Purpose: The purpose of this study was to compare the efficacy of two approaches to adolescent drug treatment. Although group treatment has been the primary model of treatment for most drug treatment agencies, some data suggest that group treatment with some adolescents may lead to negative outcomes. Other research suggests that family therapy is the treatment of choice with many adolescents who have drug abuse problems.

Method: Project Iowa SCY (Strengthening Communities for Youth) was funded for 5-years by SAMHSA's Center for Substance Abuse Treatment. The purpose of this project was to expand and enhance adolescent drug treatment in a 2-county area of Eastern Iowa. In two years, over 500 adolescents have been assessed and over 140 have been recruited into a study of drug treatment. After a comprehensive assessment with the Global Appraisal of Individual Needs (GAIN-I), adolescents who need outpatient treatment are recruited into a longitudinal study comparing the Seven Challenges group treatment approach (Schweibel, 2003) and Strengths-Oriented Family Therapy (SOFT; Hall, et al., 2004). Voluntary participants were randomly assigned to one of these two treatment approaches and then followed over a 12-month period. At intake, we found no differences between adolescents in these two groups on key demographic characteristics (e.g., gender, age, ethnicity), mental health diagnoses and substance use disorders. As of April 2004, we can compare 38 teen participants in the Seven Challenges group treatment with 42 in the SOFT approach. Data reported here were taken from the initial GAIN-I and the follow-up version called the M-90. Other process and outcome data were collected but not reported here. So far the study has attained high follow-up completion rates and treatment integrity has been addressed. The sub-sample for this investigation is part of an overall sample comprised of participants who have completed their 3-month follow-up sessions. Data were analyzed using ordinal logistic and repeated measures regression.

Results: Repeated measures regression was used to evaluate changes in the dependent variables from intake to the 3-month follow-up and to compare outcomes between treatment groups at this same point. Overall, youth in both groups reported fewer drug related problems (substance problem severity scores) and less drug use (substance use frequencies). Youth in both groups reported significant decreases in marijuana use from intake to 3 months, but only youth receiving SOFT maintained these gains at the 6-month follow-up point. Youth who received SOFT also reported significant reductions in family problems at 3 months and again at 6 months following intake. Some differences were found within each group for specific youth and outcomes (i.e., gender, rural status, ethnicity and homeless status).

Conclusions: Based on these initial results, it appears that both treatment models lead to decreases in drug use by the 3-month point. Youth receiving SOFT family treatment did maintain gains for marijuana use at the 6-month point compared with youth receiving Seven Challenges, and they also reported improved relationships with family members. Additional research will determine if these results will hold up over time and if other effects are noted.