Assessing Covariates of Drug Use Trajectories Among Adolescents Admitted to a Drug Addiction Center: Mental Health Problems, Therapeutic Alliance, and Treatment Persistence

Abstract

This study aimed to assess covariates of drug use trajectories among 102 adolescents admitted to a drug user treatment program between November 2005 and November 2006 in Québec, Canada. The influences of mental health, therapeutic alliance, and treatment persistence were examined. The Addiction Severity Index was used to measure drug use severity and mental health problems; the California Psychotherapy Alliance Scales was used for therapeutic alliance. latent growth curve analysis showed associations between (1) mental health and initial drug use severity; (2) therapeutic alliance and initial drug use severity; and (3) number of post-treatment sessions attended and drug use severity over time.

RÉSUMÉ

Évaluation des covariables associées aux trajectoires d'usage de drogues parmi des adolescents admis à un centre de traitement en dépendances : problèmes de santé mentale, alliance thérapeutique et persévérance dans le traitement.

Cette étude a pour but d’évaluer les covariables associées aux trajectoires d'usage de drogues parmi 102 adolescents admis dans un programme de traitement de la dépendance entre novembre 2005 et novembre 2006, au Québec, Canada. L'influence de la santé mentale, de l'alliance thérapeutique et de la persévérance dans le traitement a été examinée. L'Indice de gravité d'une toxicomanie (version française de l’Addiction Severity Index) a été utilisé afin de mesurer la gravité de la consommation de drogues et les problèmes de santé mentale. Aussi, la version française du California Psychotherapy Alliance Scales a été utilisée pour mesurer l'alliance thérapeutique. L'analyse des courbes de croissance latente montrent des associations entre: (1) la santé mentale et la gravité initiale de la consommation de drogues; (2) l'alliance thérapeutique et la gravité initiale de la consommation de drogues; et (3) le nombre des séances post-traitement auxquelles les participants ont assisté et la gravité de la consommation de drogues au fil du temps.

Mots clés: Adolescence, dépendance, traitement, santé mentale, alliance thérapeutique, Trajectoires d'usage de drogues.

RESUMEN

Evaluación de las covariables asociadas a las trayectorias de consumo de drogas entre adolescentes admitidos en un centro de tratamiento de la toxicomanía: problemas de salud mental, alianza terapéutica y perseverancia en el tratamiento.

La presente investigación tiene como objetivo evaluar las covariables asociadas a las trayectorias de consumo drogas de 102 adolescentes admitidos en un programa de tratamiento de la toxicomanía en Quebec, Canadá, entre noviembre del 2005 y noviembre del 2006. Examinamos la influencia de la salud mental, la alianza terapéutica y la perseverancia en el tratamiento. La versión francesa del instrumento Addiction Severity Index fue utilizada con la finalidad de medir la gravedad del consumo de drogas y los problemas de salud mental. Además, la versión francesa del instrumento California Psychotherapy Alliance Scales fue utilizada para evaluar la alianza terapéutica. El análisis de curvas de crecimiento latente muestra asociaciones entre: (1) la salud mental y la gravedad inicial del consumo de drogas; (2) la alianza terapéutica y la gravedad inicial del consumo de drogas; y (3) el número de sesiones post-tratamiento a las cuales los participantes han asistido y la gravedad del consumo de drogas a lo largo del tiempo.

Palabras clave: Adolescencia, toxicomanía, tratamiento, salud mental, alianza terapéutica, trayectorias de consumo de drogas.

Keywords :

• adolescence
• addiction
• treatment
• mental health
• therapeutic alliance
• drug use trajectories

THE AUTHORS

Karine Bertrand, Professor at the University of Sherbrooke, Department of Community Health Sciences of the Medicine Faculty, is a Clinical Psychologist and Researcher. Her research activities cover two broad themes: understanding the factors influencing alcohol and drug use trajectories as well as evaluating the effectiveness of specially targeted programs. Her work contributes to the development of best practices in addiction intervention with youth and adults.

Natacha Brunelle, Ph.D. in Criminology, is a Full Professor in the Department of Psychoeducation at the Université du Québec à Trois-Rivières (UQTR) and holder of the Canadian Research Chair on Drug Use Patterns and Related Problems. She is also a regular researcher at the Group for Research and Intervention on Psychoactive Substances of Quebec (RISQ), the Centre Dollard-Cormier—-University Institute on Dependencies, and the Groupe de recherche et d'intervention sur l'adaptation psychosociale et scolaire (GRIAPS). Her fields of interest are mainly teenage drug use patterns, addiction rehabilitation trajectories, drug–crime relationships, and links between psychoactive substance use, delinquency, and gambling. She is also interested in psychoactive substance use in Canadian Inuit territories.

Isabelle Richer received both a Bachelor's degree with Honors and a Master's degree in Psychology from the University of Montreal. She also completed a Ph.D. in Social Psychology at the University of Montreal and a postdoctoral fellowship project at the Clinical Science Department of Sherbrooke University. She served as a research professional for the Research Chair in Drug addiction of Sherbrooke University. Her research interests include substance use and dependence, traffic safety, and homelessness.

Isabelle Beaudoin, Ph.D. in Criminology, is a scientific profesional for the Institut national d'excellence en santé et services sociaux. She coordinated Karine Bertrand's research projects at the University of Sherbrooke, Department of Community Health Sciences of the Medicine Faculty. She is interested in public health and public safety.

Annie Lemieux is a Statistician at the University of Sherbrooke, Department of Psychoeducation. She specializes in longitudinal statistical analysis.

Jean-Marc Ménard received a Master's degree in Clinical Psychology from the Université du Québec à Trois-Rivières (UQTR). He is a Clinical Coordinator at DOMREMY Mauricie—Centre-du-Québec, a treatment center for drug addiction. He has developed clinical expertise on concurrent disorders.

Notes

2 The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note.