The Seven Challenges®

About This Program

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

Program Overview

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

Program Delivery

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.

Recommended Intensity:

Session frequency and length should be responsive to the severity of problems; minimum of 90 minutes of service per week for lower intensity of problems

Recommended Duration:

There is no specified length; it can be adapted and used in a very wide variety of treatment settings and lengths of treatment. There is no prescripted date for when a young person will be done with their counseling.

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Community Agency
  • Community Daily Living Setting
  • Foster/Kinship Care
  • Hospital
  • Outpatient Clinic
  • Residential Care Facility
  • Residential Treatment Center
  • School
  • Juvenile detention/justice facility
  • Courtroom
  • Day Treatment Program/Intensive Outpatient Program (IOP)

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

Education and Training

Prerequisite/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

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.

Fidelity to the model is assessed through:

  • Self-report checklists
  • Counselors being observed by their trained clinical supervisor as they facilitate sessions
  • Clinical supervisors reviewing counselor work in the journaling portion of the program
  • The Seven Challenges, LLC Program Specialist observing session facilitation role plays by counselors/supervisors
  • Program Specialist working with counselors/clinical supervisors to complete the “Fidelity Assessment Coaching Tool”

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

Child Welfare Outcome: Child/Family Well-Being

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. doi:10.1080/10550490601006253

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 purpose of this study was to evaluate the efficacy of two promising models, Strengths Oriented Family Therapy (SOFT) and The Seven Challenges (7C). Participants 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. Measures used included the Global Appraisal of Individual Needs (GAIN), the Substance Frequency Scale (SFS) and Substance Problem Scale (SPS). Results indicate 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 small sample size, follow-up attrition rates were low, results may not generalized to underserved populations and length of follow-up.

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. doi:10.1300/J160v07n03_03

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% Biracial
  • 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. Measures utilized include the Global Appraisal of Individual Needs (GAIN), the Substance Frequency Scale (SFS), the Substance Problem Scale (SPS), the Treatment Motivation Index (TMI), the General Mental Stress Index (GMSI), the Depressive Symptom Index (DSI), and the Anxiety Symptom Index (ASI). 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, reliance on self-report measures, and length of follow-up.

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. doi:10.1007/s10560-013-0307-3

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 study examines the effectiveness of The Seven Challenges® in reducing adolescent substance use and mental health problems. Measures utilized include the Seven Challenges Survey, the Relationship with Counselor Assessment, and the Global Appraisal of Individual Needs (GAIN-Short Screener). 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 measures.

Length of postintervention follow-up: 3 months.

Korchmaros, J. D. (2018). Examining the effectiveness of The Seven Challenges® comprehensive counseling program with adolescents. Journal of Social Work Practice in the Addictions, 18(4), 411-431. doi:10.1080/1533256X.2018.1518651

Type of Study: Two-group pretest-posttest design with control group
Number of Participants: 392

Population:

  • Age — 13-17 years
  • Race/Ethnicity — 27% Hispanic
  • Gender — 29% Female
  • Status — Participants were adolescents who had a diagnosed substance use disorder; and, for the juvenile drug court programs, were charged with a nonviolent offense.

Location/Institution: Different regions of the United States

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examines the effectiveness of The Seven Challenges® program. Measures utilized include the Global Appraisal of Individual Needs (GAIN). Results indicated that adolescent clients enrolled in The Seven Challenges showed decreases in number of crimes committed, in frequency of substance use, and in severity of substance problems, substance issues, substance use disorders, and internalizing and externalizing disorder symptomatology. Limitations included nonrandomization of participants, reliance on self-report measures, and length of follow-up.

Length of postintervention follow-up: 6 months.

The following studies were not included in rating The Seven Challenges® on the Scientific Rating Scale...

Taylor, L. R. (2016). General responsivity adherence in juvenile drug treatment court: Examining the impact on substance-use outcome. Journal of Drug Issues, 46(1), 24-40. doi:10.1177/0022042615610618

The purpose of this study was to explore how the risk-need-responsivity models’ general responsivity principle could be used to inform the effectiveness of the interventions provided to participants in nine juvenile drug treatment courts (JDTCs) in the United States. There was a total of 14 interventions across the JDTC programs that participants could have received during treatment: Cognitive-Behavioral Therapy (CBT), Motivational Enhancement Therapy/Cognitive-Behavioral Therapy (MET/CBT), Seven Challenges (7C), Adolescent Community Reinforcement Approach (ACRA)/Adolescent Continuing Care (ACC), Brief Strategic Family Therapy (BSFT), Multidimensional Family Therapy (MDFT), Chestnut Behavioral Treatment Manual (CBTM), Dialectical Behavior Therapy (DBT), Motivational Interviewing (MI), other 12 steps, other individual therapy (OIT), group-based outpatient treatment (GBOP), other group therapy (OGT), and other. Measures utilized the Global Appraisal of Individual Needs (GAIN). Results indicated that The Seven Challenges was effective at increasing the number of days that an increase in general responsivity adherence was associated with an increase in substance use severity score, which suggests that the effect of the JDTC model on treatment outcomes could vary by the type of interventions provided to participants. Limitations included could not determine which outcome was responsible for outcomes, attrition, and a reliance on self-report data regarding substance use as opposed to direct tests.

Additional 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

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: July 2019

Date Program Content Last Reviewed by Program Staff: August 2019

Date Program Originally Loaded onto CEBC: January 2011