The quality of highly regarded adolescent substance abuse treatment programs - Results of an in-depth national survey
The quality of highly regarded adolescent substance abuse treatment programs - Results of an in-depth national survey
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DOI：
10.1001/archpedi.158.9.904
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发表时间：
2004-09-01
影响因子：
--
通讯作者：
Millman, RB
中科院分区：
文献类型：
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作者：
Brannigan, R;Schackman, BR;Millman, RB
背景：药物和酒精滥用和依赖是美国青少年发病和死亡的最普遍原因。存在药物滥用问题的青少年迫切需要有效、易于获得的治疗。目的：对美国备受推崇的青少年药物滥用治疗项目的质量进行首次系统评估。方法：由 22 名专家组成的咨询小组根据文献回顾，确定了青少年药物滥用有效治疗的 9 个关键要素。对小组成员以及公共和私人机构确定的 144 个备受推崇的青少年药物滥用治疗项目进行了深入的电话和书面调查。初次访谈的回复率为 100%，后续调查的回复率为 65%。开放式调查回复通过定义 5 个被认为对解决 9 个关键要素至关重要的组成部分进行编码，并计算 9 个关键要素中每一个的整体质量分数。结果：在 45 分的可能总分中，平均分为 23.8，中位数为 23。前四分之一的项目获得认证的可能性并不大。大多数项目在 9 个关键要素（合格的员工）中仅获得了 1 个要素，得分至少为 4 分（满分 5 分）。质量最差的要素是评估和治疗匹配、吸引和保留青少年参与治疗、性别和文化能力以及治疗结果。结论：我们调查的大多数备受推崇的项目都没有充分解决有效的青少年药物滥用治疗的关键要素。最关键的需求包括扩大标准化评估工具的使用、提高吸引和留住年轻人的能力、更加关注性别和文化能力以及加大对治疗结果科学评估的投资。提高对治疗青少年的有效要素的认识将有助于改善方案。
Background: Drug and alcohol abuse and dependence are the most prevalent causes of adolescent morbidity and mortality in the United States. Effective, accessible treatment for adolescents with substance abuse problems is urgently needed.Objective: To conduct the first systematic evaluation of the quality of highly regarded adolescent substance abuse treatment programs in the United States.Methods: An advisory panel of 22 experts defined 9 key elements of effective treatment for adolescent substance abuse based on a review of the literature. In-depth telephone and written surveys were conducted with 144 highly regarded adolescent substance abuse treatment programs identified by panel members and by public and private agencies. There was a 100% response rate to the initial interviews, and a 65% response rate to the follow-up surveys. The open-ended survey responses were coded by defining 5 components deemed to be crucial in addressing each of the 9 key elements, and quality scores were calculated overall and for each of the 9 key elements.Results: Out of a possible total score of 45, the mean score was 23.8 and the median was 23. Top-quartile programs were not more likely to be accredited. The majority of programs scored at least 4 of a possible 5 on only I of the 9 key elements (qualified staff). The elements with the poorest-quality performance were assessment and treatment matching, engaging and retaining teens in treatment, gender and cultural competence, and treatment outcomes.Conclusions: Most of the highly regarded programs we surveyed are not adequately addressing the key elements of effective adolescent substance abuse treatment. Expanded use of standardized assessment instruments, improved ability to engage and retain youths, greater attention to gender and cultural competence, and greater investment in scientific evaluation of treatment outcomes are among the most critical needs. Expanding awareness of effective elements in treating adolescents will lead the way to program improvement.