Drug abuse treatment outcome study of adolescents: A comparison of client characteristics and pretreatment behaviors in three treatment modalities

Objectives: The present study presents background and pretreatment characte ristics of adolescent substance abuse treatment clients, and it provides a mechanism for describing perhaps the largest research sample of adolescents who were in drug treatment in this decade. Methods: The sample was 3382 su bjects who presented for treatment from 1993 to 1995 in 37 programs in Pitt sburgh, Pennsylvania; Miami, Florida; Minneapolis, Minnesota; Chicago, Illi nois; Portland, Maine; and New York City, New York. Informed permission for the youth to participate was obtained from the subject's custodial parent/ guardian, and both the youth and the youth's parents or guardians provided informed assent if they agreed to participate as subjects. Adolescents then were interviewed privately and confidentially by a trained professional in terviewer who was independent of the treatment programs. The interviews que ried subjects about their background, including education and employment; p hysical and mental health; use of tobacco, alcohol, and other drugs; sexual experiences; legal problems; religious beliefs; and treatment experience. Results: The long-term residential treatment modality was the least gender balanced of the modalities and had the most African-American and Hispanic c lients. This modality was distinguished by the proportion of clients who we re referred to treatment by the juvenile or criminal justice system. Compar ed with other clients in other modalities, short-term inpatient clients wer e more likely to be female and white. Inpatient clients also reported more indicators of psychiatric impairment. Outpatient clients were slightly youn ger than clients in the other modalities, and more of them were attending s chool at the time of admission to treatment. Outpatient clients had the lea st criminally involved lifestyles, their rates of (regular daily or weekly) drug use were also the lowest of the three modalities for all drugs assess ed, and they had the least drug treatment experience. Conclusions: These re sults merit several recommendations. One is the need for more community-bas ed adolescent substance abuse treatment programs. An additional recommendat ion is for more substance abuse treatment programs in facilities that serve incarcerated youth. Finally, and perhaps most critically, it is recommende d that programs be designed to address such specialized issues as comorbid substance abuse and psychiatric problems, family dysfunction, physical and sexual abuse, gender and ethnic differences, and academic performance.