TABLE 2. Randomized Clinical Trials of Interventions for Treating Dually Diagnosed Adolescents

Intervention study

Characteristics MST IT FBT CBT EBFT SS
Comparison group

SAU

CBT

ICPS

PET

SAU

SAU


Sample size 118 32 56 88 124 33
Gender (%)
    Male 79 61.5 82 70 59 0
    Female 21 38.5 18 30 41 100
Race/ethnicity (%)
    Hispanic 1 0 16 0 42
    Black 50 0 2 0 7
    White 47 90 79 90 37
    Others 2 10 3 10 14
Age range 12–17 13–18 12–17 13–18 12–17
    Mean 15.7 15.9 15.4 15.4 14.9
Diagnosis (% comorbid) SUD (72% comorbid) SUD and MH (100% comorbid) SUD and MH (100% comorbid) Psychoactive SUD; (predominantly comorbid) SUD and MH diagnosis (SUD 74.2% comorbid) SUD and PTSD (100% comorbid)
Attrition rate 2% tx retention in MST group 50% IT, 50% CBT 56/88 completed eight of 15 sessions Tx completion rate: 86%, 3-month follow-up: 80%; 9-month follow-up: 65% EBFT: 45% completed all 15 sessions and 77% completed five or more sessions Research attrition— intake: 18 SS/15 SAU, Post: 14 SS/12 SAU, follow-up: 11 SS/9 SAU
Delivery of treatment MST: at home, SAU outpatient Outpatient aftercare Outpatient Outpatient SAU = shelter services, EBFT = outpatient Outpatient
Data collection Pre-tx, post-tx, 6 months Pre-tx, 3 months post-tx Pre-tx, post-tx, 6-month follow-up Pre-tx, post-tx, 3-month follow-up, 9-month follow-up Pre-tx, post-tx, 6-month follow-up, 12-month follow-up Pre-tx, post-tx, 3-month follow-up
Outcomes: substance use MST significantly reduced alcohol and drug use CBT better at reducing substance use than IT at 3 months; both showed improvement at 15 months FBT and ICPS equally effective in reducing alcohol and drug problems; both groups showed significant reduction in illicit drug use pre to post and maintained at follow-up CBT lower relapse rates than PET at 3 months; similar relapse rates between groups at 9 months EBFT showed greater reduction in substance abuse than SAU SS showed significantly better improvements in substance use, cognitions related to SUD than SAU but few gains maintained at follow-up
Outcomes: related problems

MST reduced number of days in out-of-home placement and criminal activity

CBT showed more improvement in family functioning than IT at 3 month; both showed equal improvement at 15 months

FBT and ICPS = effective in reducing CD; both groups significantly improved conduct; mood improved significantly in both groups



EBFT and SAU show significant and equal improvement in psychological functioning, family functioning, and HIV knowledge

SS showed significantly better improvements, PTSD cognitions, and other psychopathology subscales than SAU

Note. MST (Henggeler et al., 1999); FBT (Azrin et al., 2001); CBT (Kaminer et al., 2002); EBFT (Slesnick and Prestopnik 2005), IT (Kaminer et al., 1998, 1999); SS (Najavits et al., in press); tx = treatment.