Organizational Predictors and Use of Evidence-Based Practices in Adolescent Substance Abuse Treatment

ABSTRACT

Background: Adolescent substance abuse remains a significant problem in the United States, yet treatment centers do not always admit adolescent clients. In this paper, we first determine the extent to which treatment is available for adolescents in general and whether or not adolescent-specific (segregated) tracks are offered. Second, we examine the organizational characteristics associated with adolescent treatment. Third, we illuminate how the adolescent caseload in a treatment center is related to offering evidence-based practices (EBPs). Methods: Drawing upon a nationally representative sample of US treatment programs, we use logistic regression to assess how organizational characteristics are associated with the provision of adolescent treatment. Using ordinal logistic regression, we analyze how the treatment center's adolescent caseload and organizational characteristics affect the extent to which a treatment center offers medication-assisted treatment (MAT) and psychosocial treatment. Results: Half (49.5%) of treatment programs admitted adolescents, and 41.8% offered an adolescent-specific track. Findings from the logistic regression suggested several organizational characteristics that were significantly associated with treating adolescents and/or having an adolescent-only track. Our findings from the ordinal models indicated a negative relationship between the percent of adolescents in a treatment center and the extent of MAT, and a positive relationship between the percent of adolescent clients and the extent of psychosocial treatment offered. Conclusions: This paper highlights organizational barriers to treatment entry for adolescents, who remain a small proportion of clients in treatment centers. When treatment centers serve adolescents, however, those adolescents are likely to receive care in adolescent-only tracks and/or services and in programs that offer several psychosocial EBPs. Finally, adolescents are less likely to receive treatment in centers that offer a variety of MAT.

Keywords:

• Adolescent
• evidence-based practices
• medication-assisted treatment
• substance abuse
• treatment centers

AUTHOR CONTRIBUTIONS

All authors made substantial contributions to this paper. Maria Paino contributed to research conception and design, analysis and interpretation of results, writing, and revision. Lydia Aletraris contributed to research conception and design, collection of data, analysis and interpretation of results, writing, and revision. Paul Roman contributed to research conception and design, collection of data, and revisions.

Funding

This research was supported by the National Institute on Alcohol Abuse and Alcoholism (grant R01AA015974). The opinions expressed are those of the authors and do not reflect the official position of the funding agency. The authors report no conflicts of interest.