Therapeutic Engagement and Posttreatment Substance Use in Adolescent TC Clients

Abstract

The problem of adolescent drug use places a huge toll on society and a heavy burden on the criminal justice system. Despite the ability of therapeutic communities (TCs) to lower drug relapse, a great deal remains unknown in terms of how the process of treatment actually works for adolescents. Using data collected as part of the Drug Abuse Treatment Outcomes Studies-Adolescents, this study examines the direct and indirect relationship between therapeutic engagement and posttreatment substance use. Though there are few direct effects of therapeutic engagement on substance use, findings suggest that those more engaged in treatment are more likely to complete treatment and, therefore, less likely to use substances. This suggests that instruments that evaluate therapeutic engagement are important in assessing involvement in treatment, and that programming designed to engage the adolescents in TC treatment should be utilized to reduce the risk of posttreatment relapse.

Body Mapping in a Drug and Alcohol Treatment Program: Eliciting New Identity and Experience

“…Additionally, our study highlights the potential applicability and utility of Body Mapping as a tool to improve understanding of the lives and experiences of adolescents undergoing AOD residential treatment and as a potential additional tool for therapeutic engagement which could potentially reduce drop out. Leaving treatment early and not engaging in treatment are major challenges in the youth residential AOD treatment field [ 16 , 17 , 18 , 21 ].…”

“…In this treatment field, research underscores the importance of treatment completion to improve long-term outcomes for these young people [ 13 , 14 ]. Benefits of treatment completion or longer stays are shown to include lower levels of drug use, fewer arrests, increased employment rates and improved social engagement and psychological well-being following treatment compared with those who left the program early [ 12 , 15 , 16 , 17 , 18 , 19 ]. ‘Engagement’ in programs, not just time in treatment, has also been identified as important in ensuring positive outcomes from residential programs [ 18 , 20 , 21 , 22 , 23 ].…”

“…However, according to Foster and colleagues (2010), adolescents in a TC in Sydney Australia wanted methods beyond the typical journaling and talk-based group sessions to reflect on their experiences, including their experiences in the program [ 24 ]. This finding, together with the increasing evidence of the need for ‘engagement’ to reduce treatment drop out and maximise positive outcomes from treatment [ 18 , 20 , 21 , 22 , 23 ], led the authors of this paper to explore the role of arts-based methods as a research tool in this setting, but also as a means of ‘engagement’ for clients in residential treatment programs.…”