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13 - Developmentally informed diagnostic and treatment considerations in comorbid conditions

from Part III - Comprehensive assessment and integrative treatment planning with adolescent substance abusers

Published online by Cambridge University Press:  26 August 2009

By
Elizabeth A. Whitmore  and
Paula D. Riggs
Edited by
Howard A. Liddle  and
Cynthia L. Rowe
Elizabeth A. Whitmore
Affiliation:
University of Colorado, School of Medicine Denver, CO, USA
Paula D. Riggs
Affiliation:
University of Colorado, School of Medicine Denver, CO, USA
Howard A. Liddle
Affiliation:
University of Miami School of Medicine
Cynthia L. Rowe
Affiliation:
University of Miami School of Medicine
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Summary

A burgeoning of research into child and adolescent substance use in the 1990s has significantly advanced our understanding of adolescent substance use disorders (SUDs) and of effective treatment approaches (Muck et al., 2001; Drug Strategies, 2003). Developmental research has demonstrated that adolescents who present for drug treatment have a broad range of behavioral problems, skills deficits, academic difficulties, and family and mental health problems, which have generally been shaped by a series of environmental adversities and biological vulnerabilities from early childhood (Dawes et al., 2000; Hops et al., 2000; Tarter, 2002; Tims et al., 2002). Developmental research has also supported the development of a number of manual-guided, behavioral, cognitive–behavioral, and family-based modalities that integrate treatment across multiple problem domains (Deas & Thomas, 2001; Muck et al., 2001; Riggs & Whitmore, 1999). A growing research and clinical consensus indicates that substance treatment is most effective when it attends to the multiple psychosocial problems and medical and mental health needs of adolescents in addition to their drug abuse. Such multimodal treatment, including the concurrent assessment and treatment of psychiatric comorbidity, is recommended by the leading research and clinical professional organizations in the field (AACAP, 1997; Drug Strategies, 2003; NIDA, 1999). Despite these recommendations, implementation of integrated treatment of comorbidity in substance treatment programs has lagged behind the integration of other treatment services owing to a number of barriers, including a lack of research evaluating the safety and efficacy of psychotropic medications in adolescents with SUD (Sohlkhah & Wilens, 1998).

Type
Chapter
Information
Adolescent Substance Abuse
Research and Clinical Advances
 , pp. 264 - 283
Publisher: Cambridge University Press
Print publication year: 2006

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