Differences in self-reported victimization and outcomes for residential (n=114) vs. outpatient (n=73) substance abuse treatment samples were examined. Repeated measures MANOVAs for victimization level by level of care were performed on days of alcohol and marijuana use and substance-related problems. Residential treatment participants reported higher prevalence of victimization and higher levels of general victimization but did not differ on acute (high) victimization at intake. Analyses revealed a significant interaction between follow-up outcomes and level of care for adolescents with acute intake victimization. Adolescents placed in residential treatment were more likely to reduce their days of alcohol and marijuana use and past month substance-related problems at follow-up. Adolescents with low intake levels of victimization did not differ by level of care. Findings suggest that clinicians must carefully weigh placement recommendations for adolescents with maltreatment histories and that researchers should study ways to increase outpatient treatment effectiveness for these adolescents.
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References
1.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
American Society of Addictive Medicine. (1996). Patient placement criteria for the treatment of psychoactive substance disorders (2nd ed.). Chevy Chase, MD: Author.
3.
Bandura, A. (1997a). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
4.
Bandura, A. (1997b). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.
5.
Berenson, A. B., San Miguel, V. V., & Wilkinson, G. S. (1992). Violence and its relationship to substance use in adolescent pregnancy. Journal of Adolescent Health, 34, 470-474.
6.
Blood, L., & Cornwall, A. (1996). Childhood sexual victimization as a factor in the treatment of substance misusing adolescents. Substance Use & Misuse, 31, 1015-1039.
7.
Cavaiola, A., & Schiff, M. (2000). Psychological distress in abused, chemically dependent adolescents. Journal of Child and Adolescent Substance Abuse, 10, 81-92.
8.
Chandy, J. M., Blum, R. W., & Resnick, M. D. (1996). History of sexual abuse and parental alcohol misuse: Risk, outcomes, and protective factors in adolescents. Child and Adolescent Social Work Journal, 13, 411-432.
9.
Clark, D. B., Lesnick, L. A., & Hegedus, A. M. (1997). Traumas and other adverse life events in adolescents with alcohol abuse and dependence. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1744-1751.
10.
DeLeon, G., Melnick, G., & Kressel D. (1997). Motivation and readiness for therapeutic community treatment among cocaine and other drug abusers. American Journal of Drug and Alcohol Abuse, 23(2), 169-189.
11.
Dembo, R., Dertke, M., LaVoie, L., Borders, S., Washburn, M., & Schmeidler, J. (1987). Physical abuse, sexual victimization and illicit drug use: A structural analysis among high risk adolescents. Journal of Adolescence, 10, 13-31.
12.
Dembo, R., Williams, L., Berry, E., Getreu, A., Washburn, M., Wish, E. D., et al. (1988). The relationship between physical and sexual abuse and illicit drug use: A replication among a new sample of youths entering a juvenile detention center. International Journal of the Addictions, 23, 1101-1123.
13.
Dennis, M. L. (1999). Global Appraisal of Individual Needs (GAIN): Administration guide for the GAIN and related measures. Bloomington, IL: Chestnut Health Systems. Retrieved from http://www.chestnut.org/LI/gain/Gadm1299.pdf
14.
Dennis, M. L., Babor, T. F., Diamond, G., Donaldson, J., Godley, S. H., Titus, J. C., et al. (2000). The Cannabis Youth Treatment (CYT) experiment: Preliminary findings. Rockville, MD: Center for Substance Abuse Treatment.
15.
Dennis, M. L., Babor, T. F., Roebuck, M. C., & Donaldson, J. (2002). Changing the focus: The case for recognizing and treating marijuana use disorders. Addiction, 97, 4-15.
16.
Dennis, M. L., Funk, R., Godley, S. H., Godley, M. D., & Waldron, H. (in press). Cross validation of the alcohol and cannabis use measures in the Global Appraisal of Individual Needs (GAIN) and Time Followback (TLFB; Form 90) among adolescents in substance abuse treatment. Manuscript submitted for publication.
17.
Dennis, M. L., Funk, R., McDermeit, M., Godley, M., Scott, C., Godley, S. H. (1998, January 10-15). Towards better placement and case mix adjustments in adolescent and adult substance abuse treatment systems. Paper presented at the Eighth International Conference on Treatment of Addictive Behavior, Sante Fe, NM.
18.
Dennis, M. L., Scott, C. K., Godley, M. D., & Funk, R. (1999). Comparisons of adolescents and adults by ASAM using GAIN data from the Drug Outcome Monitoring Study (DOMS): Preliminary data tables. Bloomington, IL: Chestnut Health Systems. Retrieved from http://www.chestnut.org/LI/Posters/index.html
19.
Dennis, M. L., Scott, C. K., Godley, M. D., & Funk, R. (2000). Predicting outcomes in adult and adolescent treatment with case mix vs. level of care: Findings from the Drug Outcome Monitoring Study. Journal of Drug and Alcohol Dependence, 60(1), S51.
20.
Dennis, M. L., & Titus, J. C. (2000, August). Patterns of adolescent substance dependence, abuse, and use. Paper presented at the 108th Annual Convention of the American Psychological Association, Washington, DC.
21.
Dennis, M. L., Titus, J. C., Diamond, G., Donaldson, J., Godley, S. H., Tims, F., et al. (2002). The Cannabis Youth Treatment (CYT) experiment: Rationale, study design, and analysis plans. Addiction, 97, 16-34.
22.
Deykin, E., & Buka, S. (1997). Prevalence and risk factors for posttraumatic stress disorder among chemically dependent adolescents. American Journal of Psychiatry, 154, 752-757.
23.
Foa, E. B., Keane, T. M., & Friedman, M. J. (2000). Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Distress. New York: The Guilford Press.
24.
Gil-Rivas, V., Fiorentine, R., & Anglin, M. D. (1996). Sexual abuse, physical abuse, and posttraumatic stress disorder among women participating in outpatient drug abuse treatment. Journal of Psychoactive Drugs, 28, 95-102.
25.
Godley, M. D., Godley, S. H., Dennis, M. L., & Funk, R. R. (2002). A randomized field trial of an assertive continuing care protocol for adolescents following discharge from residential treatment: Preliminary outcomes. Journal of Substance Abuse Treatment, 23, 21-32.
26.
Godley, M. D., Godley, S. H., Funk, R. R., Dennis, M. L., & Loveland, D. (2001). Discharge status as a performance indicator: Can it predict adolescent substance abuse treatment outcome? Journal of Child & Adolescent Substance Abuse, 11, 91-109.
27.
Godley, S. H., Godley, M. D., & Dennis, M. L. (2001). The assertive aftercare protocol for adolescent substance abusers. In E. Wagner & H. Waldron (Eds.), Innovations in adolescent substance abuse interventions. New York: Elsevier Science.
28.
Gutierres, S. E., & Todd, M. (1997). The impact of childhood abuse on treatment outcomes of substance abusers. Professional Psychology: Research and Practice, 28, 348-354.
29.
Harrison, P. A., Fulkerson, J. A., & Beebe, T. J. (1997). Multiple substance use among adolescent physical and sexual abuse victims. Child Abuse and Neglect, 21, 529-539.
30.
Harvey, E., Rawson, R., & Obert, J. (1994). History of sexual assault and the treatment of substance abuse disorders. Journal of Psychoactive Drugs, 26, 361-367.
31.
Hawke, J. M., Jainchill, N., & DeLeon, G. (2000). The prevalence of sexual abuse and its impact on the onset of drug use among adolescents in therapeutic community drug treatment. Journal of Child & Adolescent Substance Abuse, 9, 35-49.
32.
Hussey, D. L., & Singer, M. (1993). Psychological distress, problem behaviors, and family functioning of sexually abused adolescent inpatients. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 954-961.
33.
Jainchill, N. (1997). Therapeutic communities for adolescents: The same and not the same. In G. DeLeon (Ed.), Community as method: Therapeutic communities for special population and special settings (pp. 161-177). Westport, CT: Praeger/Greenwood.
34.
Jarvis, T., Copeland, J., & Walton, L. (1998). Exploring the nature of the relationship between child sexual abuse and substance use among women. Addiction, 93, 865-875.
35.
Kilpatrick, D. G., Acierno, R., Saunders, B., Resnick, H. S., Best, C. L., & Schnurr, P. P. (2000). Risk factors for adolescent substance abuse and dependence: Data from a national sample. Journal of Consulting & Clinical Psychology, 68, 19-30.
36.
Liebschutz, J. M., Mulvey, K. P., & Samet, J. H. (1997). Victimization among substance-abusing women: Worse health outcomes. Archives of Internal Medicine, 157, 1093-1097.
37.
Miller, W. R. (1996). A structured assessment interview for drinking and related behaviors (Project MATCH, Vol. 5, Test Manual). Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.
38.
Miller, W. R., & Del Boca, F. K. (1994). Measurement of drinking behavior using the form 90 family of instruments. Journal of Studies on Alcohol, 12, S112-S118.
39.
Mullen, P. E., Martin, J. L., Anderson, J. C., Romans, S. E., & Herbison, G. P. (1996). The long-term impact of the physical, emotional, and sexual abuse of children: A community study. Child Abuse & Neglect, 20, 7-21.
40.
Singer, M. I., Petchers, M. K., & Hussey, D. (1989). The relationship between sexual abuse and substance abuse among psychiatrically hospitalized adolescents. Child Abuse & Neglect, 13, 319-325.
41.
Titus, J. C., Dennis, M. L., White, W. L., Scott, C. K., & Funk, R. R. (2003). Gender differences in victimization severity and outcomes among adolescents treated for substance abuse. Child Maltreatment, 8(1), 19-35.
42.
Van Hasselt, V., Null, J., Kempton, T., & Bukstein, O. (1993). Social skills and depression in adolescent substance abusers. Addictive Behaviors, 18, 9-18.
43.
Walen, S. R., DiGuiseppe, R., & Dryden, W. (1992). A practical guide to rational-emotive therapy (2nd ed.). New York: Oxford University Press.
44.
White, W. L. (1996a). Pathways from the culture of addiction to the culture of recovery: A travel guide for addiction professionals (2nd ed.). Center City, MN: Hazelden.
45.
White, W. L. (1996b). Sexual trauma and substance abuse developmental trajectory and implications for treatment: The Project Safe experience (1986-1996). Bloomington, IL: Lighthouse Institute.
46.
Yankura, J., & Dryden, W. (1990). Doing RET—Albert Ellis in action. New York: Springer.
