Skip to main content
SpringerLink
Log in

Inpatient Behavioral and Cognitive Therapy for Substance Abuse in Adolescents

  • Chapter
Inpatient Behavior Therapy for Children and Adolescents

Abstract

Substance abuse, or chemical dependency, continues to be a major public health problem, with substance use or abuse among adolescents occupying increasing national attention and concern. In the United States, overall drug use in young people is the highest among the industrialized nations, despite recent statistics indicating a continued trend of gradual decline (Johnston, Bachman, & O’Malley, 1988). In this highly quoted annual (1987) survey of high school seniors, over half (57%) of the seniors reported having tried an illicit drug and 92% reported some experience with alcohol. The seniors indicated a daily use of 4.8%, 3.3%, and 0.3% of alcohol, marijuana, and cocaine, respectively (Johnston et al., 1988). Adolescents who use alcohol or other drugs have an increased vulnerability to accidents, injuries, and a variety of dangerous behaviors. Alcohol-related motor vehicle accidents are the leading cause of death among American youth between the ages of 15 and 24, and increased alcohol levels are found in victims of suicide and homicide (American Academy of Pediatrics, 1987). Clearly, with increasing recognition of this serious problem, society in the United States now directs more resources toward the treatment of chemically dependent adolescents. In this chapter, we hope to describe the entity of adolescent chemical dependency and to discuss assessment methods and appropriate behavioral treatment modalities as applied to hospitalized adolescents with alcohol and/or drug use problems.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Achenbach, T. M., & Edelbrock, C. S. (1983). Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington: University of Vermont, Department of Psychiatry.

    Google Scholar 

  • American Academy of Pediatrics, Committee on Adolescence. (1987). Alcohol use and abuse; A pediatric concern. Pediatrics, 79, 450–453.

    Google Scholar 

  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

    Google Scholar 

  • Armor, D. J., Polich, J. M., & Stambul, H. B. (1978). Alcoholism and treatment. Santa Monica, CA: Rand Corporation.

    Google Scholar 

  • Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.

    Google Scholar 

  • Blane, H. (1979). Middle-aged alcoholics and young drinkers. In H. T. Blane & M. E. Chafetz (Eds.), Youth, alcohol, and social policy (pp. 102–124). New York: Plenum Press.

    Chapter  Google Scholar 

  • Botvin, G., Baker, E., Renick, N., Filazzola, N., & Botvin, A. (1984). A cognitive behavioral approach to substance abuse prevention. Journal of Addictive Behaviors, 9, 137–147.

    Article  Google Scholar 

  • Brown, S. A. (1985). Reinforcement expectancies and alcoholism outcome after a one year follow-up. Journal of Studies on Alcohol, 46, 305–308.

    Google Scholar 

  • Brown, S. A., Christiansen, B. A., & Goldman, M. S. (1987). The alcohol expectancy questionnaire: An instrument for the assessment of adolescent and adult alcohol expectancies. Journal of Studies on Alcohol, 48, 483–491.

    PubMed  Google Scholar 

  • Bukstein, O. G., Brent, D. A., & Kaminer, Y. (1989). Comorbidity of substance abuse and other psychiatric disorders in adolescents. American Journal of Psychiatry, 146, 1131–1141.

    PubMed  Google Scholar 

  • Chafetz, M. E. (1972). Alcoholism criteria: An important step. American Journal of Psychiatry, 129, 214–215.

    PubMed  Google Scholar 

  • Chaney, E. F., O’Leary, M. R., & Marlzit, G. A. (1978). Skill training with alcoholics. Journal of Consulting and Clinical Psychology, 46, 1092–1104.

    Article  PubMed  Google Scholar 

  • Childress, A. R., McLellan, A. T., & O’Brien, C. P. (1986). The role of conditioning factors in the development of drug dependence. Psychiatric Clinics of North America, 9, 413–426.

    PubMed  Google Scholar 

  • Christiansen, B. A., Goldman, M. S., & Inn, A. (1982). Development of alcohol-related expectancies in adolescents: Separating pharmacological from social learning influences. Journal of Consulting and Clinical Psychology, 50, 336–344.

    Article  PubMed  Google Scholar 

  • Christiansen, B. A., Goldman, M. S., & Brown, S. A. (1985). The differential development of adolescent alcohol expectancies may predict adult alcoholism. Journal of Addictive Behaviors, 10, 299–306.

    Article  Google Scholar 

  • Craig, R. J. (1987). Clinical management of substance abuse programs. Springfield, IL: Charles C Thomas.

    Google Scholar 

  • Cummings, N. A. (1979). Turning bread into stones: Our modern anti-miracle. American Psychologist, 34, 1–8.

    Article  Google Scholar 

  • Deykin, E. Y., Levy, J. C., & Wells, V. (1987). Adolescent depression, alcohol and drug abuse. American Journal of Public Health, 77, 178–182.

    Article  PubMed  Google Scholar 

  • Donovan, J. E., & Jessor, R. (1978). Adolescent problem drinking—psychosocial correlates in a national sample study. Journal of Studies on Alcohol, 39, 1506–1524.

    PubMed  Google Scholar 

  • Edwards, G., & Gross, M. M. (1976). Alcohol dependence: Provisional description of a clinical syndrome. British Journal of Medicine, 1, 1058–1061.

    Article  Google Scholar 

  • Edwards, G., Orford, J., Egert, S., Guthrie, S., Hawker, A., Hensman, C., Mitcheson, M., Oppenheimer, O., & Taylor, C. (1977). Alcoholism: A controlled trial of “treatment” and “advice.” Journal of Studies on Alcohol, 38, 1004–1031.

    PubMed  Google Scholar 

  • Fischman, M. W. (1988). Behavioral pharmacology of cocaine. Journal of Clinical Psychiatry, 49 (Suppl. 2), 7–10.

    PubMed  Google Scholar 

  • Flay, B. (1975). What do we know about the social influences approach to smoking prevention? Review and recommendations. In C. Bell & R. Bettles (Eds.), Prevention research; Deterring drug abuse among children and adolescents (pp. 67–112). Washington, DC: NIDA Research Monogram.

    Google Scholar 

  • Gawin, F. H., & Ellenwood, E. H. (1988). Cocaine and other stimulants: Actions, abuse, and treatment. New England Journal of Medicine, 18, 1173–1182.

    Article  Google Scholar 

  • Gawin, F. H., Kleber, H. D., & Byck, R. (1989). Desipramine facilitation of initial cocaine abstinence. Archives of General Psychiatry, 46, 117–121.

    Article  PubMed  Google Scholar 

  • Gittleman, R., Mannuzza, S., Shenker, R., & Bonagura, N. (1985). Hyperactive boys almost grown up: I. Psychiatric status. Archives of General Psychiatry, 42, 937–947.

    Article  Google Scholar 

  • Hawkins, J. O., Catalano, R. F., & Well, E. A. (1986). Measuring effects of a skill training intervention for drug abusers. Journal of Consulting and Clinical Psychology, 54, 661–664.

    Article  PubMed  Google Scholar 

  • Henly, G. A., & Winters, K. C. (1988). Development of problem severity scales for the assessment of adolescent alcohol and drug abuse. International Journal of the Addictions, 23, 65–85.

    PubMed  Google Scholar 

  • Holden, C. (1987). Is alcoholism treatment effective? Science, 236, 20–22.

    Article  PubMed  Google Scholar 

  • Horan, J. J., & Williams, J. M. (1982). Longitudinal study of attention training as a drug abuse prevention strategy. American Educational Research Journal, 19(3), 341–351.

    Article  Google Scholar 

  • Hull, J. (1981). A self-awareness model of the causes and effects of alcohol consumption. Journal of Abnormal Psychology, 90, 586–600.

    Article  PubMed  Google Scholar 

  • Jones, E. E., & Berglas S. (1978). Control of attributions about the self through self-handicapping strategies: The appeal of alcohol and the role of underachievement. Personality and Social Psychology Bulletin, 4, 200–206.

    Article  Google Scholar 

  • Jellinek, E. M. (1960). The disease concept of alcoholism. New Haven: College and University Press.

    Book  Google Scholar 

  • Jessor, R., & Jessor, S. L. (1978). Theory testing on longitudinal research. In D. B. Kandel (Ed.), Longitudinal research on drug use: Empirical findings and methodological issues (pp. 41–71). Washington, DC: Hemisphere-Wiley.

    Google Scholar 

  • Johnston, L., O’Malley, P., & Eveland, L. (1978). Drugs and delinquency: A search for causal connections. In D. B. Kandel (Ed.), Longitudinal research on drug use: Empirical findings and methodological issues (pp. 137–156). Washington, DC: Hemisphere-Wiley.

    Google Scholar 

  • Johnston, L. D., Bachman, J. G., & O’Malley, P. M. (1988). Press release. Ann Arbor: University of Michigan News and Information Service.

    Google Scholar 

  • Kaminer, Y., & Frances, R. J. (1991). Adolescent substance abuse and comorbid psychiatric disorders: Inpatient treatment. Hospital and Community Psychiatry, 42, 951–953.

    Google Scholar 

  • Kaminer, Y., Bukstein, O. G., & Tarter, R. E. (1991). The Teen Addiction Severity Index (T-ASI): Rationale and reliability. International Journal of the Addictions, 26, 219–226.

    PubMed  Google Scholar 

  • Kandel, D. B. (1982). Epidemiological and psychosocial perspectives on adolescent drug use. Journal of the American Academy of Child Psychiatry, 21, 328–347.

    Article  PubMed  Google Scholar 

  • Kandel, D. B., Kessler, R. C., & Margulies, R. Z. (1978). Antecedents of adolescent initiation into stages of drug use: A developmental analysis. In D. B. Kandel (Ed.), Longitudinal research on drug use: Empirical findings and methodological issues. Washington, DC: Hemisphere-Wiley.

    Google Scholar 

  • Killen, J. D., Maccoby, N., & Taylor, C. B. (1984). Nicotine gum and self-regulation training in smoking relapse prevention, Behavior Therapy, 15, 234–248.

    Article  Google Scholar 

  • Klinge, V., Lachar, D., Grisell, J., & Berman, W. (1978). Effects of scoring norms on adolescent psychiatric drug users’ and nonusers’ MMPI profiles. Adolescence, 13, 1–10.

    PubMed  Google Scholar 

  • Kosten, T. R., Rounsaville, B. J., Babor, T. F., Spitzer, R. L., & Williams, J. B. W (1987). Substance-use disorders in DSM-III-R. British Journal of Psychiatry, 151, 834–843.

    Article  PubMed  Google Scholar 

  • Levine, J., & Zigler, E. (1973). The essential-reactive distinction in alcoholism: A developmental approach. Journal of Abnormal Psychology, 81, 242–249.

    Article  PubMed  Google Scholar 

  • MacAndrew, C. (1979). On the possibility of the psychometric detection of persons who are prone to the abuse of alcohol and other substances. Addictive Behaviors, 4, 11–20.

    Article  PubMed  Google Scholar 

  • Marlatt, G., & George, W. H. (1984). Relapse prevention: Introduction and overview of the model. British Journal of Addiction, 79, 261–275.

    PubMed  Google Scholar 

  • Marlatt, G. A. (1982). Relapse prevention: A self-control program for the treatment of addictive behaviors. In R. B. Stuart (Ed.), Adherence, compliance and generalization in behavioral medicine (pp. 329–378). New York: Brunner/Mazel.

    Google Scholar 

  • Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford Press.

    Google Scholar 

  • Mayer, J. E., & Filstead, W. J. (1979). Empirical procedures for defining adolescent alcohol abuse. Journal of Studies on Alcohol, 40, 291–300.

    PubMed  Google Scholar 

  • McLellan, A. T., O’Brien, C. P., & Woody, G. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The addiction severity index. Journal of Nervous and Mental Disease, 168, 26–33.

    Article  PubMed  Google Scholar 

  • McLellan, A. T., Luborsky, L., O’Brien, C. P., Woody, G. E., & Druley, K. A. (1983). Is treatment for substance abuse effective? Journal of the American Medical Association, 247, 1423–1428.

    Article  Google Scholar 

  • Meyer, R. E. (1986). Old wine, new bottle: The alcohol dependency syndrome. Psychiatric Clinics of North America, 9, 435–453.

    PubMed  Google Scholar 

  • Miller, W R., & Hester, R. K. (1980). Treating the problem drinker: Modern approaches. In W. R. Miller (Ed.), The addictive behaviors: Treatment of alcoholism, drug abuse, smoking and obesity (pp. 11–141). New York: Pergamon Press.

    Google Scholar 

  • Miller, W. R., & Hester, R. K. (1986). Inpatient alcoholism treatment: Who benefits? American Psychologist, 41, 794–805.

    Article  PubMed  Google Scholar 

  • Moberg, D. P. (1983). Identifying adolescents with alcohol problems: A field test of the Adolescent Alcohol Involvement Scale. Journal of Studies on Alcohol, 44, 701–721.

    PubMed  Google Scholar 

  • National Council on Alcoholism. (1972). Criteria for the diagnosis of alcoholism. American Journal of Psychiatry, 129, 127–135.

    Google Scholar 

  • Oei, T. P. S., & Jackson, P. R. (1982). Social skills and cognitive behavioral approaches to the treatment of problem drinking. Journal of Studies on Alcohol, 43, 532–546.

    PubMed  Google Scholar 

  • Oetting, E. R., Beauvais, F., Edwards, R., & Waters, M. (1984). The Drug and Alcohol Assessment System. Fort Collins, CO: Rocky Mountain Behavioral Science Institute.

    Google Scholar 

  • O’Leary, D. E., O’Leary, M. R., & Donovan, D. M. (1975). Social skills acquisition and psychosocial development of alcoholics: A review. Addictive Behaviors, 1, 111–120.

    Article  Google Scholar 

  • Pattison, E. M. (1985). The selection of treatment modalities for the alcoholic patient. In J. H. Mendelson & N. K. Mello (Eds.), The diagnosis and treatment of alcoholism (pp. 189–294). New York: McGraw-Hill.

    Google Scholar 

  • Pavlov, I. P. (1927). Conditioned reflexes (G. V. Anrep, Trans.). Oxford: Oxford University Press.

    Google Scholar 

  • Perry, C., Kullen, J., Slinkard, L., & McAlister, A. (1980). Peer teaching and smoking prevention among junior high school students. Adolescence, 58, 277–281.

    Google Scholar 

  • Puig-Antich, J., Orvaschel, H., Tabrizi, M., & Chambers, W. (1980). The schedule for affective disorders and schizophrenia for school-age children—epidemiologic version (K-SADS-E) (3rd ed.). New York: New York State Psychiatric Institute and Yale University School of Medicine.

    Google Scholar 

  • Rachal, J. V., Guess, L. L., Hubbard, R. L., Maisto, S. A., Cavanaugh, E. R., Waddell, R., & Benrud, C. H. (1980). Vol. I. Adolescent drinking behavior—The extent and nature of adolescent alcohol and drug use: The 1974 and 1978 national sample studies. Final report to the National Institute on Alcohol Abuse and Alcoholism (Contract No. ADM 281-76-0019). Research Triangle Park, NC: Research Triangle Foundation.

    Google Scholar 

  • Reuger, D. R., & Liberman, R. P. (1984). Behavioral family therapy for delinquent and substance-abusing adolescents. Journal of Drug Issues, 14(2), 403–418.

    Google Scholar 

  • Rist, F., & Watzl, H. (1983). Self assessment of relapse risk and assertiveness in relation to treatment outcome of female alcoholics. Addictive Behaviors, 8, 121–127.

    Article  PubMed  Google Scholar 

  • Rounsaville, B. J. (1987). An evaluation of the DSM-III substance-use disorders. In G. L. Tischler (Ed.), Diagnosis and classification in psychiatry (pp. 175–194). Cambridge: Cambridge University Press.

    Google Scholar 

  • Rounsaville, B. J., Spitzer, R. L., & Williams, J. B. W. (1986). Proposed changes in DSM-III substance use disorders: Description and rationale. American Journal of Psychiatry, 143, 463–468.

    PubMed  Google Scholar 

  • Rounsaville, B. J., Kosten, T. R., Weissman, M. M., & Kleber, H. D. (1986). Prognostic significance of psychiatric disorders in treated opiate addicts. Archives of General Psychiatry, 43, 739–745.

    Article  PubMed  Google Scholar 

  • Sanchez-Craig, M. (1984). A therapist manual for secondary prevention of alcohol problems. Toronto: Addiction Research Foundation.

    Google Scholar 

  • Schuckit, M. A., Irwin, M., Howard, T., & Smith, T. (1988). A structured diagnostic interview for identification of primary alcoholism: A preliminary examination. Journal of Studies on Alcohol, 49, 93–99.

    PubMed  Google Scholar 

  • Selzer, M. L. (1971). The Michigan Alcoholism Screening Test: The quest for a new diagnostic instrument. American Journal of Psychiatry, 127, 1653–1658.

    PubMed  Google Scholar 

  • Siegel, S. (1973). Evidence from rats that morphine tolerance is a learned response. Journal of Comprehensive and Physiological Psychology, 89, 498–506.

    Article  Google Scholar 

  • Simpson, D. D., Savage, L. J., & Sells, S. B. (1978). Evaluation of drug abuse treatments based on first year follow-up (NIDA Monograph No. ADM 78-701). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  • Skinner, H. A. (1982). The Drug Abuse Screening Test. Addictive Behaviors, 7, 363–371.

    Article  PubMed  Google Scholar 

  • Skinner, H. A., & Goldberg, A. E. (1986). Evidence for a drug dependence syndrome among narcotic users. British Journal of Psychiatry, 81, 479–484.

    Google Scholar 

  • Sobell, L. C., Sobell, M. B., & Nirenberg, T. D. (1982). Differential treatment planning for alcohol abusers. In E. M. Pattison & E. Kaufman (Eds.), Encyclopedia handbook of alcoholism (pp. 173–203). New York: Gardner Press.

    Google Scholar 

  • Sobell, L. C., Sobell, M. B., & Nirenberg, T. D. (1988). Behavioral assessment and treatment planning with alcohol and drug abusers: A review with an emphasis on clinical application. Clinical Psychology Review, 8, 19–54.

    Article  Google Scholar 

  • Tarter, R. E. (1990). Evaluation and treatment of adolescent substance abuse: A decision tree method. American Journal of Drug and Alcohol Abuse, 16, 1–46.

    Article  PubMed  Google Scholar 

  • Tucker, J. A., Vuchinich, R. G., & Sobell, M. B. (1981). Alcohol consumption as a self-handicapping strategy. Journal of Abnormal Psychology, 90, 220–230.

    Article  PubMed  Google Scholar 

  • Vingilis, E., & Smart, R. G. (1981). Physical dependence on alcohol in youth. In Y. Israel, F. B. Glaser, & H. Kalant, R. E. Popham, W. Schmidt, & R. G. Smart (Eds.), Research advances in alcohol and drug problems (Vol. 6, pp. 197–215). New York: Plenum Press.

    Chapter  Google Scholar 

  • Watson, D. W., & Maisto, S. (1983). A review of the effectiveness of assertiveness training in the treatment of alcohol abusers. Behavioral Psychotherapy, 11, 36–49.

    Article  Google Scholar 

  • Wechsler, H. (1979). Patterns of alcohol consumption among the young: High school, college and general population studies. In H. T. Blane & M. E. Chafetz (Eds.), Youth, alcohol, and social policy (pp. 173–192). New York: Plenum Press.

    Google Scholar 

  • White, H. R. (1987). Longitudinal stability and dimensional structure of problem drinking in adolescence. Journal of Studies on Alcohol, 48, 541–550.

    PubMed  Google Scholar 

  • Wilder, A. (1965). Conditioning factors in opiate addiction and relapse. In D. M. Wilner, & G. C. Kassabaum (Eds.), Narcotics (pp. 85–100). New York: McGraw-Hill.

    Google Scholar 

  • Wilson, G. T. (1982). Alcohol and anxiety: Recent evidence on the tension reduction theory of alcohol use and abuse. In K. R. Blankstein & J. Polivy (Eds.), Self-control and self-modification of emotional behavior (pp. 91–122). New York: Plenum Press.

    Google Scholar 

  • Wilson, G. T. (1987). Cognitive processes in addiction. British Journal of Addiction, 82, 343–353.

    Article  PubMed  Google Scholar 

  • Wolfson, K. P., & Erbaugh, S. E. (1984). Adolescent responses to the MacAndrew Alcoholism Scale. Journal of Consulting and Clinical Psychology, 52, 625–630.

    Article  PubMed  Google Scholar 

  • Yankofsky, L., Wilson, G. T., Adler, J., Hay, W, & Vrana, S. (1986). The effect of alcohol on self-evaluation, awareness of negative interpersonal feedback and perceptions of control and power. Journal of Studies on Alcohol, 47, 26–37.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Alcohol and Addictions Studies, Brown University, East Providence, Rhode Island, 02915, USA

    Yifrah Kaminer

  2. Adolescent Substance Abuse Intervention Center, Emma Pendleton Bradley Hospital, East Providence, Rhode Island, 02915, USA

    Yifrah Kaminer

  3. Department of Psychiatry, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, Pennsylvania, 15213, USA

    Oscar G. Bukstein

Authors
  1. Yifrah Kaminer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Oscar G. Bukstein
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Center for Psychological Studies, Nova University, Fort Lauderdale, Florida, 33314, USA

    Vincent B. Van Hasselt Ph.D.

  2. Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, Pennsylvania, 15213, USA

    David J. Kolko Ph.D.

Rights and permissions

Reprints and permissions

Copyright information

© 1992 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kaminer, Y., Bukstein, O.G. (1992). Inpatient Behavioral and Cognitive Therapy for Substance Abuse in Adolescents. In: Van Hasselt, V.B., Kolko, D.J. (eds) Inpatient Behavior Therapy for Children and Adolescents. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-2332-5_11

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-2332-5_11

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-2334-9

  • Online ISBN: 978-1-4899-2332-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation