“My Journey Map”: Developing a Qualitative Approach to Mapping Young People's Progress in Residential Rehabilitation

Abstract

Young people with substance misuse issues are at risk of harm from significant negative health and life events. Contemporary research notes both a historical failure to recognize the unique needs of adolescents, and the ongoing need for dedicated adolescent treatment programs and outcome measures. It is concerning that there is so little literature assessing the quality, availability, and effectiveness of adolescent-focused treatment programs, and no adolescent-specific measurement tools centered on a young person's progress in residential treatment. This article reports on the process of developing a qualitative approach to mapping progress in treatment over time. The research seeks to develop an approach that captures, at three points in time and from multiple viewpoints, the progress of young people in four residential rehabilitation services located in New South Wales and Western Australia, across several dimensions of the personal and social aspects of life. Our aim is to develop an approach that is accessible to the alcohol and other drug workforce, and that informs the development of a psychometrically robust quantitative measure of progress that is meaningful and useful both to practitioners and to the young people themselves.

Keywords

Residential rehabilitation young people qualitative outcomes treatment progress

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References

American Association of Children's Residential Centers. (2009). Redefining residential: Performance indicators and outcomes. Residential Treatment for Children & Youth, 26(4), 241–245.

Australian Institute of Health and Welfare. (2005). National Comorbidity Initiative. A review of data collections relating to people with coexisting substance use and mental health disorders [AIHW cat. no. PHE 60]. Canberra: Author.

Bell

(2007). Time, space and body in adolescent residential services: Reimagining service research. Addiction Research and Theory, 15(1), 97–111.

Boyd

A. S.

Einbinder

S. D.

Rauktis

M. E.

, & Portwood

S. G.

(2007). Building research capacity in residential treatment centers: An approach for empirical studies. Child & Youth Care Forum, 36, 43–58.

Brown

S. A.

(2004). Measuring youth outcomes from alcohol and drug treatment. Addiction, 99(Suppl. 2), 38–46.

Bukstein

O. G.

, & Winters

(2004). Salient variables for treatment research of adolescent alcohol and other substance use disorders. Addictions, 99(Suppl. 2), 23–37.

Butler

L. S.

Little

, & Grimard

A. R.

(2009). Research challenges: Implementing standardized outcome measures in a decentralized, community-based residential treatment program. Child & Youth Care Forum, 38(2), 75–90.

Chassin

Knight

Vargas-Chanes

Losoya

S. H.

, & Naranjo

(2009). Substance use treatment outcomes in a sample of male serious juvenile offenders. Journal of Substance Abuse Treatment, 36(2), 183–194.

Chung

, & Maisto

S. A.

(2009). “What I got from treatment”: Predictors of treatment content received and association of treatment content with 6-month outcomes in adolescents. Journal of Substance Abuse Treatment, 37, 171–181.

10.

Colby

S. M.

Lee

C. S.

Lewis-Esquerre

Esposito-Smythers

, & Monti

P. M.

(2004). Adolescent alcohol misuse: Methodological issues for enhancing treatment research. Addiction, 99(Suppl. 2), 47–62.

11.

Collins

D. J.

, & Lapsley

H. M.

(2002). Counting the cost: Estimates of the social costs of drug abuse in Australia 1998–9. NDS Monograph Series, No. 49. Canberra: AGPS.

12.

Deady

(2009). A review of screening, assessment and outcome measures for drug and alcohol settings. Sydney, New South Wales: Network of Alcohol & other Drug Agencies.

13.

Delaney

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.

14.

Etheridge

R. M.

Smith

J. C.

Rounds-Bryant

J. L.

, & Hubbard

R. L.

(2001). Drug abuse treatment and comprehensive services for adolescents. Journal of Adolescent Research, 16(6), 563–589.

15.

Faw

Hogue

, & Liddle

H. A.

(2005). Multidimensional implementation evaluation of a residential treatment program for adolescent substance abuse. American Journal of Evaluation, 26, 77–94.

16.

Flanzer

(2005). The status of health services research on adjudicated drug-abusing juveniles: Selected questions and remaining questions. Substance Use & Misuse, 40, 887–911.

17.

Fletcher

Calafat

Pirona

, & Olszewski

(2010). Young people, recreational drug use and harm reduction. In Rhodes

& Hedrich

(Eds.), Harm reduction: Evidence, impacts and challenges (pp. 357–376). Luxembourg: Publications Office of the European Union.

18.

Ford

J. H.

II Green

C. A.

Hoffman

K. A.

Wisdom

J. P.

Riley

K. J.

Bergmann

(2007). Process improvement needs in substance abuse treatment: Admissions walk-through results. Journal of Substance Abuse Treatment, 33, 379–389.

19.

Gray

, & Saggers

(2005). Preventing harmful substance use among Indigenous people. In Stockwell

Gruenewald

Toumbourou

& Loxley

(Eds.), Preventing harmful substance use: The evidence base for policy and practice (pp. 383–393). Chichester: John Wiley & Sons Ltd.

20.

Hser

Grella

C. E.

Hubbard

R. L.

Hsieh

S. C.

Fletcher

B. W.

Brown

B. S.

, & Anglin

M. D.

(2001). An evaluation of drug treatments for adolescents in four U.S. cities. Archives of General Psychiatry, 58(7), 689–695.

21.

Joshi

Grella

C. E.

, & Hser

Y. I.

(2001). Drug use and treatment initiation patterns: Differences by birth cohorts. Journal of Drug Issues, 31(4), 1039–1062.

22.

Knudsen

H. K.

(2009). Adolescent-only substance abuse treatment: Availability and adoption of components of quality. Journal of Substance Abuse Treatment, 36(2), 195–204.

23.

Loxley

Toumbourou

, & Stockwell

(2004). The prevention of substance use, risk and harm in Australia: A review of the evidence. Canberra: Department of Health and Ageing.

24.

Marsden

Gossop

Stewart

Best

Farrell

, & Strang

(1998). The Maudsley Addiction Profile. A brief instrument for treatment outcome research. Development and user manual. London: National Addiction Centre/Institute of Psychiatry.

25.

National Health and Medical Research Council. (2007). National statement on ethical conduct in research involving humans. Canberra: Author.

26.

Prior

Sanson

Smart

, & Oberklaid

(2000). Pathways from infancy to adolescence: Australian Temperament Project 1983–2000. Canberra: Australian Institute of Family Studies.

27.

Prochaska

J. O.

DiClemente

C. C.

, & Norcross

J. C.

(1992). In search of how people change. Applications to addictive behaviors. American Psychologist, 47(9), 1102–1114.

28.

Reisinger

H. S.

Bush

Colom

M. A.

Agar

, & Battjes

(2003). Navigation and engagement: How does one measure success? Journal of Drug Issues, 33(4), 777–800.

29.

Rounds-Bryant

J. L.

Kristiansen

P. L.

Fairbank

J. A.

, & Hubbard

R. L.

(1998). Substance use, mental disorders, abuse, and crime: Gender comparisons among a national sample of adolescent drug treatment clients. Journal of Child & Adolescent Substance Use, 7(4), 19–34.

30.

Staiger

P. K.

Melville

Hides

Kambouropoulos

, & Lubman

D. I.

(2009). Can emotion-focused coping help explain the link between posttraumatic stress disorder severity and triggers for substance use in young adults? Journal of Substance Abuse Treatment, 36(2), 220–226.

31.

Substance Abuse and Mental Health Services Administration. (2004). Results from the 2004 National Survey on Drug Use and Health: National findings. US: Author.

32.

Szirom

King

, & Desmond

(2004). Barriers to service provision for young people with presenting substance misuse and mental health problems. Canberra: Australian Government Department of Family and Community Services.

33.

Toumbourou

J. W.

Hamilton

, & Fallon

(1998). Treatment level progress and time spent in treatment in the prediction of outcomes following drug-free therapeutic community treatment. Addiction, 93(7), 1051–1064.

34.

Wagner

E. F.

(2008). Developmentally informed research on the effectiveness of clinical trials: A primer for assessing how developmental issues may influence treatment responses among adolescents with alcohol use problems. Pediatrics, 121, S337–S347.

35.

Wagner

E. F.

(2009). Improving treatment through research: Directing attention to the role of development in adolescent treatment success. Alcohol Research & Health, 32(1), 67–75.

36.

Williams

R. J.

, & Chang

S. Y.

(2000). A comprehensive and comparative review of adolescent substance abuse treatment outcome. Clinical Psychology: Science and Practice, 7(2), 138–166.

37.

Wilson

Saggers

, & Wildy

(2008). Outcome measures for young people attending substance misuse services for detoxification and residential rehabilitation in Perth, Western Australia. Perth: Centre for Social Research, Edith Cowan University.

38.

Winters

Stinchfield

Latimer

, & Lee

(2007). Long-term outcome of substance-dependent youth following 12-step treatment. Journal of Substance Abuse Treatment, 33, 61–69.

39.

Winters

K. C.

(1992). Development of an adolescent alcohol and other drug abuse screening scale: Personal experience screening questionnaire. Addictive Behaviors, 17, 479–490.