Purpose To explore how youth contextualize substance use problems and recovery, in general and for themselves, in relation to the commonly accepted chronicity framework. Methods Fourteen focus groups were conducted with 118 youth in substance abuse treatment settings (aged 12-24; 78.3% male; 66.1% Latino) located throughout diverse areas of Los Angeles County. Transcribed qualitative focus group data were analyzed for major substance use and recovery themes. Results Most (80%) youth do not accept a chronicity framework that conceptualizes substance use problems as recurring and constituting a life-long illness. Most (65%) view substance use problems as a function of poor behavioral choices or a developmental/social lifestyle phase. Youth perceptions of recovery tend to parallel this view, as most define recovery to mean having an improved or changed lifestyle that is achieved through making better behavioral choices (67%) and exerting personal control over one's behavior (57%) through willpower, confidence, or discipline. Other recovery themes identified by youth were substance use related (47%), wellness or well-being related (43%) and therapeutic or treatment related (14%). Conclusions Findings highlight the importance of considering youth perceptions about substance use chronicity and recovery in making improvements and promoting new developments in clinical and recovery support approaches to better meet the needs of youth with substance use problems. Findings are discussed under a theoretical context of behavior change to provide insights for the treatment and recovery communities.

Objective To qualitatively explore how treatment-involved youth retrospectively contextualize relapse from substance use. Methods Fourteen focus groups were conducted with 118 youth (78.3% male; 66.1% Latino) enrolled in participating substance abuse treatment programs (4 young adult and 10 adolescent) throughout Los Angeles County. Transcripts were analyzed for relapse perception themes. Results Dominant relapse themes include emotional reasons (90%), life stressors (85%), cognitive factors (75%), socialization processes (65%), and environmental issues (55%). Conclusions Youth perceptions about relapse during treatment should be used to better inform clinical approaches and shape early-intervention recovery agendas for substance-abusing youth.

It is widely acknowledged that involvement in sport has positive physical and psychosocial benefits for adolescents. However, concerns have been expressed, both in New Zealand and internationally, about the relatively high attrition rates in youth sport. This qualitative study captured the experiences of eight (five male, three female) adolescents who were no longer participating in high school rowing programs in New Zealand. Data were gathered through semi-structured interviews, and we conducted an inductive thematic analysis. A secondary analysis was then conducted using a self-determination and basic psychological needs framework that placed specific emphasis on need satisfaction and need thwarting. Key findings from this study suggest that participants’ experiences of rowing were initially positive but were subsequently influenced by dissatisfaction and thwarting of basic psychological needs. The findings confirm the significance of coaches and parents providing an environment that supports young athletes’ needs for relatedness. Concerns are also raised about the potentially damaging effects of weight-restricted sport for adolescents. By drawing upon athlete voice, it is hoped that the findings of this study can inform coach education and result in the development of more athlete-supportive rowing programs for adolescent athletes.

Lee et al.: Supporting access to alcohol and other drug treatment: the Los Angeles County screening, brief intervention, and referral to treatment project for short-term jail detainees. Addiction Science & Clinical Practice 2012 7(Suppl 1):A57.