Intervention Principles and Practice Guidelines for - Underage ...

• Presence and severity of psychological problems: If individuals have a concomitant psychological
problem, they should be placed in treatment programs that will address both the alcohol and
mental disorder. If the individual needs to be placed in separate programs for each problem
area, the treatment providers should be willing to work collaboratively to provide the person
with comprehensive and consistent care.
• Ethnic and gender considerations: Individuals may remain in treatment longer if most others in
the program are of the same gender and ethnic group. The ethnicity and gender of staff also
should be similar to that of the participants in the program.
• Family involvement: Effective programs should be able to develop working relationships with,
and gain the cooperation and participation of, family members.
Many treatment models have been developed; however, not all of them have been thoroughly
researched and found to be effective. Although more research is needed in every case, treatment
approaches that have been found to improve positive outcomes for adolescents include the following:
• Twelve-step approaches are highly structured programs that involve detoxification,
psychological evaluation, general and individualized treatment planning, group therapy,
lectures, and individualized counseling. Examples of this approach include the Minnesota
Model and Twelve-Step Facilitation. Group therapy is a key ingredient of this approach because
those who are further along in the recovery process pass on knowledge, experience, and values
to new people in the group. Participants are referred to Alcoholics Anonymous programs after
completing treatment to help stem the possibility of relapse.
• Therapeutic communities focus on re-socializing individuals with drug and alcohol problems.
Substance use disorders are viewed as symptoms of broader life problems. The treatment is
delivered in long-term residential settings in which peers and professionals emphasize that
individuals are responsible for their own addiction and recovery.
• Cognitive behavioral therapies are structured approaches that focus on individuals’ thoughts
and behaviors. Strategies include teaching individuals about the internal and external cues that
prompt them to drink. This is based on the theory that individuals’ beliefs and urges generate
their actions. Individuals learn coping strategies and skills to deal with problems they encounter
and prevent relapse.
• Family therapy includes several specific approaches and is based on the assumption that
alcohol use is influenced by a youth’s environment, including family, peers, and the community.
Treatment strategies include both individual and family therapy sessions through which
adolescents are helped to build essential skills, improve communication with their families, and
enhance coping mechanisms for dealing with stress. Sessions with parents address parenting
styles and focus on having a more positive influence on their children. Many programs combine
two or more of these approaches (Brannigan et al., 2004).
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