Abstract
The increasing range, availability and affordability of both licit and illicit substances is one of many factors that make the contemporary young person's transition from childhood to adulthood increasingly treacherous. Adolescents are presenting to services younger and with ever more severe alcohol and other drug (AOD) problems. Previously those working and researching in the developing specialty of youth addiction have had little in the way of reliable texts to guide their endeavours. Adolescent substance abuse: research and clinical advances is thus a welcome condensation of the current evidence base.
That said, the evidence base is still relatively small and this is reflected in the content of the book, which can be repetitive at times, the findings from key studies reworked in a number of the chapters. Most of the evidence is USA based but the established North American emphasis on abstinence-based approaches is not as evident as one might anticipate. In contrast, the lack of reference to harm reduction, except obliquely, is striking, especially given that a central premise for most of the writers is the fact that adolescents seldom present with ‘adult-like' addiction. As most working in the area would agree, teenagers who view their substance use problems as a disease and respond to a disease model are the exception. For this reason the book's reluctance to address the importance of minimizing harm in plain language is disappointing, a reflection perhaps on the lack of research under this paradigm.
The text is structured in four main sections, with chapters covering research principles, policy and service delivery, assessment and treatment planning, and empirically based interventions. The importance of comprehensive assessment and treatment planning is explored in detail, the challenge of engaging young people into a therapeutic alliance so that this can be achieved, less so. It is encouraging to see reviews of the effectiveness of cognitive behaviour therapy, motivational enhancement therapy and family-based therapies. There are useful chapters examining the state of the evidence with regard to a range of other approaches such as contingency management, school-based programmes and therapeutic communities.
After reading the 500 pages of this book someone new to the field might be forgiven for baulking at the sheer diversity of risk factors, clinical presentations and treatment approaches that are covered. Unfortunately the text lacks a convincing summarization and formulation of key principles and practice. This omission takes the gloss off what is otherwise a high-quality read.
Adolescent substance abuse succeeds as an up-to-date and thorough volume for a conscientious reader interested in the area. The contributors are all respected researchers and writers in the field and as far as the current knowledge base extends, this book is the authoritative text. Adolescent substance abuse also functions reasonably as a reference text. As a practical resource to guide day-to-day practice it is less easy to recommend, but in light of the fact that there are few alternative resources, by default it remains essential.
Grant Christie
Auckland, New Zealand
© 2007 Grant Christie