Screening and
Assessing Adolescents for Substance Use Disorders
Screening and Assessing Adolescents For Substance Use Disorders
Treatment Improvement Protocol (TIP) Series 31
Ken C. Winters, Ph.D.
Revision Consensus Panel Chair
U.S.DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
Rockwall II, 5600 Fishers Lane
Rockville, MD 20857
DHHS Publication No. (SMA) 99-3282
Printed 1999
[Disclaimer]
This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated.
This publication was written under contract number 270-95-0013 with The CDM Group, Inc. (CDM). Sandra Clunies, M.S., I.C.A.D.C., served as the CSAT government project officer. Rose M.
Urban, M.S.W., J.D., C.S.A.C., served as the CDM TIPs project director. Other CDM TIPs personnel included Y-Lang Nguyen, production/copy editor, Raquel Ingraham, M.S., project manager, Virginia Vitzthum, former managing editor, Mary Smolenski, Ed.D., C.R.N.P., former project director, and MaryLou Leonard, former project manager.
The opinions expressed herein are the views of the Consensus Panel members and do not reflect the official position of CSAT, SAMHSA, or the U.S.
Department of Health and Human Services (DHHS). No official support or endorsement of CSAT, SAMHSA, or DHHS for these opinions or for particular instruments or software that may be described in this document is intended or should be inferred. The guidelines proffered in this document should not be considered as substitutes for individualized client care and treatment decisions.
What Is a TIP?
Treatment Improvement Protocols (TIPs) are best practice guidelines for the treatment of substance use disorders, provided as a service of the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT). CSAT's Office of Evaluation, Scientific Analysis and Synthesis draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to a growing number of facilities and individuals across the country. The audience for the TIPs is expanding beyond public and private treatment facilities for substance use disorders as substance use disorders are increasingly recognized as a major problem.
The TIPs Editorial Advisory Board, a distinguished group of substance use disorder experts and professionals in such related fields as primary care, mental health, and social services, works with the State Alcohol and Other Drug Abuse Directors to generate topics for the TIPs based on the field's current needs for information and guidance.
After selecting a topic, CSAT invites staff from pertinent Federal agencies and national organizations to a Resource Panel that recommends specific areas of focus as well as resources that should be considered in developing the content of the TIP. Then recommendations are communicated to a Consensus Panel composed of non-Federal experts on the topic who have been nominated by their peers. This Panel participates in a series of discussions; the information and recommendations on which they reach consensus form the foundation of the TIP. The members of each Consensus Panel represent treatment programs for substance use disorders, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A Panel Chair (or Co-Chairs) ensures that the guidelines mirror the results of the group's collaboration.
A large and diverse group of experts closely reviews the draft document. Once the changes recommended by these field reviewers have been incorporated, the TIP is prepared for publication, in print and online. The TIPs can be accessed via the Internet on the National Library of Medicine's home page at the URL: http://text.nlm.nih.gov. The move to electronic media also means that the TIPs can be updated more easily so they continue to provide the field with state-of-the-art information.
Although each TIP strives to include an evidence base for the practices it recommends, CSAT recognizes that the field of substance use disorder treatment is evolving, and published research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. For this reason, recommendations proffered in the TIP are attributed to either Panelists' clinical experience or the literature. If there is research to support a particular approach, citations are provided.
This TIP, Screening and Assessing Adolescents for Substance Use Disorders, updates TIP 3, published in 1993, and presents information on identifying, screening, and assessing adolescents who use substances. Adolescents differ from adults both physiologically and emotionally as they make the transition from child to adult. Although experimentation with substances is common with this population, substance abuse can seriously impair development, leaving an adolescent unprepared for the demands of adulthood. Therefore, it is important for a wide range of professionals who come into regular contact with adolescents to recognize the signs of substance use. This TIP focuses on the most current procedures and instruments for detecting substance abuse among adolescents, conducting comprehensive assessments, and beginning treatment planning. Chapter 1 provides an overview of the document. Chapters 2 and 3 present appropriate strategies and guidelines for screening and assessment. An explanation of legal issues concerning Federal and State confidentiality laws appears in Chapter 4. Chapter 5 provides guidance for screening and assessing adolescents in juvenile justice settings. Appendix B summarizes instruments to screen and assess adolescents for substance abuse and general functioning domains, many of them updated since 1993. Appendix C excerpts a 1998 publication on drug testing juvenile detainees prepared under a grant from the Office of Juvenile Justice and Delinquency Prevention of the U.S.
Department of Justice.
Other TIPs may be ordered by contacting SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), (800) 729-6686 or (301) 468-2600; TDD (for hearing impaired), (800) 487-4889.
Editorial Advisory Board
- Karen Allen, Ph.D., R.N., C.A.R.N.
- President of the National Nurses Society on Addictions
- Associate Professor
- Department of Psychiatry, Community Health, and Adult Primary Care
- University of Maryland
- School of Nursing
- Baltimore, Maryland
- Richard L.
Brown, M.D., M.P.H.
- Associate Professor
- Department of Family Medicine
- University of Wisconsin School of Medicine
- Madison, Wisconsin
- Dorynne Czechowicz, M.D.
- Associate Director
- Medical/Professional Affairs
- Treatment Research Branch
- Division of Clinical and Services Research
- National Institute on Drug Abuse
- Rockville, Maryland
- Linda S.
Foley, M.A.
- Former Director
- Project for Addiction Counselor Training
- National Association of State Alcohol and Drug Directors
- Washington, D.C.
- Wayde A.
Glover, M.I.S., N.C.A.C.
II
- Director
- Commonwealth Addictions Consultants and Trainers
- Richmond, Virginia
- Pedro J.
Greer, M.D.
- Assistant Dean for Homeless Education
- University of Miami School of Medicine
- Miami, Florida
- Thomas W.
Hester, M.D.
- Former State Director
- Substance Abuse Services
- Division of Mental Health, Mental Retardation and Substance Abuse
- Georgia Department of Human Resources
- Atlanta, Georgia
- Gil Hill
- Director
- Office of Substance Abuse
- American Psychological Association
- Washington, D.C.
- Douglas B.
Kamerow, M.D., M.P.H.
- Director
- Office of the Forum for Quality and Effectiveness in Health Care
- Agency for Health Care Policy and Research
- Rockville, Maryland
- Stephen W.
Long
- Director
- Office of Policy Analysis
- National Institute on Alcohol Abuse and Alcoholism
- Rockville, Maryland
- Richard A.
Rawson, Ph.D.
- Executive Director
- Matrix Center and Matrix Institute on Addiction
- Deputy Director, UCLA Addiction Medicine Services
- Los Angeles, California
- Ellen A.
Renz, Ph.D.
- Former Vice President of Clinical Systems
- MEDCO Behavioral Care Corporation
- Kamuela, Hawaii
- Richard K.
Ries, M.D.
- Director and Associate Professor
- Outpatient Mental Health Services and Dual Disorder Programs
- Harborview Medical Center
- Seattle, Washington
- Sidney H.
Schnoll, M.D., Ph.D.
- Chairman
- Division of Substance Abuse Medicine
- Medical College of Virginia
- Richmond, Virginia
Consensus Panel
1997-98 Revision Consensus Panel Chair
- Ken Winters, Ph.D.
- Associate Professor
- Department of Psychiatry
- University of Minnesota Hospital and Clinic
- Minneapolis, Minnesota
1997-98 Revision Consensus Panel
- Gayle A.
Dakof, Ph.D.
- Research Assistant Professor
- Center for Family Studies
- Department of Psychiatry and Behavioral Sciences
- University of Miami School of Medicine
- Miami, Florida
- Richard Dembo, Ph.D.
- Professor of Criminology
- University of South Florida
- Tampa, Florida
- Nancy Jainchill, Ph.D.
- Senior Principal Investigator
- Center for Therapeutic Community Research
- National Development and Research Institutes
- New York, New York
- Michele D.
Kipke, Ph.D.
- Director
- Board on Children, Youth, and Families National Research Council
- Institute of Medicine
- Washington, D.C.
- John R.
Knight, M.D.
- Associate Director for Medical Education
- Division on Addictions
- Harvard Medical School
- Assistant in Medicine
- Children's Hospital
- Boston, Massachusetts
- Howard Liddle, Ed.D.
- Professor and Director
- Center for Treatment Research and Adolescent Drug Abuse
- Department of Psychiatry and Behavioral Sciences
- University of Miami School of Medicine
- Miami, Florida
1992--93 Consensus Panel Co-Chairs
- Tom McLellan, Ph.D.
- University of Pennsylvania School of Medicine
- Philadelphia, Pennsylvania
- Richard Dembo, Ph.D.
- Professor of Criminology
- University of South Florida
- Tampa, Florida
1992--93 Workgroup Leaders
- Murray Durst
- Manager
- Substance Abuse Programs
- National Council for Juvenile and Family Court Judges
- University of Nevada
- Reno, Nevada
- Terence McSherry, M.P.H., M.P.A.
- Executive Director
- North-East Treatment Centers
- Philadelphia, Pennsylvania
- Roger Peters, Ph.D.
- University of South Florida
- Florida Mental Health Institute
- Department of Law and Mental Health
- Tampa, Florida
1992--93 Workgroup Members
- Linda Albrecht
- Facility Director
- Lansing Residential Center
- New York State Division for Youth
- Lansing, New York
- Jack Araza, Ph.D.
- Nevada Certified Psychologist and Alcohol and Drug Abuse Counselor
- Carson City, Nevada
- Andrea G.
Barthwell, M.D.
- Medical Director
- Interventions
- Chicago, Illinois
- La Claire Bouknight, M.D., F.A.C.P.
- Medical Director
- Residential Care Division
- Michigan Department of Social Services
- Maxey Training School
- Whitmore Lake, Michigan
- Wesley R.
Bowman, Ph.D.
- Licensed Psychologist
- Director
- PACE, Inc.
- Wilmington, Delaware
- Margaret K.
Brooks, J.D.
- Consultant
- Montclair, New Jersey
- Cheryl G.
Davis, M.S.W.
- Mental Health and Substance Abuse Advisor
- Chelsea School District
- Chelsea, Michigan
- Donald W.
Dew, Ed.D., C.R.C.
- Director of Regional Rehabilitation and Continuing Education Program
- Washington, D.C.
- Harvey M.
Goldstein
- Assistant Director for Probation
- Administration Office of the Courts
- Trenton, New Jersey
- Peter E.
Leone, Ph.D.
- Associate Professor
- University of Maryland
- Department of Special Education
- College Park, Maryland
- Kenneth F.
Pompi, Ph.D.
- Vice President
- Research and Information Management
- Abraxas Group, Inc.
- Pittsburgh, Pennsylvania
- Gloria M.
Roney, L.I.S.W.
- Clinical Director
- Hogares Incorporated
- Albuquerque, New Mexico
- John L.
Syphax, M.D.
- Director
- Inpatient Psychiatry
- Howard University Hospital
- Washington, D.C.
- Anne Wake, Ph.D.
- Private Practitioner
- Washington, D.C.
- Barbara J.
Wiest, M.A.
- Program Supervisor
- Youth Alcohol and Drug Treatment and Prevention Programs
- Clackamas County Mental Health
- Marylhurst College
- Marylhurst, Oregon
Foreword
The Treatment Improvement Protocol (TIP) series fulfills SAMHSA/CSAT's mission to improve treatment of substance use disorders by providing best practices guidance to clinicians, program administrators, and payors. TIPs are the result of careful consideration of all relevant clinical and health services research findings, demonstration experience, and implementation requirements. A panel of non-Federal clinical researchers, clinicians, program administrators, and patient advocates debates and discusses their particular area of expertise until they reach a consensus on best practices. This panel's work is then reviewed and critiqued by field reviewers.
The talent, dedication, and hard work that TIPs panelists and reviewers bring to this highly participatory process have bridged the gap between the promise of research and the needs of practicing clinicians and administrators. We are grateful to all who have joined with us to contribute to advances in the substance use disorder treatment field.
- Nelba Chavez, Ph.D.
- Administrator
- Substance Abuse and Mental Health Services Administration
- H.
Westley Clark, M.D., J.D., M.P.H., CAS, FASAM
- Director
- Center for Substance Abuse Treatment
- Substance Abuse and Mental Health Services Administration
Source: The National Clearinghouse for Alcohol and Drug Information
DHHS Publication No. (SMA) 99-3282
Return to:Table of Contents
Next Section: Executive Summary and Recommendations
|
 |
|
|
advertisement
Find a
Treatment Center
Click here
Additional Information
Alcohol
and Families
Marijuana
Anabolic
Steroids
Dual
Diagnosis
Adolescent
Substance
Abuse
Domestic
Violence
Anger and
Alcohol
|
