Child and Adolescent Psychiatry

Substance Use and Abuse 209

particularly effective when administered by highly skilled therapists, but
has much smaller effects with less accomplished therapists.

Prevention

There have been several randomised controlled trials of preventive, educa-
tional programmes for adolescents in the USA. However, most only engage
about 30% of the ‘at risk’ population, and have modest effects. Building
on these trials is a major public health task.

Subject review

Heath AC. et al. (2008) Substance use and substance use disorder. In:Rut-
ter M et al. (eds) Rutter’s Child and Adolescent Psychiatry, 5th edn. Wiley-
Blackwell, Chichester, pp. 565–586.

Further reading

Bowden-Jones H, Clark L. (2011) Pathological gambling: a neurobiological
and clinical update. British Journal of Psychiatry 199 , 87–89.
Fuller E et al. (2008) Drug Use, Smoking and Drinking among Young People
in England in 2007. The NHS Information Centre, Leeds. Available at:
http://www.ic.nhs.uk.
Lynskey MTet al.(2010) Genetically informative research on adolescent
substance use: Methods, findings, and challenges.Journal of the American
Academy of Child and Adolescent Psychiatry 49 , 1202–1214.
NICE (2007)Psychosocial Interventions for Substance Misuse. National Clinical
Practice Guideline Number 51. NICE, London.
Robbins Met al. (2011) Therapist adherence in brief strategic family
therapy for adolescent drug abusers.Journal of Consulting and Clinical
Psychology 79 , 43–53.