What is Evidence-Best Substance-Abuse Treatment for Boys?

"Unfortunately, no one can be told what The Matrix is. You have to see it for yourself."

Neo, from The Matrix

Fortunately, a matrix of another sort can be told about...the Matrix of Evidence-based Practices for Substance Abuse Disorders, a database developed by the University of Washington's Alcohol and Drug Abuse Institute. Among those "practices" outlined in this matrix are the best of the best evidence-based substance-abuse treatments for adolescents, whether they be male or female. These treatment approaches have empirically demonstrated they are the "go to" interventions in the world of substance-abuse therapy.

Treatments for General Substance Abuse

Behavioral Therapy for Adolescents

Behavioral Therapy for Adolescents operates on the principle that unwanted behavior can be changed by a clear demonstration of the desired behavior and consistent reward of incremental steps toward achieving it. Therapeutic activities include completing specific assignments, rehearsing desired behaviors, and recording and reviewing progress, with praise and privileges given for meeting assigned goals. This therapy aims to equip the patient to gain three types of control: Stimulus Control, Urge Control, and Social Control. Such favorable results are attributed largely to including family members in therapy and rewarding drug abstinence as verified by urinalysis.1

Brief Strategic Family Therapy

Brief Strategic Family Therapy (BSFT) is an intervention used to treat adolescent drug use that occurs with co-occurring problem behaviors. These extra problem behaviors include conduct problems at home and at school, oppositional behavior, delinquency, associating with antisocial peers, aggressive and violent behavior, and risky sexual behavior. The goal of BSFT is to eliminate or reduce the adolescent's use of drugs and associated problem behaviors and to change the family interactions that are associated with the adolescent's drug abuse.1

Multisystemic Therapy

Multisystemic Therapy (MST) addresses the factors associated with serious antisocial behavior in children and adolescents who abuse drugs. These factors include characteristics of the adolescent (for example, favorable attitudes toward drug use), the family (poor discipline, family conflict, parental drug abuse), peers (positive attitudes toward drug use), school (dropout, poor performance), and neighborhood (criminal subculture). By participating in intense treatment in natural environments (homes, schools, and neighborhood settings) most youths and families complete a full course of treatment. 1

Node-Link Mapping

Node-Link Mapping involves counselor and client in the development of visual representations, or maps, of issues that emerge in substance abuse treatment. Drawing a map or diagram can help clients see and understand relationships between their actions and consequences and can help them express complex relationships and parallel ideas that are difficult to verbalize. Maps can also be used as communication aids for group and individual discussions. The counselor leads the client through the first mapping process by asking a series of questions and then drawing the answers in the form of a schematic or map. 1

Seeking Safety

Seeking Safety is a present-focused therapy to help people attain safety from co-occurring PTSD and substance abuse. This approach was designed for use in group and individual format; for women, men, and mixed-gender; for adolescents; using all topics or fewer topics; in a variety of settings (e.g., outpatient, inpatient, residential); and for both substance abuse and dependence. It has also been used with people who have a trauma history but do not meet criteria for PTSD. 1

Treating Alcohol Abuse

Brief Intervention

Through a person's primary care practitioner, alcohol problems can be screened and brief interventions referred to on the spot. Brief interventions target persons drinking excessively but not yet experiencing major problems. The aim of the intervention is to convince the drinker that they are drinking at levels that could be harmful to their health and encourage them to reduce consumption to sensible limits. Such intervention is generally restricted to four or fewer sessions, each session lasting from a few minutes to one hour. 1

Treating Cannabis Abuse

Family Support Network

The Family Support Network (FSN) intervention seeks to extend the focus of treatment beyond the world of the adolescent by engaging the family. The FSN process is a family intervention designed to be used in conjunction with any standard adolescent treatment approach. 1

Cannabis Youth Treatment

Cannabis Youth Treatment (CYT) adapts promising adolescent treatments for use in clinical practice for adolescent marijuana users seeking outpatient treatment. Those treatment approaches include: Motivational Enhancement Therapy (MET) combined with Cognitive-Behavioral Therapy (CBT), Family Support Network (FSN), Adolescent Community Reinforcement Approach (ACRA), and Multidimensional Family Therapy (MDFT). 1

Motivational Enhancement Therapy and Cognitive Behavior Therapy

This treatment is designed for adolescents between ages 12 and 18 exhibiting one or more of the following: meeting criteria for cannabis abuse or dependence; experiencing problems (emotional, physical, legal, social, academic) associated with marijuana use; evidencing frequent (weekly or more often) marijuana use over a three-month period.1

Treating Tobacco Addiction

Combined Scheduled Reduced Smoking and Cognitive Behavior Therapy

Scheduled reduced smoking is a procedure where smokers are instructed to smoke only at specific times of the day and the interval between cigarettes is progressively lengthened, thereby gradually reducing their total daily intake of nicotine. This procedure has been combined with cognitive behavior therapy. 1

Matrix Intensive Outpatient Program for Stimulant Abuse

The Matrix Model provides a framework for engaging stimulant abusers in treatment and helping them achieve abstinence. The therapist functions simultaneously as teacher and coach, fostering a positive, encouraging relationship with the patient and using that relationship to reinforce positive behavior change. The interaction between the therapist and the patient is realistic and direct but not confrontational or parental. 1

Poly-drug Use Therapy

Multidimensional Family Therapy

Multidimensional Family Therapy (MDFT) for Adolescents is an outpatient family-based drug abuse treatment for teenage substance abusers. From the perspective of MDFT, adolescent drug use is understood in terms of a network of influences (i.e., individual, family, peer, community). This multidimensional approach suggests that reductions in target symptoms and increases in prosocial target behaviors occur via multiple pathways, in differing contexts, and through different mechanisms. The treatment format includes individual and family sessions. 1

1 "Evidence-based Practices Substance Abuse Database," University of Washington's Alcohol and Drug Abuse Institute.

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