Comparing Outcomes of Best-Practice and Research-Based Outpatient Treatment Protocols for Adolescents

Abstract

Comparisons of well-developed practice-based interventions with research-based interventions are rare. This quasi-experimental study compares the outcomes of 274 adolescents (75% male; 63% weekly+ users; 54% dependent; 27% prior treatment; 73% with co-occurring problems) who received Chestnut Health System's best-practice Outpatient Treatment (CHS) or Cannabis Youth Treatment (CYT) research-based interventions. Ninety-five percent of participants completed follow-up interviews at three, six, nine, and 12 months after their intake GAIN interview. Initially, the CYT cohort scores indicated greater severity on several substance-related measures, while the CHS cohort scored higher on prior mental health treatment, victimization, and illegal activities measures. Adolescents in the CHS cohort were more likely to have longer lengths of stay and receive over three times as many hours of treatment. Mixed effects models revealed that CHS participants were significantly more likely to report a decrease in recovery environment risk, an increase in self-help attendance after treatment, and greater decreases in emotional problems, while CYT participants were significantly more likely to report decreases in their substance use. The results suggest that neither the best-practice nor the research-based interventions were clearly superior and call for a more rigorous randomized field experiment to better understand the differences in effectiveness between interventions.

The Washington circle engagement performance measures’ association with adolescent treatment outcomes

“…We also found that adolescents with the most serious clinical issues or behavioral problems at intake (e.g., high levels of victimization, Conduct Disorder, or truancy) were more likely to still report using some substances at six month follow-up and some problem behaviors, as also reported by other studies that do not consider treatment engagement (Arria, 2003; Godley et al, 2004b; Luchansky et al, 2006a; Williams et al, 2008). By and large, however, we did not confirm other research showing that co-morbid mental health disorders negatively influence abstinence (Godley et al, 2004a; Hser et al, 2003a; Tomlinson et al, 2004).…”

The Effectiveness of Self-Help Groups for Adolescent Substance Misuse: A Systematic Review

“…Our finding that studies in which substance use intervention was based partly or completely on the 12-step philosophy had high attendance rates is consistent with previous findings that integrating 12-step concepts in professional substance use treatments and referring to 12-step groups is related to higher 12-step attendance (Godley, Jones, Funk, Ives, & Passetti, 2004;Kaskutas, Subbaraman, Witbrodt, & Zemore, 2009;Timko & DeBenedetti, 2007;Tonigan, Connors, & Miller, 2003). Including the 12-step approach in the treatment may be a way to increase attendance rates within the adolescent population.…”

Adolescent outpatient treatment and continuing care: Main findings from a randomized clinical trial☆

“…In a quasi-experiment (Godley et al, 2004), outcomes for 274 adolescents were compared with those who received either Chestnut Health System’s Bloomington Outpatient Treatment (CBOP; Godley et al, 2003) or one of three research-based interventions (including MET/CBT) in the CYT study (Dennis et al, 2004). Adolescents in the CBOP cohort had significantly longer lengths of stay and received over three times as many hours of treatment.…”