Which Type of Therapy is Most Effective for Adolescent Substance Abusers?

According to a new study led by Michael S. Robbins of the Miller School of Medicine at the University of Miami, Brief Strategic Family Therapy (BFST) is a more effective form of treatment for adolescent substance users than traditional drug treatment provided in community programs. Teens with substance use problems often find themselves thrown into treatment as usual (TAU) programs offered within their towns and cities. Adolescents in the criminal justice system are even more likely to receive TAU rather than specialized therapy such as BFST. The researchers worked within the National Drug Abuse Treatment Clinical Trials Network to gather the participants for their study. They enrolled 480 adolescents and families and provided either TAU or BFST services. The teens were assessed for drug use each month for 12 months, and the family progress was evaluated quarterly throughout the year.

Some of the families were put into the BFST group and were taught how to deal with relational and systemic interactions that stemmed from the drug use and its ensuing consequences. The BFST group was also exposed to traditional family therapy theories during their four months of treatment. The remaining participants were given TAU. The results revealed that the teens in the TAU group reported a significantly higher amount of drug use at 12 months than those in the BFST. “The results demonstrated that the BSFT intervention was significantly more effective than TAU in engaging and retaining adolescents into treatment and improving parent-reported family functioning,” said Robbins. “In this study, adolescents in TAU were 2.5 times more likely to fail to engage and 1.41 times more likely to fail to retain in treatment than adolescents in the BSFT condition. The current findings provide support for the impact of the BSFT intervention on engagement, retention, and parent-reported family functioning with adolescents from diverse racial/ethnic groups.”

Robbins, M. S., Feaster, D. J., Horigian, V. E., Rohrbaugh, M., Shoham, V., Bachrach, K., Miller, M., Burlew, K. A., Hodgkins, C., Carrion, I., Vandermark, N., Schindler, E., Werstlein, R., & Szapocznik, J. (2011, October 3). Brief Strategic Family Therapy Versus Treatment as Usual: Results of a Multisite Randomized Trial for Substance Using Adolescents. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0025477

© Copyright 2011 by By John Smith, therapist in Bellingham, Washington. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • rhett


    October 17th, 2011 at 3:22 PM

    The way I see it, if the entire family does not go through with therapy, then there is no hope for the kid. He needs a strong support system behind him to kick the habit and without that therapy you know that the families are just going to blame and blame the kid, never doing anything that will really make the situation any better. As a matter of fact most kids are gonna rebel against that kind of treatment and do more of the same that you don’t want.

  • Florence


    October 18th, 2011 at 1:01 PM

    The old treatment procedure is just not suited for today and they need to keep updating and upgrading the treatments with the passage of time.

    For a teenager,things have not been the same at all in the past few decades and it can become very hectic and challenging.And when it comes to addiction or related issues,a well thought-out approach is necessary.We don’t want to lock up these youngsters but only help them get back on their feet.

  • serenA


    October 18th, 2011 at 5:47 PM

    What good is the treatment if the family is not involved? Most of the time they are probably the biggest source of the problem anyway

  • C.K


    October 19th, 2011 at 12:30 PM

    Although family being so involved could make a teen anxious,I believe it is for the good of the teen and parental and familial involvement actually lends a lot of importance and seriousness to the therapy and the teen would be more inclined to quit afterwards.

  • Cameron Daniels

    Cameron Daniels

    October 19th, 2011 at 1:02 PM

    If the teen’s problems are rooted in the family dynamics then sorting the kids out only to return them to that same environment isn’t going to be of much help. Every family member needs to be onboard and gain a better understanding of what’s happened, why it did and how to resolve it- not only the teenage substance abuser.

  • L. Armando

    L. Armando

    October 19th, 2011 at 1:30 PM

    And what if they do indeed send the child back home where nothing has changed within the family and it’s business as usual? They may or may not get back on drugs. My concern would be if they have younger siblings, what the chances are they will go down the same road if they are raised in the same environment that fed the teen’s issues.

    Much needs to change in the home setting apart from what the teen alone does.

  • Shar Cartwright

    Shar Cartwright

    October 19th, 2011 at 7:05 PM

    Someone who willingly abuses substances deserves some form of blame for getting themselves into the mess in the first place. They are not total innocents!

    At the same time if you are family and not behind them, you’re not helping the problem get any better. In fact, you’re only going to be making it worse if you don’t at least try imho. There is a limit to what people can do, but no limit to the damage. I think just the teen seeing the family care and to want to help goes a long way to encouraging them in their recovery.

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