Abstract: Comparing Three Substance Use Interventions for Youth with and without Homelessness Experiences Prior to Treatment (Society for Social Work and Research 26th Annual Conference - Social Work Science for Racial, Social, and Political Justice)

Schedule:

Saturday, January 15, 2022

Liberty Ballroom N, ML 4 (Marriott Marquis Washington, DC)

* noted as presenting author

Graham DiGuiseppi, ScM, PhD Student, University of Southern California, Los Angeles, CA

Jordan Davis, PhD, Assistant Professor, University of Southern California, Los Angeles, CA

John Prindle, PhD, Research Faculty, University of Southern California, Los Angeles, CA

Joan Tucker, PhD, Senior Behavioral Scientist, RAND Corporation, Santa Monica, CA

Eric Rice, PhD, Associate Professor, University of Southern California, Los Angeles, CA

Benjamin Henwood, PhD, Assistant Professor, University of Southern California, Los Angeles, CA

Stanley Huey, PhD, Associate Professor, University of Southern California, Los Angeles, CA

Background and Purpose: Adolescents and young adults receiving substance use treatment have experienced or are at risk for homelessness. However, it is unknown whether specific treatment approaches are more effective for youth experiencing homelessness (YEH), versus stably housed youth. The current study compared the effectiveness of the Adolescent Community Reinforcement Approach (ACRA), Motivational Enhancement Therapy combined with Cognitive Behavioral Therapy (MET/CBT), and Treatment as Usual (TAU) for these two groups. Further subgroup differences were investigated by age, sex, and sexual and gender minority status.

Methods: YEH (n = 855) and a matched sample of stably housed youth (n = 855) were drawn from the Global Appraisal of Individual Needs, a comprehensive clinical assessment used for treatment monitoring and evaluation at U.S. treatment sites from 2002-2010. Propensity weighting and multiple-group latent change score modeling was used to examine change in substance use frequency and related problems at baseline, 3, 6, and 12-month follow-ups.

Results: Results indicated significant declines in substance use frequency and problems during treatment for all intervention groups. YEH and stably housed youth in the TAU group showed the greatest declines in substance use problems during treatment, and the greatest declines in substance use frequency post-treatment. Compared to stably housed youth, YEH entered treatment with greater substance use frequency and problems, and had greater declines in substance use frequency in the MET/CBT group only. Other differences were found by age and sex.

Conclusions and Implications: Overall, all three substance use interventions appear to be effective in reducing substance use and related problems for YEH and stably housed youth. This demonstrates the importance of removing barriers to treatment for YEH, who may enter treatment with more severe substance use disorders than stably housed youth. Furthermore, TAU and MET/CBT may be particularly effective for YEH in treatment settings.