Sunday, 16 January 2005 - 10:15 AM

This presentation is part of: Interventions for Adolescent Drug Abuse: Individual, Group, Family and Community Approaches

Case Management with Individual Adolescents as Drug Treatment

Objective The objective of this study was to evaluate the effectiveness of case management with individual adolescents to improve outcomes.

Method A classical experimental design was used to examine the impact of case management (CM) on four functional areas known to be associated with problematic substance use behavior (mental health, family relations, peer relations, aggressive behavior/delinquency). The sample was 292 adolescent women, ages 14-19 years, who had an increased susceptibility to multiple health, social, emotional, and developmental problems as defined by the Problem Oriented Screening Instrument for Teens (POSIT). Participants were randomly assigned to either receive case management or not. CM consisted of 16 weekly sessions with a master’s level social worker who used a primary-therapist as case manager model of case management. CM was manualized such that case managers were trained to use a cognitive-behavioral ideology and to focus their interactions with participants on areas of social functioning that contributed to or maintained substance use behavior, as well as on ameliorating the effects of substance use in participants lives. Participants were Assessed at four points through out the study, once before the intervention, once immediately after the intervention, and at 3-month and 12-month follow-ups. Five domains of mental health were assessed (anger, anxiety, depression, self-esteem and locus of control) along with family cohesion and adaptability, parent-child communication, peer relations, and aggressive behavior/delinquency, using standardized assessment instruments. A repeated measures multivariate analysis of variance was conducted with treatment condition treated as the between-subject factor, and functional domains (anger, anxiety, depression, self-esteem and locus of control, family cohesion and adaptability, parent-child communication, peer relations, and aggressive behavior/delinquency) as within-subject factors.

Results Participants assigned to the CM condition reported greater improvements in depression, self–esteem, peer relations and aggressive behavior/delinquency than participants not assigned CM.

Conclusion Adolescents with increased susceptibility to multiple health, social, emotional, and developmental problems have a higher risk for problems with substance use than their peers who do not have an increased susceptibility. These adolescents also are not as likely to be deterred by broad-based intervention efforts. Comprehensive interventions targeted to their special needs may be essential to preventing and/or reducing their high rates of substance use problems. CM is a promising intervention for such targeted groups.

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