Abstract
BackgroundReducing substance use in youth is a global health priority. We compared two cohorts from the same 12-week residential substance use disorder (SUD) facility over a 10 year period: Cohort A (2008–2009) and Cohort B (2018–2020). The essential components of the program remained the same with the primary treatment being dialectical behaviour therapy (DBT) plus residential milieu.MethodsYoung people in the current Cohort B (N = 100) versus historical Cohort A (N = 102) had a similar ratio of males (74 vs. 70%) but were slightly older (mean 20.6 vs. 19.5 years). Linear mixed models were used to model outcome measures (global psychiatric symptoms, substance use severity, and quality of life) longitudinally up to 12 months later.ResultsBaseline to end-of-treatment comparisons showed that the current Cohort B had overall higher levels of global psychiatric symptoms (d = 0.70), but both groups reduced psychiatric symptoms (Cohort A: d = 1.05; Cohort B: d = 0.61), and had comparable increases in confidence to resist substance use (d = 0.95). Longitudinal data from the current Cohort B showed significant decreases in substance use severity from baseline to 6-month follow-up (d = 1.83), which were sustained at 12-month follow-up (d = 0.94), and increases in quality of life from baseline to end-of-treatment (d = 0.83).ConclusionsWe demonstrate how DBT plus milieu residential care for young people continues to show positive effects in a 10-year comparison. However, youth seeking treatment today compared to 10 years ago evidenced higher acuity of psychiatric symptoms reinforcing the importance of continuous improvement of psychological treatments.Trial registrationAustralian New Zealand Clinical Trials Registry: trial IDACTRN12618000866202, retrospectively registered on 22/05/2018, .
Highlights
Adolescence is a key developmental period in which neuromaturation influences changes across biological, psychological, and social spheres of the young person [1]
A small number of studies support the effectiveness of residential treatment for substance use disorder (SUD) in adult populations [8], but less is known about residential programs that cater to young people with SUD [9]
These broad psychosocial interventions may be beneficial when integrated in residential treatment for young people with SUD because a range of co-occuring mental disorders are very common in this population and difficult to treat, though integrated care represents the most effective form of treatment [11, 12]
Summary
Adolescence is a key developmental period in which neuromaturation influences changes across biological, psychological, and social spheres of the young person [1]. A small number of studies support the effectiveness of residential treatment for SUD in adult populations [8], but less is known about residential programs that cater to young people with SUD [9] Psychosocial interventions such as family-based therapies, cognitive behavioural therapy, motivational interviewing/motivational enhancement therapy, and third-wave cognitive behavioural therapies are effective for the treatment of young people with SUD [10]. These broad psychosocial interventions may be beneficial when integrated in residential treatment for young people with SUD because a range of co-occuring mental disorders are very common in this population and difficult to treat, though integrated care represents the most effective form of treatment [11, 12]. The essential components of the program remained the same with the primary treatment being dialectical behaviour therapy (DBT) plus residential milieu
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