Addiction Medicine: Closing the Gap between Science and Practice

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motivational-enhancement therapy (MET), CBT
and social influence approaches in which
adolescents address the influences that promote
or maintain smoking behavior.^51


Treatment for Addiction Involving Alcohol and Other Drugs ..................................


Psychosocial therapies such as CBT^52 and
family-based therapies are effective treatments
for adolescents with addiction.^53 Interventions
that integrate a family component into
psychosocial interventions are particularly
effective for adolescent patients.^54 Adolescents
generally seem to fare better in treatment
programs that include family members in
counseling sessions or that encourage families to
take an active role in the treatment process.^55


Particular types of family-based therapies that
have proven effective for adolescents include:


 Multidimensional Family Therapy (MDFT)--
an outpatient family-based treatment program
that addresses adolescent alcohol and other
drug use in relation to individual-, family-,
peer- and community-level influences.^56 One
study found that adolescents who received
MDFT were likelier than those who received
other interventions, such as group therapy or
educational interventions, to complete their
treatment and to demonstrate reduced alcohol
and other drug use directly following
treatment and one year later.^57


 Functional Family Therapy (FFT)--a
comprehensive approach to treatment
implemented in the home or in clinical or
school settings based on the idea that
behaviors influence and are influenced by
multiple systems in the adolescent’s life,
including the family. The three-month
program consists of engaging and
motivating adolescents and families; the
development and implementation of an
individually tailored, long-term behavior
change plan; and an attempt to generalize
positive behavior change to other areas of
family functioning. Research suggests that
interventions that include FFT produce


better treatment outcomes than those
without an FFT component.^58

 Multi-Systemic Therapy (MST)--a family-
based approach to addressing risk factors
associated with serious antisocial behavior
in children and adolescents who use alcohol
or other drugs. The treatment generally
takes place in familiar environments (homes,
schools or other neighborhood settings)
which contributes to a high retention rate.^61
In addition to addressing substance use,
MST also attempts to reduce criminal and
other forms of problem behavior and
decrease future involvement with juvenile
justice and child welfare systems.^62 MST is
associated with reduced alcohol and other
drug use during treatment and for at least six
months following program completion,^63
and is particularly effective for those
involved with the juvenile justice system.^64

A large study of adolescent treatment
participants in different types of programs*
found that in the year following treatment, the
percentage of adolescents using marijuana at
least weekly was cut by approximately half.

* The study included more than 1,100 adolescent
treatment participants from 23 different programs in
four cities.

You have an addicted family system. The family
needs education and therapy, especially with
adolescents in treatment.^59

--John Coppola
Executive Director
New York Association of Alcoholism and
Substance Abuse Providers, Inc. (ASAP)

...It is clear the family plays an important role in
encouraging and supporting recovery, especially
in adolescents.^60

--Jose Szapocznik, PhD
Professor and Chair,
Department of Epidemiology and Public Health
Director, Center for Family Studies
Director,
Miami Clinical
Translational Science Institute
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