The relationship between treatment implementation factors and core CBT goals in adolescent substance abuse treatment

Adolescent substance abuse continues to be a major problem in this country and effective treatments are needed to minimize the negative consequences associated with drug use. Although research has supported the use of Cognitive-Behavioral Therapy (CBT) to treat adolescent substance abuse, clinicians know little about which treatment factors are most important to achieving positive outcome. Treatment implementation factors in CBT for adolescent substance abusers were examined in the current study. Participants were 64 inner-city adolescents who participated in a larger randomized psychotherapy clinical trial. Videotaped therapy sessions were judged by trained raters using a fourteen-point measure developed specifically for use with CBT for adolescent substance abuse. Results showed that despite training and supervision in the larger clinical trial, therapists largely did not adhere to the treatment manual, resulting in low use of specific CBT techniques. Regression analyses indicated that treatment implementation factors associated with specific CBT techniques largely did not predict outcome. Implications for future research with adolescent substance abuse as well as the importance of verifying treatment integrity in psychotherapy research are discussed