Book Description

EXECUTIVE SUMMARY AND RECOMMENDATIONS. In recognition of the importance of developing reliable, valid, and clinically useful instruments as well as procedures for screening adolescents for substance use disorders, the Center for Substance Abuse Treatment (CSAT) in 1992 convened a Panel of experienced researchers and clinicians who work with troubled youths and their families. A year later, CSAT convened another Panel that examined substance use disorder treatment for adolescents and outlined state-of-the-art treatment guidelines. Two Treatment Improvement Protocols (TIPs 3 and 4) were developed from these efforts. Given the continued significance of assessment and treatment of adolescents' substance use, CSAT convened another Panel in 1997 to update both of the earlier TIPs. This TIP should be viewed as a companion volume to TIP 32, Treatment of Adolescents With Substance Use Disorders (CSAT, 1999), which updates TIP 4. The original Panel on adolescent substance use screening and assessment had two goals. The first was to discuss the problems of adolescent substance use disorders from the viewpoints of the Panel Members, who come from a wide spectrum of backgrounds and specialty areas. The emphasis was on practical clinical procedures to help treatment providers improve care. A second goal for the Panel was to review, from a practical perspective, available instruments, procedures, and measures for assessing adolescent substance use in various settings, including rehabilitation, that could be used easily by clinicians and other workers in the field. The Revision Panel preserved the original goals but also incorporated new research, updated summaries of previously listed instruments, and added recently developed tools. This TIP incorporates the deliberations of the 1992 Consensus Panel and the 1997 Revision Panel. It concentrates on the strategies, procedures, and instruments that are appropriate for the initial detection of substance-using adolescents, the comprehensive assessment of their problems, and subsequent treatment planning. Although the TIP summarizes many instruments, it does not endorse any screening or assessment tools. The purposes of the TIP are several: (1) To provide general guidelines for evaluating, developing, and administering screenings and assessment instruments and processes for those who screen and assess young people for substance use disorders (2) To inform a wide range of people whose work brings them in contact with adolescents in problem situations (e.g., teachers, guidance counselors, school nurses, police probation officers, coaches, and family service workers) about the processes, methods, and tools available to screen for potential substance use problems in adolescents (3) To discuss strategies and accepted techniques that can be used by treatment personnel to detect related problems in the adolescent's life, including problems with family and peers, and psychiatric issues, and to see that these problems are dealt with during the primary intervention for a substance use disorder (4) To outline a screening and assessment system designed to identify those youths with potential substance use problems in various settings Adolescents differ from adults physiologically and emotionally and are covered by different laws and social services. This revised TIP is designed to help juvenile justice, health and human service, and substance use disorder treatment personnel better identify, screen, and assess people 11 to 21 years old who may be experiencing substance-related problems. The TIP details warning signs of substance use disorders among adolescents, when to screen, when to assess, what domains besides substance use to assess, and how to involve the family and other collaterals. Also covered are the legal issues of screening and assessing teenagers, including confidentiality, duty to warn, and how to communicate with other agencies. The TIP also includes a chapter specifically for those working in the juvenile justice system who want to improve their screening and assessment procedures. Appendix A lists the citations referred to throughout this TIP and relevant to the instrument summaries. Appendix B provides up-to-date summaries of instruments relevant for screening and comprehensively assessing substance-abusing adolescents. Appendix C contains excerpts from "Drug Testing of Juvenile Detainees," a publication prepared by the American Correctional Association and the Institute for Behavior and Health, Inc., under a grant from the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice.