Adolescent Treatment Services: Young Adult Outcomes

描述（由申请人提供）： 1995年至1998年期间，12至17奥尔兹接受公共资助的药物滥用治疗的人数增加了46%。这一增长几乎全部归因于刑事司法系统的移交。治疗可能会减少犯罪青少年在成年早期出现社会和行为问题的高风险，但治疗服务对青少年的长期影响目前尚不清楚。我们的目标是评估青少年治疗对成年早期观察到的关键结果的影响，这是一个关键的发展时期，在此期间，许多人停止了各种问题行为，而另一些人则建立了终生的吸毒，犯罪和经济功能低下的模式。我们将研究治疗对药物问题，艾滋病毒风险行为，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。长期的结果将有效地研究，利用正在进行的研究违法青年（N=449）谁已被随访长达30个月后，转介缓刑无论是住宅药物治疗计划（凤凰学院）或住宅组家庭，是减少药物使用和其他问题的有效性较低。我们建议在参与者初次访谈后的66、78、90和102个月进行四次额外的调查波。测试从物质使用和服务利用的发展理论得出的假设，我们将：1）估计凤凰学院治疗对关键结果的影响程度，相对于非凤凰学院治疗的影响程度，随着青少年进入青年期; 2）估计在青年期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对这些发展转变的影响介导的关键结果有间接影响; 3）估计凤凰学院治疗对后来物质滥用治疗利用的相对影响，并测试是否有任何这样的影响是由客户认知介导的治疗服务或药物滥用; 4）识别结果轨迹的多变量潜在类别;表征与每个类别相关的服务利用和经济功能模式;并估计相对凤凰学院治疗效果之间的关联潜在类和服务利用和经济功能。

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.