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Adolescent Treatment Outcomes
Journal of Adolescent Research (2001)   

Grella, C. E., & Hser, Y. (Guest Eds.) (2001).  Special issue on Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A).  Journal of Adolescent Research, 16(6), 537-696.

1)  Fletcher, B. W., & Grella, C. E. (2001).  Preface to the JAR special issue:  The Drug Abuse Treatment Outcome Studies for Adolescents.  Journal of Adolescent Research, 16(6), 537-544.

2)  Kristiansen, P. L., & Hubbard, R. L. (2001).  Methodological overview and research design for adolescents in the Drug Abuse Treatment Outcomes Studies (DATOS-A).  Journal of Adolescent Research, 16(6), 545-562.

Abstract:  The adolescent component in Drug Abuse Treatment Outcome Studies (DATOS) was the first designed specifically to conduct an in-depth, systematic investigation of the outcomes and effectiveness of drug treatment programs for adolescents.  This national study included 3,382 participants who presented for treatment from 1993 to 1995 in 37 therapeutic community, inpatient and outpatient programs in Pittsburgh, Miami, Minneapolis, Chicago, Portland (OR), and New York City.  This article gives an overview of the study methodology.  The sample of programs was selected to reflect the nature of treatment available to adolescents in these six urban areas.  The design, content and quality of interview protocols, modified from the adult instruments, and conducted at admission, during treatment, and 12 months after termination of treatment, are described.  Data collection procedures and the completion rates for each of the phases of interviewing are discussed.  The potential utilization of the data for clinical and policy guidance is outlined.

3)  Etheridge, R. M., Rounds-Bryant, J. L., Smith, J. C., & Hubbard, R. L. (2001).  Drug abuse treatment and comprehensive services for adolescents.  Journal of Adolescent Research, 16(6), 563-589. 

Abstract:  Data from two national studies of treatment spanning two decades—Treatment Outcome Prospective Study (TOPS), 1979 to 1981, and Drug Abuse Treatment Outcome Studies for adolescents (DATOS-A), 1993 to 1995—provided a comparison of treatment and services provided to 261 TOPS and 1,519 DATOS-A intreatment adolescent patients in a cross-modality sample of 24 TOPS and 31 DATOS-A programs.  The authors used patient self-reports of treatment needs and services received to compare unmet needs for six services.  Findings showed a general decline over treatment eras in services received that was only partially offset by significant decreases in some self-reported service needs in DATOS-A.  Unmet needs increased significantly over treatment eras for specific services, including psychological, family, employment, and financial services.  Potential explanations include changes in treatment access and decreases in program resources for services.

4)  Delany, P. J., Broome, K. M., Flynn, P. M., & Fletcher, B. W. (2001).  Treatment service patterns and organizational structures:  An analysis of programs in DATOS-A.  Journal of Adolescent Research, 16(6), 590-607.

Abstract:  The availability of a variety of treatment services was examined within a national sample of programs treating adolescent drug abuse patients.  Treatment service delivery profiles were created and examined in the context of organizational variables such as program modality, program directors’ academic credentials, program capacity, staff composition, accreditation, and patient problems.  Results suggested that distinct profiles of services existed within residential and outpatient modalities and that these service profiles were related both to organizational factors and to patient problem profiles.

5)  Broome, K. M., Joe, G. W., & Simpson, D. D. (2001).  Engagement models for adolescents in DATOS-A.  Journal of Adolescent Research, 16(6), 608-623. 

Abstract:  Based on the importance of during-treatment activities for improving outcomes, relationships between patient background, treatment readiness, and therapeutic engagement were examined in a national sample of adolescents admitted to 20 treatment programs representing three modalities.  Patients with higher readiness for treatment at intake subsequently became more therapeutically involved, replicating previous findings on relationships between motivation and engagement in adult samples.  One of the most influential background factors associated with higher treatment readiness was patient relationships with family and friends. Interventions that focus on treatment readiness appear to be appropriate strategies for improving treatment engagement.

6)  Rounds-Bryant, J. L., & Staab, J. (2001).  Patient characteristics and treatment outcomes for African American, Hispanic, and White adolescents in DATOS-A.  Journal of Adolescent Research, 16(6), 624-641.

Abstract:  This study attempts to extend what is known about adolescent substance abusers in adolescent-oriented substance abuse treatment by describing and comparing background and pretreatment characteristics and posttreatment outcomes of African American (n = 213), Hispanic (n = 108), and White adolescent (n = 773) substance abusers who participated in the Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A).  The pretreatment data indicated that patients in each group were similar only with respect to basic demographics.  Posttreatment comparisons revealed racial/ ethnic differences in serious illegal activity only. Logistic regression results indicated that African American adolescents had a lower likelihood of engaging in serious illegal activity as compared to White adolescents during the posttreatment period.  The results of this study provide a mechanism for more comprehensive understanding of adolescent substance abusers, their treatment needs, and their treatment outcomes.

7)  Joshi, V., Hser, Y., Grella, C. E., & Houlton, R. (2001).  Sex-related HIV risk reduction behavior among adolescents in  DATOS-A.  Journal of Adolescent Research, 16(6), 642-660.

Abstract:  This study examines the effect of drug treatment on reducing HIV-related risky sex behavior among 796 adolescents entering drug treatment programs in four cities in the United States.  More than half of the adolescents (54%) reported reductions in risky sex behavior after treatment. Conduct-disordered adolescents with abuse history, unmet physical and emotional needs, and low commitment to school were associated with lack of improvement.  Furthermore, conduct-disordered adolescents who perceived treatment to be effective were more likely to show posttreatment improvement, with the exceptions that those who scored high on hostility or low in self-perception were not likely to improve. Among adolescents without conduct disorder, receipt of mental health services was associated with improvements in their risky sex behavior.  The effect of drug treatment on HIV risk reduction can be increased when attention is focused on adolescents’ pretreatment risk factors, service needs, intreatment responses, and key personality characteristics.

8)  Galaif, E. R., Hser, Y., Grella, C. E., & Joshi, V. (2001).  Prospective risk factors and treatment outcomes among adolescents in DATOS-A.  Journal of Adolescent Research, 16(6), 661-678. 

Abstract:  The relationships between risk factors and outcomes in adolescents participating in the Drug Abuse Treatment Outcome Studies for Adolescents (DATOS-A) were examined.  The study included 292 admissions to nine outpatient drug-free (ODF) and 418 admissions to eight residential (RES) programs.  Assessments were administered at intake into treatment and 12 months following discharge.  For ODF participants, (a) severity of drug use predicted less retention in treatment, and (b) family drug involvement predicted more alcohol use after treatment.  For RES participants, (a) family drug involvement and criminal involvement predicted less treatment retention, and (b) conduct disorder predicted more marijuana use at follow-up.  The findings underscore the need for intervention strategies that address the intrapsychic and interpersonal functioning of drug-abusing adolescents to improve their behavioral outcomes.

9)  Farabee, D., Shen, H., Hser, Y., Grella, C. E., & Anglin, M. D. (2001).   The effect of drug treatment on criminal behavior among adolescents in DATOS-A.  Journal of Adolescent Research, 16(6), 679-696.

Abstract:   This study examined criminal activity among 1,167 adolescents who participated in a community-based substance abuse treatment study (Drug Abuse Treatment Outcome Studies for Adolescents) (DATOS-A).  The primary goals of this study were to assess the effect of substance abuse treatment on adolescent crime and to identify the patient characteristics that were most closely associated with reductions in crime during the posttreatment period.  Results confirmed that among adolescents who had engaged in criminal activity during the 12 months prior to entering DATOS-A treatment, reductions in alcohol or marijuana use were independently associated with significant reductions in the likelihood of committing crimes during the 12-month follow-up period.  The present study also provides further support for emphasizing dynamic rather than static patient characteristics to predict the likelihood of continued drug-related offending among substance-abusing adolescents.

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