Adolescent Treatment Services: Young Adult Outcomes

描述(由申请人提供)： 1995年至1998年间，接受公共资助的药物滥用治疗的12至17岁青少年人数增加了46%。几乎所有这一增长都归因于刑事司法系统的转介。治疗可能会降低犯罪青少年在青年期出现社会和行为问题的高风险，但针对青少年的治疗服务的长期效果目前尚不清楚。我们的目标是评估青春期治疗对青年时期观察到的关键结果的影响，青年时期是许多人停止各种问题行为的关键发育时期，而其他人则建立终生吸毒、犯罪和经济运行不佳的模式。我们将审查治疗对毒品问题、艾滋病毒危险行为、健康、犯罪活动、卫生服务利用、心理社会和经济功能以及发展转型的影响。通过利用对犯罪青年(N=449)进行的一项正在进行的研究，将有效地研究长期结果。这些青少年通过缓刑被转介到住宅药物治疗计划(菲尼克斯学院)或在减少药物使用和其他问题方面效果较差的住宅团体之家后接受长达30个月的跟踪调查。我们建议在参与者最初面谈后的66、78、90和102个月内进行四次额外的调查。通过检验物质使用和服务利用的发展理论得出的假设，我们将：1)估计随着青少年进入青年期，凤凰学院治疗对关键结果的影响的大小，相对于非凤凰学院治疗的影响；2)估计青年成年期间特定的理论上重要的发展转变对关键结果的影响，并测试凤凰学院治疗是否通过其对这些发展转变的影响而间接影响关键结果；3)估计相对的凤凰学院治疗对后来的药物滥用治疗的利用的影响，并测试是否有任何这种影响是通过客户对治疗服务或药物滥用的认知来调节的；4)确定结果轨迹的多变量潜在类别；描述与每一类相关的服务利用和经济功能模式；并估计潜在类与服务利用和经济功能之间的关联的相对凤凰学院治疗效果。

DESCRIPTION (provided by applicant): Admissions of 12 to 17-year olds to publicly funded substance abuse treatment rose by 46 percent between 1995 and 1998. Nearly all of this growth was attributable to referrals by the criminal justice system. Treatment might reduce delinquent adolescents' otherwise high risk of social and behavioral problems in young adulthood, but the long-term effects of treatment services for adolescents are currently unknown. Our objective is to assess the effects of adolescent treatment on key outcomes observed during young adulthood, the critical developmental period during which many people discontinue a variety of problem behaviors, while others establish lifelong patterns of drug use, crime and poor economic functioning. We will examine treatment effects on drug problems, HIV risk behaviors, health, criminal activity, health service utilization, psychosocial and economic functioning, and developmental transitions. Long-term outcomes will be efficiently studied by capitalizing on an ongoing study of delinquent youths (N=449) who have been followed for up to 30 months after referral by Probation to either a residential drug treatment program (Phoenix Academy) or to residential group homes that were less effective in reducing drug use and other problems. We propose four additional survey waves conducted 66, 78, 90, and 102-months after participants' initial interviews. Testing hypotheses drawn from developmental theories of substance use and service utilization, we will: 1) estimate the magnitude of Phoenix Academy treatment effects on key outcomes, relative to those of non-Phoenix Academy treatment, as youths enter young adulthood; 2) estimate the effect of specific theoretically important developmental transitions during young adulthood on key outcomes, and test whether Phoenix Academy treatment has an indirect effect on key outcomes mediated by its effect on these developmental transitions; 3) estimate the relative Phoenix Academy treatment effect on later substance abuse treatment utilization, and test whether any such effect is mediated by client cognitions regarding treatment services or substance abuse; 4) identify multivariate latent classes of outcome trajectories; characterize the service utilization and economic functioning patterns associated with each class; and estimate the relative Phoenix Academy treatment effect on the associations between latent classes and service utilization and economic functioning.