Adolescent Substance Abuse: Progressive Treatment (ADAPT)

The purpose of this study is to find out more about how to provide effective further treatment for adolescents who have received six weeks of group therapy for substance-use problems and continue to use drugs. Treatments used in the study include a group therapy (MET/CBT), an individual therapy (CBT), and a family therapy (FFT). The study will look at whether abstinence or a very low level of use is a better guide for deciding whether further treatment is needed, how well different combinations of treatment work to reduce substance use, and whether it is possible to predict in advance which adolescents will respond best to which types of treatment. Study investigators expect that a treatment strategy using what is learned about these issues in the first half of the project to develop an "adaptive" treatment model will work better than a "fixed" treatment to reduce adolescent substance use.

• Behavioral: CBT, Cognitive Behavioral Therapy
  Eight weekly sessions of individual Cognitive Behavioral Therapy, to develop skills enabling adolescents stop or reduce their drug use.
• Behavioral: FFT, Family Functional Therapy
  Eight weekly sessions of Functional Family Therapy designed to strengthen family relationships and build skills to help the adolescent stop or reduce his/her drug use.

• Active Comparator: 1
  Eight weeks of individual CBT for adolescents who have completed six weeks of group therapy and continue to use drugs.
  Intervention: Behavioral: CBT, Cognitive Behavioral Therapy
• Active Comparator: 2
  Eight weeks of FFT for adolescents who have received six weeks of group therapy and continue to use drugs.
  Intervention: Behavioral: FFT, Family Functional Therapy

Inclusion Criteria:

1. 13 to 18 years if age
2. Meet DSM-IV (APA, 1994) diagnostic criteria for substance abuse or dependence
3. Live in the Albuquerque metropolitan area or surrounding communities
4. Sufficient residential stability to permit probable contact at follow-up (e.g., not homeless at time of intake).

Exclusion Criteria:

1. There is evidence of psychotic or organic state of sufficient severity to interfere with the understanding of study instruments and procedures
2. The adolescent is deemed dangerous to self or others during evaluation
3. Services other than outpatient treatment are required for the adolescent (e.g., inpatient, detoxification)
4. Marijuana use is reported as being less than 13% of days in the previous 90 days.