A comparison of treatment outcomes for adolescent community reinforcement approach participants with and without co-occurring problems

Abstract

This study examined the relationship between Adolescent Community Reinforcement Approach (A-CRA) participation with treatment engagement, retention, and satisfaction, and with substance use and emotional problem outcomes. Participants had substance use disorders (SUD) only or co-occurring substance use and psychiatric problems. Those with co-occurring problems reported more days of substance use and emotional problems at intake to treatment than those with SUD only. All groups received equivalent exposure to A-CRA during treatment implementation. At the 12-month follow-up, adolescents classified as externalizers (n = 468) or those with both externalizing and internalizing problems (n = 674) had significantly greater improvement in their days of abstinence and substance problems relative to adolescents with substance use disorders only (n = 666). Additionally, adolescents reporting symptoms of internalizing (n = 154), externalizing, or both externalizing and internalizing disorders had significantly greater improvements in days of emotional problems relative to adolescents with SUD only.

Keywords: A-CRA; Adolescents; Co-occurring; Substance use; Treatment.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Fig. 1

Results of HLM growth model analyzing group differences percent of days abstinent.

Fig. 2

Results of HLM growth model analyzing group differences for Substance Problem Scale.

Fig. 3

Results of HLM growth models analyzing group differences for the Emotional Problems Scale.