Regular article Outcomes of a comprehensive treatment program for adolescents with a substance-use disorder Catherine Spooner, B.A., M.P.H., Ph.D. a, *, Richard P. Mattick, B.Sc., M.Psych., Ph.D. a , Wesley Noffs b a National Drug and Alcohol Research Centre, Faculty of Medicine, University of New South Wales, UNSW Sydney, NSW 2052, Australia b Ted Noffs Foundation, P.O. Box 120, Randwick, NSW 2031, Australia Received 27 April 2000; received in revised form 16 November 2000; accepted 22 December 2000 Abstract Outcomes of a multimodal residential treatment program for adolescents were compared with usual care. The quasiexperimental design included pretest, 3-month posttest, and 6-month follow-up of program referrals mean age 16; 53% male). The intervention group IG) comprised referrals who entered the program n =61) and the comparison group CG) comprised referrals who did not enter the program n =60). The six outcomes substance use, criminal behavior, social functioning, psychological distress, physical health, and HIV risk-taking behavior) were assessed using the Opiate Treatment Index and the Symptom Checklist-90-Revised. The study groups demonstrated equivalent improvement on all six outcomes. Multiple factors are likely to have influenced these results, including inadequate program implementation and differential drop-out. There was, however, a higher prevalence of multiple improvements among the IG than the CG. It is concluded that adolescents with a PSUD can improve, however, a superior means of achieving this improvement has yet to be demonstrated. D 2001 Elsevier Science Inc. All rights reserved. Keywords: Adolescents; Illicit drugs; Drug abuse treatment; Australia 1. Introduction Reviews of the research on treatment outcome for ado- lescents with a psychoactive substance use disorder PSUD) have identified that exposure to treatment is generally associated with improved outcome. However, while there has been some support for family therapy and cognitive± behavioral skills training, no treatment method has been demonstrated to be superior to other treatments for adoles- cents Henggeler, 1997; Landry, 1997; Williams and Chang, 2000). There is, however, support for multimodal programs that include family-based interventions, case management, skills training, and aftercare Henggeler, 1997; Weinberg, Rahdert, et al., 1998; Williams & Chang, 2000). A PSUD-treatment intervention for adolescents was designed on the basis of research and expert opinion Spooner, Mattick, et al., 1996). An assumption of the intervention was that it needed to address the multiple risk factors, protective factors, and consequences of substance abuse. To do this, the treatment program needed to be comprehensive, intensive, and longer-term. The intervention was a 3-month residential program followed by aftercare. It included assessment and case management, cognitive± behavioral skills training, individual and family counseling, a recreation program in a therapeutic community environ- ment. It was not a replication of an intervention of proven efficacy, so it was important to evaluate its effectiveness. The central question of the evaluation was whether participation in an intensive, comprehensive PSUD treat- ment program was associated with more positive outcomes than usual care. Comparison with usual care provided an investigation of what naturally happened to study partic- ipants who were not able to get into the intervention, and an assessment of whether the intervention was superior to the existing management options. The aim was to investigate the short- 3-month) and medium-term 6-month) effects of the intervention rela- 0740-5472/01/$ ± see front matter D 2001 Elsevier Science Inc. All rights reserved. PII:S0740-547201)00166-0 * Corresponding author. Tel.: +61-2-9310-0709; fax: +61-2-9399- 7143. E-mail address: c.spooner@unsw.edu.au C. Spooner). Journal of Substance Abuse Treatment 20 2001) 205±213