Commentary: Quality Care for Adolescents, a Consumer Guide to Treatment
As we recognize the significance of recovery this month and head toward implementation of the evolving Affordable Care Act and Parity legislation, we have more opportunities than ever to improve the adolescent substance abuse treatment system, and consequently, the lives of the next generation of Americans. Because treatment for adolescent substance use disorder is most effective when it is of high quality and when evidence-based treatments and practices (EBTs/EBPs) are delivered well, the Treatment Research Institute is contributing to promoting such practices by employing a consumer guide approach to measuring, reporting on (and ultimately improving) the quality of adolescent substance abuse treatment. Consumer Guides, as we know them, offer comparable information on features such as relevance, quality and value which can inform and direct a consumer’s purchase, but equally, and perhaps more importantly, can improve the service marketplace. This approach offers transparency for measurable quality indicators and reports on the availability of such within specific treatment programs. Consumers can make informed choices by selecting programs that offer elements a teenager needs. Programs can advocate for dollars to support EBPs they cannot offer due to budget constraints, and purchasers can see areas where funding limits should be reconsidered. In this way, more stakeholders can contribute to treatment improvements.
We have systematically identified 10 key elements with 67 corresponding components of effective adolescent substance abuse treatment programs. By conducting literature reviews and commissioning panels of scientific experts, practitioners and parents, we built the Consumer Guide1 to improve upon and advance the seminal work of Drug Strategies2. We have standardized a protocol to measure treatment quality and have adapted transparent means to present comparative information in an intuitively understandable manner. We are measuring quality features of adolescent programs and are in the process of developing a Consumer Guide to Adolescent Substance Abuse Treatment website to display the results of this work. We believe that this guide will reveal the baseline measures of where programs currently stand, offer rapid expansion of consumers’ access to, and utilization of, comparative information for decision-making, result in system-wide improvements, and provide a transportable protocol for use by others interested in this work. This stepping stone toward greater delivery of EBPs and improved treatment quality provides an opportunity for our field to advocate on behalf of adolescents dealing with addiction. Informed consumers (and providers) are an essential force for improving availability, quality and costs of services and products – particularly those within healthcare3.
Adolescent substance use treatment has been woefully underfunded, often misunderstood and sometimes inadequate for far too long. The time is now to change this. Treatment Research Institute looks forward to sharing the Consumer Guide to Adolescent Substance Abuse Treatment in the new year ahead, and we are eager to have the community join in our efforts to represent and demand the best in substance use treatment and care for adolescents.
Kathleen Meyers, Ph.D. has more than 25 years of clinical research experience and is a Senior Scientist at Treatment Research Institute. She is a recognized leader in the assessment and treatment of adolescent substance use disorders (SUD), delinquency and co-morbidity and is the author of the Comprehensive Adolescent Severity Inventory (CASI), a multidimensional assessment instrument for youth with co-morbidity that is widely used throughout the United States, Canada and abroad. She has served on numerous expert panels sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), the National Institute of Drug Abuse (NIDA), the National Institute of Justice (NIJ), and the Office of Juvenile Justice and Delinquency Prevention (OJJDP), as well as on peer review, institutional review and editorial review boards. She holds a Bachelor of Arts degree in Psychology & Statistics from Rutgers University, a Master of Science in Evaluation and Applied Research from Hahnemann University and a Doctorate degree in Educational Psychology from Temple University.
1Cacciola, et al., in press
2Brannigan, et al, 2004
3Hibbard et al., 2005; Ippolito, 1992; Hirth, 1999