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Is there a better way to treat substance use in adolescents with co-occurring mental health disorders?

The majority (55-74%) of adolescents entering substance use treatment also have , such as depression, ADHD and trauma-related problems. Unfortunately, these youth face poorer treatment outcomes (e.g., relapse), and their issues are often not directly addressed. Furthermore, few studies exist to guide those clinicians who would like to use integrated care to treat adolescent with co-occurring disorders. A review published in the new Substance Abuse Special Issue: Evaluating and Addressing Adolescent Alcohol and Other proposes that the Adolescent Community Reinforcement Approach (A-CRA), which is a combination of cognitive-behavioral and family therapies, may be an ideal treatment method for this patient population.

“The Adolescent Community Reinforcement Approach (A-CRA) is a well-tested intervention for substance use disorders that has demonstrated potential as a treatment for co-morbid youth,” says lead author Dr. Susan H. Godley. “This paper shows that several A-CRA procedures are consistent with procedures in evidence-supported treatments for common co-occurring , and as an example, describes in detail how A-CRA can be used in the treatment of co-occurring substance use and depression disorders.”

The A-CRA offers substance use treatment providers a new option when caring for youth with co-occurring substance use disorders and mental health diagnoses. Although further research into A-CRA’s efficacy in treating various combinations of substance use and psychiatric disorders is warranted, the authors argue that there’s no reason for providers to wait when it comes to offering comprehensive treatment to adolescents who could benefit from their help right now.


The Adolescent Community Reinforcement Approach (A-CRA) as a Model Paradigm for the Management of Adolescents with Substance Use Disorders and Co-occurring Psychiatric Disorders, Susan H. Godley PhD, Jane Ellen Smith PhD, Lora L. Passetti MS & Geetha Subramaniam MD, Substance Abuse, DOI: 10.1080/08897077.2014.936993

Taylor & Francis