Many Teen Substance Abuse Programs Found Lacking

The nation’s most respected treatment programs for teen drug abusers may frequently fall short of what’s necessary for effective treatment, a new study suggests.

Researchers found that most of the 144 U.S. substance abuse programs they surveyed lack “key elements” that an expert panel deemed crucial to successful treatment. Among the areas where programs were most lacking was the initial assessment of each teenager’s particular treatment needs. According to the study authors, the findings are particularly important in light of the fact that the programs they surveyed are designed for teens and are well regarded by experts in substance abuse treatment. “Even programs that are highly regarded in the field are sorely lacking,” said Mathea Falco, president of the Washington-based non-profit research group Drug Strategies and one of the researchers on the study. A good first step for many of these programs would be to improve the way they assess teenagers and match them to appropriate therapies, Falco told Reuters Health. Assessment, she said, “is basically the gate through which other things happen.” According to the expert panel Falco and her colleagues assembled, programs should conduct assessments that consider the full scope of a teenager’s life, including psychological and physical health, learning disabilities and family relationships. Only 28 of the 144 programs in the study scored well in the area of assessment and treatment matching, according to findings published in the current issue of the Archives of Pediatrics & Adolescent Medicine. For the study, the authors gathered an expert panel of researchers, practitioners at nationally recognized treatment programs and federal policymakers. The panel developed nine core elements it believed should be part of any teen drug treatment program. The programs included in the study — chosen because they were considered “exemplary” by government agencies, panel members or national medical organizations — were then surveyed to see how well they were addressing the nine key elements. Programs could score up to 5 points for each element. Overall, the researchers report, programs scored an average of 23.8 out of a possible 45. There was only one element — qualified staff — in which the majority of programs scored well, and no program scored highly on all nine elements.Besides assessment, other areas deemed particularly lacking were the programs’ ability to “engage” and retain teens, and their “gender and cultural competence.” For example, just 35 percent of the programs had different services for boys and girls, and only one-quarter had services designed for minority teens. In addition, more than 90 percent of the programs had never been subject to any “scientifically rigorous” research to see whether they work, according to the report. Falco said she hopes the findings will spur the field to take a closer look at the quality of teen substance abuse programs, and that they will help those trying to choose a program for a child. A profile of each program evaluated in the study is available on the Drug Strategies Web site, at www.drugstrategies.org. (SOURCE: Archives of Pediatrics & Adolescent Medicine: Reuters Health News: September 2004.)