Problem Severity and Treatment Outcomes Among African American Youth Attending an Urban Intensive Outpatient Treatment Program: An Examination of Gender Differences

Background: Adolescent substance abuse continues to be identified as a major health concern which results in ongoing negative consequences.  Research has indicated that African Americans who engage in substance use experience those consequences at far greater levels than their non-Hispanic white counterparts.  Consistently, researchers have reported on the paucity of literature related to minority treatment outcomes.  At the same time, some of the same researchers advocate for the need to increase research that examines treatment related factors and needs of minority substance abusing adolescents. 

Purpose: This study was to examine gender differences in problem severity and treatment outcomes among a sample of African American youth who participated in an intensive outpatient program.   

Methods: Data was abstracted from an administrative database and consisted of individuals seeking outpatient treatment during the period of January 2010 to December 2012.  Clients were selected for analysis if they met the following criteria: (1) African American, (2) Ages 13-20, (3) indicated marijuana as primary drug of choice (4) and had complete intake and discharge information. Records were reviewed for duplicity based on client identification number.  1,152 valid records were used in this analysis. Problem severity and treatment outcomes (retention and completion status) measures were compared by gender using chi-square and independent sample t-tests. Multivariate logistic regression was used to identify independent associations between gender and treatment outcomes controlling for other variables.

Results: Females accounted for 17.5% of the sample with an overall mean age of 16.27 years.  Sample make-up included: referral by criminal justice system (52.5%), 62% reported past or current legal involvement, 37.1% reported current or past psychiatric co-morbidity, and 49.8% reported no previous treatment.  Overall, females within this sample reported higher rates of treatment completion (40.1%) compared to males (25.4%) (p=.002).  Moreover, females were retained longer in treatment (30 days, p=.047 & 60 days, p=.05).  In regards to problem severity, females reported higher severity in the mild and moderate use categories (10.4 and 32.4 percent respectively) but lower in the severe use category (55.4%).  This finding was not statistically significant however was approaching significance (p=.08) and warrants further research.  

Conclusions: The findings from this study expand the literature on the importance of enhancing treatment retention for African American youth with multiple treatment needs.  More specifically, culturally sensitive treatment interventions should be specifically tailored to increase treatment retention for both males and females among this population.  Consistent with existing research individuals with higher problem severity and less legal involvement have been identified as individuals where retention rates could be problematic.   

Implications: These findings present opportunities for social work program administrators and directors in the development of culturally sensitive treatment programs for African American youth.  Given that research has demonstrated increased treatment retention as highly associated with positive post-treatment outcomes, it is equally important to monitor trends in treatment dropout and develop early intervention procedures to ensure treatment retention.