Maureen Fitzgerald
Communications Coordinator, ATTC Network
Editor, NIATx
This year, the Center for Substance Abuse Research (CASAR) at the University of Minnesota Medical School celebrates 25 years of developing research-based tools and resources for adolescent drug abuse assessment and treatment. Dr Ken C. Winters, director of CASAR, shares some insights on adolescent treatment in the interview that follows.
KW: We started CASAR in 1990 with a focus on studying adolescent drug abuse from a research perspective. We're celebrating our Silver Anniversary this year.
I think we were one of the first research centers to focus on assessment and treatment issues with respect to adolescent drug abuse. In the late 1980s and early 1990s, there were numerous school- and community-based prevention research programs, and there was a fair amount of treatment research on adult addiction, but we had few research peers in the area of adolescent chemical dependency. Minnesota was unique at that time in that our state had several adolescent drug treatment programs, and it was somewhat rare in those days for one region to have so many programs. Clinicians sought our help in how to do a better job of identifying and treating teenagers who may have a drug problem. The treatment field didn't have the knowledge base to know if a 12-step program makes sense of adolescents, or how to define drug abuse and dependence in an adolescent. Clinicians also wanted to know about emerging counseling techniques that could be applied an an adolescent drug treatment program.
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| CASAR staff (l-r): Patrick McIlvaine, Tamara Fahnhorst, Randy Stinchfield, Andria Botzet, Ken Winters, and Christine Dittel. Not pictured: Ali Nicholson, Maureen Laschen, and Bradley Campbell. |
Our body of work is very applied, and we focus on getting new tools into service providers' toolboxes using mechanism that folks in the service sector can access easily. These include user-friendly manuals, trainings, workshops, and lately, a lot of webinars. The tools inlcude the short Personal Experience Screening Questionnaire (PESQ) that we developed about 25 years ago--a quick screening tool that a clinician can use in 10 minutes to aid in screening for a possible drug problem in a teenager and to help determine if he or she may need either a brief intervention, or a full assessment. For a teen with a moderate drug problem, we developed Teen Intervene--a three-session intervention and counseling program. Teen Intervene was developed and tested in an effort to address the need for briefer counseling services for teens who may not need intensive treatment. This was an effort to develop an effective tool that could be used by a wide range of counseling professionals--not just those in substance abuse treatment settings. A current project called the MPower Program is evaluating if an intervention with "more dosage" can help those teens who also have mild mental or behavioral health problems.
What are the most significant advances in adolescent substance abuse research that have occurred in the past 25 years?
KW: I would say that there have been two major advances. We do know a lot more about what works in the field of drug prevention than ever before. The last 25 years of prevention research have led to some basic principles that can be used when developing new of choosing existing prevention programs.
Several evidence-based programs and practices are available, including the Life Skills program, which helps adolescents deal with a range of issues, such as how to deal with the stress and strain of being an adolescent without using drugs. There are also a host of community-based programs--Communities that Care, for example--that focus on developing strong community initiatives and including parents to optimize opportunities to build assets and reduce risk factors in youth.
The other major advance is the greater ability to understand what kinds of features and elements work well when you are treating a teen with a drug abuse problem. This knowledge has helped to adjust and shape treatment approaches that have been applied to adults but are adapted to work with adolescents. Counselors working with adolescents today now have a lot of knowledge upon which to base their treatment approaches. For example, 12-step programs can work very well when adapted to teenagers. Family-based treatment and cognitive behavior therapy are also very promising when working with youth.
(See related article: Winters, K., Tanner-Smith, E., Bresani, E., & Meyers (2014). Current advances in the treatment of adolescent drug use. Adolescent Health, Medicine and Therapeutics, 2014:5, 199-210)
From your perspective at CASAR, what is the most pressing issue today in adolescent substance use disorders?
KW: Most pressing today is the challenge of how to educate young people and help them make healthy decisions in a pro-marijuana era. We are in an interesting conundrum, with the pro-marijuana camp talking about the health benefits of marijuana, and this is getting a lot of attention. Unfortunately, much of the information is not science-based, and uninformed adults have moved the discussion and public policy way beyond where science suggests it should go.
Another pressing lies in figuring out how to get services to teens who want them and need them and may be willing to accept them, if they are presented in a way that connects with them today--and that means exploring social media platforms where young people are also connecting with each other at the social level.
Finally, to address teens' substance use issues most effectively, clinicians and counselors need to recognize that drug abuse doesn't happen in a vacuum--it's usually co-occurring with many issues. And adolescents are at a stage of brain development that simply does not promote healthy decision-making. It's important to think of all the reasons why a teen might be using drugs or alcohol and address those as well. Mental health and behavioral issues should be considered, even in screening and brief intervention.
What are some of the activities planned for your 25th anniversary celebration this year?
KW: We be hosting an open house here at the University of Minnesota, and we're also planning a celebration event to reward a group or individual whose work is consistent with our Center's philosophy of advancing resources to address adolescent drug abuse. We'll be sending out an announcement about this award and how people can apply for it, or how than can nominate someone or a group. We want to acknowledge ways that young people are striving to make their community a healthy place.
To view current projects and a list of publications, visit the CASAR website at: http://www.psychiatry.umn.edu/research/casar/home.html
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