Residential Adolescent Substance Abuse Treatment: Recommendations for Collaboration between School Health and Substance Abuse Treatment Personnel
Wood, Ralph I., Drolet, Judy C., Fetro, Joyce V., Synovitz, Linda B., Wood, Angela R., Journal of School Health
Substance use and abuse represent major threats to the health of adolescents. (1-3) Adolescents who develop problems from use and abuse of substances often require treatment services? Between 1993 and 1998, the Substance Abuse and Mental Health Services Administration's Treatment Episode Data Set revealed more than 700,000 youth (a 45% increase) participated in drug and alcohol treatment services. In 1998, some 100,322 adolescents participated in residential and outpatient substance abuse treatment in the United States. (4)
Historically, adult substance abuse treatment programs served as the model for adolescent drug and alcohol treatment programs. Needs of substance abusing adolescents differ, however, from those of their adult counterparts. (5-9) Successful adolescent treatment not only must address substance use, but numerous other factors such as anger control, impulsivity, personal and social skills, and sexuality education. (5,8,9) Due to multiple problems facing adolescent substance abusers, a range of comprehensive, integrated services must be available including individual counseling, drug education, group therapy, family therapy, education services, and vocational training. (8,9)
The range of adolescent substance abuse treatment options represents a continuum of care that begins when youth are referred for residential treatment services and continues through discharge and return to school. Schools with coordinated school health programs (CSHP) can play an important role in the reintegration of youth into school. To assist returning students, CSHP personnel must understand the treatment process, skills youth should acquire while in treatment, and the need to collaborate with treatment personnel when youth leave treatment and return to school. (10)
While alcohol and drug treatment programs have existed for years, little qualitative research has examined the practices and procedures they involve. The purposes of this study were threefold: 1) to observe and analyze the goal and process of substance abuse treatment at one adolescent treatment center, the Generations Youth Program; 2) to identify opportunities for collaboration for school health personnel in the treatment process; and 3) to determine how school health personnel can support sobriety for at-risk youth.
METHODS A qualitative case study design was used for this study. A qualitative case study method works best when the research seeks an indepth exploration of an event, institution, or individual. (11)
The site for this study was a floor called the Upper Male Unit (UMU) at Generations Youth Program. The unit houses 24 young men, who range in age from 12 to 18 years, and are referred for services due to problems from drug and alcohol use. Admission criteria for services include a diagnosis of substance abuse or dependence, an age between 12 and 18 years, and willingness to participate in treatment. Generations also requires evidence of the client's inability to abstain from substance use without residential placement, medical clearance from a physician if the client takes medication, parental/guardian consent to treatment, and the identification of a funding source to pay for treatment. Cost for treatment is determined by a sliding scale fee based on the funding source (insurance, Medicaid), as well as the parent/guardian's income. Average length of stay for a client at Generations is four to six months.
When fully staffed, the Upper Male Unit employs 12 full-time and part-time staff including a treatment unit coordinator and four counselors. In addition to unit staff, the intake counselor, family therapist, registered nurse, and community teachers play significant roles in the clients' treatment at Generations.
This study used a multimethod data collection approach. Field observations, interviews, and an analysis of program documents were conducted to develop a comprehensive view of the overall treatment program. …