescent FBT is designed to be used with youth, multiple ethnicities, differing types of substance abuse (alcohol, marijuana, and hard drugs), and across genders. Drafts of standardized client record keeping forms and quality assurance may be customized to fit agency needs.

EBFT addresses multiple ecological systems and originated from the therapeutic work with substance-abusing adolescents who have run away from home. The treatment was developed to address immediate needs, to resolve the crisis of running away, and to facilitate emotional re-connection through communication and problem solving skills among family members. Family interaction is a necessary target of the therapeutic techniques. Therapy relies on understanding the individual, interpersonal, and environmental context as well as the unique resources and needs of the family and its members. The intervention includes family systems techniques such as reframes, relabels, and relational interpretations; communication skills training; and conflict resolution, but also therapeutic case management in which systems outside the family are directly targeted. The model includes 12 home-based (or office-based) family therapy sessions and 2-4 individual HIV prevention sessions.

FFT is a family intervention program for dysfunctional youth with disruptive, externalizing problems. FFT has been applied to a wide range of problem youth and their families in various multi-ethnic, multicultural contexts. Target populations range from at-risk pre-adolescents to youth with moderate to severe problems such as conduct disorder, violent acting-out, and substance abuse. While FFT targets youth aged 11-18, younger siblings of referred adolescents often become part of the intervention process. Intervention ranges from, on average, 12 to 14 one-hour sessions. The number of sessions may be as few as 8 sessions for mild cases and up to 30 sessions for more difficult situations. In most programs, sessions are spread over a three-month period. FFT has been conducted both in clinic settings as an outpatient therapy and as a home-based model. The FFT clinical model offers clear identification of specific phases which organizes the intervention in a coherent manner, thereby allowing clinicians to maintain focus in the context of considerable family and individual disruption. Each phase includes specific goals, assessment foci, specific techniques of intervention, and therapist skills necessary for success.

Voices Lite: A Program of Self-Discovery and Empowerment for Girls addresses the unique needs of adolescent girls and young women. This is a shorter 12-session version of the full 18-session Voices: A Program of Self-Discovery and Empowerment for Girls. The program includes modules on self, connecting with others, healthy living, and the journey ahead. Topics include bullying, the pressures of social media, gender exploration, and binge drinking. Texting, social media, and online or “in real life” (IRL) friends also included.

The facilitator’s guide includes background information about young women, gender-responsive principles, and the theoretical foundation of the program. It provides information about conducting the twelve group sessions that are the core of the program (the structure and content for each topic and activity), as well as a program overview and lists of materials needed for the sessions. The program materials also can be used to train staff members in working with girls.

The participant’s journal utilizes an established process called Interactive Journaling®. In the context of girls’ lives, structured journaling provides an outlet for creativity, personal expression, exploration, and application of new concepts and skills.

The Brief Strategic Family Therapy® (BSFT®) Model uses a structured family-systems approach to treat families with youth (6 to 18 years) who display or are at risk for developing problem behaviors including substance abuse, conduct problems, and delinquency. There are three intervention components:

• Therapists must establish and maintain a viable and effective therapeutic relationship with family members = Joining.
• By eliciting and observing family interactions (Enactments), therapists identify interactional patterns that are associated with problematic youth behavior = Systemic Diagnosis.
• Therapists design and execute a treatment plan. The interventions are designed to be done in the session focusing on the here and now using Highlights, Reframes, and assigning Tasks that elicit more effective and adaptive family interactions = Restructuring

BSFT® is typically delivered in 12 to 16 weekly sessions in community centers, clinics, health agencies, or homes. BSFT® therapists are required to participate in a structured program of training to achieve Competency, and then are required to remain in a course of fidelity monitoring for adherence.

CHOICE Group Motivational Interviewing (MI) for Teens is a group-based prevention/intervention program that addresses substance use and ways to increase protective factors. CHOICE is for middle school teens who have not used or have just begun to use substances and consists of 5 sessions. The groups use MI as the counseling method. MI is a client-centered, directive communication method designed to enhance motivation for change. Counselors use specific skills to explore and increase clients’ intrinsic motivation regarding healthy behaviors.

Two other versions of Group Motivational Interviewing (MI) are also highlighted on the CEBC at Free Talk Group MI for Teens and MICUNAY Group MI for Teens.

CIFFTA is a 12–24-week outpatient treatment for adolescents 11 to 18 years old and their family/caregivers. CIFFTA incorporates content relevant to diverse adolescents (e.g., race, ethnicity, LGBTQ) and is designed to engage marginalized communities, reduce symptoms of behavioral and mental disorders and substance use, and to improve family functioning (e.g., increase parental involvement and cohesion and reduce conflict). CIFFTA uses an adaptive and flexible modular design to tailor treatment to unique clinical and cultural characteristics. CIFFTA includes individual adolescent treatment, family treatment, and psychoeducational components. Its Social Ecological and Human Development foundation means it focuses on 1) sharing information, building skills, and increasing motivation at the individual child level; 2) creating more adaptive and healthy interactions in the family; 3) empowering parents to work more effectively with school, health, welfare and juvenile justice systems; and 4) buffering destructive societal messages and forces. Materials are available in Spanish and English.

RSAP is designed to prevent and reduce substance use among adolescents in residential child care facilities due to committing delinquent acts, being neglected or abused, experiencing chronic school problems, and/or having mental health and other behavioral health problems. Most of these adolescents have a history of early substance use and/or have a parent with a substance abuse disorder (SUD).

Highly trained substance abuse prevention specialists implement a multicomponent program consisting of screening, individual and group counseling for substance using youth and/or having a parent with a SUD, awareness activities, an eight-session curriculum for all residents, referral for treatment when needed, and environmental strategies to change facility culture and norms.

Seeking Safety is a present-focused, coping skills therapy to help people attain safety from trauma and/or substance abuse. The treatment is available as a book, providing both client handouts and clinician guidelines. The treatment may be conducted in group or individual format for adolescents (both females, and males) in various settings (e.g., outpatient, inpatient, residential, home care, and schools). Seeking Safety consists of 25 topics that can be conducted in any order and number. Examples of topics are Safety, Asking for Help, Setting Boundaries in Relationships, Healthy Relationships, Community Resources, Compassion, Creating Meaning, Discovery, Recovery Thinking, Taking Good Care of Yourself, Commitment, Coping with Triggers, Self-Nurturing, Red and Green Flags, and Life Choices. Seeking Safety has been also rated by the CEBC in the areas of Substance Abuse Treatment (Adult) and Trauma Treatment (Adult), click here to see that entry.

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.