The Strengthening Communities For Youth (SCY) Initiative: A Cluster Analysis of the Services Received, Their Correlates and How They are Associated with Outcomes

Abstract

This article describes the Strengthening Communities for Youth (SCY) initiative using data from 1,297 adolescents in eight U.S. cities (Oakland, CA; Tucson, AZ; Iowa City, IA; Bloomington, IL; St. Louis, MO; Cleveland, OH; Louisville, KY, New York, NY) to better understand the pattern of services they received, how these services varied by need, and how services were associated with initial treatment outcomes. Data include adolescent reports collected with the Global Assessment of Individual Needs (GAIN) at treatment intake and 90 days post-intake, information on early therapeutic alliance using a modified Working Alliance Inventory (WAI), and staff reports from service logs. Cluster analysis identified four patterns of treatment received: (1) substance abuse and mental health treatment, (2) primarily residential treatment, (3) interrupted treatment, and (4) primarily outpatient treatment. Outcomes examined included changes in substance use, substance abuse/dependence problems, recovery environment risk, as well as risk from social peers, illegal activity and emotional problems. Overall and for most groups, treatment was associated with reduced or unchanged problems in each of these areas. The exception was for cluster 1, for whom emotional problems actually increased. Implications for placement, treatment planning and future research are discussed.

Severity of Victimization and Co-Occurring Mental Health Disorders Among Substance Using Adolescents

“…It has eight sections covering background information, substance abuse, physical health, risk behaviors, mental health, environment, legal information, and vocational information. GAIN’s measures have been validated with collateral reports, urine tests, follow-up methods, and treatment records (Dennis 1999; Dennis et al 2008; Garner et al 2008). …”

The Reinforcing Therapist Performance (RTP) experiment: Study protocol for a cluster randomized trial

“…Intake and follow-up versions of this measure were collected using the GAIN [79], which is a comprehensive biopsychosocial assessment designed to integrate research and clinical assessment into one structured interview. The GAIN's main scales have been shown to demonstrate good internal consistency (alpha greater than 0.90 on main scales, 0.70 on subscales), test-retest reliability (Rho greater than 0.70 on days/problem counts, kappa greater than 0.60 on categorical measures), and to be highly correlated with measures of use based on timeline follow-back methods, urine tests, collateral reports, treatment records, and blind psychiatric diagnoses (rho of 0.70 or more, kappa of 0.60 or more) [79-81]. GAIN data were collected as part of the AAFT project's evaluation and were de-identified prior to being used as part of the RTP study.…”

Exposure to Adolescent Community Reinforcement Approach treatment procedures as a mediator of the relationship between adolescent substance abuse treatment retention and outcome

“…Dennis, personal communication, May 3, 2008), making it one of the most widely used measures in adolescent treatment. The GAIN’s main scales have been shown to demonstrate good internal consistency (alpha over .90 on main scales, .70 on subscales), test-retest reliability (Rho over .70 on days/problem counts, Kappa over .60 on categorical measures), and to be highly correlated with measures of use based on timeline follow-back methods, urine tests, collateral reports, treatment records, and blind psychiatric diagnosis (Rho of .70 or more, Kappa of .60 or more; Dennis, Chan, & Funk, 2006; Dennis, Ives, White, & Muck, 2008; Dennis et al, 2003). Copies of the instruments, manual, publications and documentation on the 100 plus scales in the GAIN are available at www.chestnut.org/li/gain.…”