Feasibility of implementing the Adolescent Community Reinforcement Approach in school settings for adolescents with substance use disorders

Abstract

Nationally, approximately 10% of adolescents in need of treatment for a substance use (SU) disorder receive treatment. School-based treatment may provide an important opportunity to reduce the treatment gap by facilitating access to services. While some school-based SU treatment exists, little is known about whether newer, evidence-based treatments (e.g. Adolescent Community Reinforcement Approach [A-CRA]) can be well implemented in schools. The objectives of this study were to compare adolescents receiving A-CRA services in school-based versus clinic-based settings in regard to (1) intake characteristics, (2) treatment implementation quality, and (3) clinical outcomes. Results suggest that A-CRA in school-based settings was more likely to reach girls and youth with shorter SU histories; A-CRA was well implemented within school-based settings and the school-based group had equivalent or better outcomes than the clinic-based group.

Keywords::

• Adolescent Community Reinforcement Approach
• A-CRA
• school-based treatment
• substance use disorders
• adolescents

Acknowledgments

The authors wish to thank the SAMHSA Center for Substance Abuse Treatment grantees and their patients, and Stephanie Merkle for manuscript preparation. The opinions are those of the authors and do not reflect official positions of the contributing grantees' project directors or the federal government.

Additional information

Funding

Support for this study was provided by the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment [HHSS270201200001C, No. 270-12-0397] and by the National Institute on Alcohol Abuse and Alcoholism [R01 AA021118].