STRENGTHSBASED TREATMENT:

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STRENGTHS-BASED TREATMENT

• From Case Management to Family Therapy

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Objectives for Today

• Describe four strengths-based approaches for
  treatment of adolescent drug abuse.
• Describe the active ingredients for each
  intervention model.
• Evaluate the evidence (or lack thereof)
  supporting each approach.
• Propose future applications and research.

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Presenters

• James A Hall, PhD, LISW, University of Iowa
• Julie K Williams, LMSW, University of Iowa
• Douglas C Smith, LMSW, University of Iowa
• Michael Mason, PhD, Georgetown University
• Brad Richardson, PhD, University of Iowa
• Jerry Flanzer, PhD, National Institute on Drug
  Abuse (discussant)

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Agenda

• Introduction to key concepts
• adolescence,
• drug use and abuse,
• Strengths-based drug treatment.
• Group treatment with teens only
• Case management for individual teens
• Family treatment with teens parents
• Community strengthening

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What is Adolescence?

• Ages 10-23 years (WHO)
• Onset of puberty average age
• girls 11,
• boys 13.
• Average age of onset of puberty has decreased 4
  months per decade since 1900 still true? Why?
• Implications of this decrease for developmental
  needs such as independence what is biologic and
  what is cultural?

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Stereotypes and Adolescence

• Storm stress theory
• Needs of individuation
• Pressure to be independent
• Time of raging hormones
• Others?
• So, what is TRUE about adolescence? (follow the
  data)

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DefinitionsLevels of Drug Use

• Abstinence Is this possible in todays society?
• Drug use or social use Can this be true for
  adolescents? Legal constraints.
• Drug abuse Problems due to use. (What makes a
  problem a problem?)
• Addiction Chronic disorder with remissions and
  relapses like any chronic disease.

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Prevalence of Teen Drug Use

• Cant cover all substances
• See Monitoring the Future website
• Today, we examine rates of so-called Gateway
  drugs
• Marijuana
• Alcohol
• Cigarettes (tobacco)

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FIGURE 1 Trends in Annual Prevalence of an
Illicit Drug Use Index
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ASAM Levels of Severity

• 0.5 Early Intervention
• 1.0 Standard Outpatient Treatment
• 2.1 Intensive Outpatient Treatment
• 3.0 Residential Treatment
• (Beyond 3.0, more intensive treatment for
  adolescents probably does not exist.)

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DSM-IV Diagnosesby Substance Type

• Drug type Abuse
• Drug type Dependence
• Diagnoses do not always match up with ASAM
  severity levels.
• Impact of Co-Occurring Disorders

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So, What about Treatment?

• Who needs drug treatment?
• Why?
• Who thinks so?
• Treatment model versus active ingredients
• Matching clients with treatment model and/or
  active ingredients?
• Use of Evidence-based Treatment?
• What is evidence?

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Strengths-Based Treatment

• What makes treatment strengths-based?
• Are problems ignored?
• Is training necessary for SB treatment?
• What is a strength?

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Definition of Evidence

• Ask counselors from drug treatment agency
• Ask administrators of drug treatment agencies
• Ask state government staff
• Ask researchers

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Leshner, 1/14/05

• The plural of anecdote is not evidence.

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And now, the featured presentations.

• Strengthening Communities
• SB Group treatment using MET/CBT
• Case management using SB procedures
• Strengths-Oriented Family Therapy
• Discussion