The Effectiveness of Substance Abuse Treatment with Young Offenders

Executive Summary

Previous research has demonstrated that substance abuse is a key need area for young offenders and contributes to their criminal activity. The negative impacts of this problem behaviour are not only limited to delinquency but are also evident in several other important behavioural areas for the adolescent including academics, peer group involvement, and family relationships.

Given the strong relationship between substance abuse and delinquency, many academics and practitioners alike have focused on developing effective treatment programs. The extant literature has identified several key areas that affect the therapeutic potential of these types of programs for adolescent substance abusers and include: pre-treatment factors, in-treatment factors, and post-treatment factors.

Pre-treatment factors are essentially equivalent to client characteristics such as age, gender, and race/ethnicity and are important treatment considerations as they may affect program content and/or delivery style. The advantage of designing gender- and/or racial-specific treatment is that it will increase the relevance of the program to these youth, thereby maximizing client retention and enhancing program performance. In addition, certain variables from this set of pre-treatment factors have been found to affect client outcome in substance abuse treatment. For example, underlying psychopathology is one of the strongest predictors of program attrition and poor performance.

In-treatment factors correspond to issues surrounding the process of program administration, including program content and delivery aspects as well as more external considerations such as the organizational environment in which the program is delivered. In terms of program content and delivery variables, the literature clearly illustrates that in order for substance abuse treatment to be effective, it should target the multiple need areas of youthful offenders, including family, academic, and peer problems, while incorporating elements of relapse prevention. In addition, research has demonstrated quite strongly that the program should employ behavioural/cognitive-behavioural methods to impart program content to the clients. In terms of key organizational variables, it is strongly recommended that programs should be delivered in community as opposed to residential settings and attend to various indicators of program integrity such as appropriate training and monitoring of program staff.

Post-treatment factors represent those areas that can be targeted by criminal justice agencies once the client has left the program. Two of the most important are the provision of aftercare services to the youth and identifying and enhancing protective factors. The few studies that have explored the effectiveness of aftercare services within a correctional population have shown mild reductions in re-offending, but this conclusion is tempered by the limited amount of available data. Unfortunately, none of the young offender literature reviewed for this report studied the impact of protective factors on correctional treatment outcome.

Several other concerns have been raised in the literature when dealing with substance abusing young offenders. Program dropout is quite high within this population and researchers have made several solid recommendations in order to address this problem area. HIV/AIDS is another critical health issue, both for the offender and the outside community to which he or she returns. Given the high levels of HIV/AIDS in correctional populations, and the fact that young offenders are even more at risk than their adult counterparts, ensuring that comprehensive and systematic programming in this area is of paramount importance.

One of the key debates that has been staged in the substance abuse treatment literature is how to define an effective program. More specifically, given the multiple areas that are affected by substance abusing behaviour, it has been extremely difficult for researchers to agree on a single or comprehensive set of program success indicators. Several recent efforts have attempted to address this problem area and have focused on the methodological criteria used in the evaluation, as well as the outcomes measured by the program. Concomitantly, these recommendations suggest that programs should use classical experimental designs utilizing the most stringent controls as well as measuring the impacts of the program across many different areas including physical, emotional, and behavioural outcomes.

There are several clear directions for future research, which would touch several of the different areas mentioned within this report. One particularly important research project would be to conduct a series of focus groups with young offenders across Canada to determine the factors that are linked with their substance abusing and criminal behaviour, and more importantly, identify potentially motivating and de-motivating factors that affect their involvement in treatment. An additional line of scientific inquiry would be to explore the presence of strength or protective factors in this group of adolescents and explore how these may be more appropriately incorporated into the treatment protocol.

Finally, based on the entire literature reviewed for this report, this paper concludes with a checklist that can be used by program administrators to develop effective substance abuse programming.

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