Bridging Disciplinary Boundaries (January 11 - 14, 2007)

Objective. The purpose of this study was to compare rural-urban differences on the efficacy of two drug treatment models for adolescents.

Method. Data were collected between February 2003 and December 2005 from adolescents who presented for a substance abuse evaluation at a centralized assessment center in eastern Iowa. Data were also collected from an eligible subset of those adolescents who agreed to participate in our longitudinal study.

Results. With the exception of minority status, significant rural-urban differences were not found for demographic characteristics and initial mental health measures. Although treatment was effective for both rural and urban participants, no rural-urban differences were found for treatment effectiveness. However, we found that rural clients were improving at about the same rate as urban clients, despite receiving significantly fewer hours of treatment.

Conclusion. Few studies have tested the efficacy of drug treatment with rural youth. This study not only examined outcomes of drug treatment with rural youth, but also compared those youth to their urban counterparts. We found that rural clients were improving at about the same rate as urban clients despite our knowledge that they are getting less treatment. Because rural culture typically promotes autonomy, future research might examine whether individual treatments in fact do benefit rural youth more than group treatment. Future research might also study the cost-benefit ratio: such treatments may cost more than group treatments to deliver due to higher staff to client ratios per service hour delivered, but they may lessen the time the youth needs to remain in treatment.

Implications for Policy and Practice. This study provides an important first step in examining drug treatment for rural youth. By comparing the efficacy of two drug treatment models with rural adolescents, this research may benefit practitioners in rural areas where drug treatment is needed. Because so few studies have been conducted on substance abuse treatment with rural youth, further research is needed to determine how rural youth respond to substance abuse treatment, treatment mechanisms that impede or enhance outcomes for rural youth, and best practices for rural youth in treatment.