Cognitive Behavior Therapy
It is not uncommon for adolescents to experiment with a variety of substances. However, studies have shown that children who experiment with substances at a young age are more likely to use other drugs later in life (Focus Adolescent Services, 2000). For example, an estimated 40% of youth who begin drinking at or before the age of 14 years will become dependent on alcohol (Schneider Institute for Health Policy, 2001). Some adolescents’ exposure may be limited to experimentation, but others may develop a dependency, potentially experiment with other dangerous drugs and even cause significant harm to themselves and others.
In a national survey conducted in 2003, half of all high school seniors reported that they had tried illicit drugs at least once (Snyder & Sickmund, 2006). The survey also revealed that 41% of 10th grade students and 23% of 8th grade students had tried illegal drugs. Marijuana was the most frequently-used drug, as reported by 46% of the 12th grade students participating in the survey. More than three-quarters of these students also reported experimenting with alcohol: recent heavy drinking was reported by 28% of seniors, 22% of 10th graders and 12% of 8th graders. Another survey conducted by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) examined the past year and lifetime prevalence rates for alcohol use among youth ages 12 to 17 (National Survey on Drug Use and Health, 2007). These findings are alarming because substance use among youth has been associated with a number of negative consequences, including physical aggression, academic and occupational problems, delinquency and criminal behavior, developmental problems and long-term health problems (U.S. Department of Health and Human Services, 2007). In addition, children and adolescents who become chronic substance users often develop psychological or social problems. Studies of males entering the juvenile justice system confirm the link between substance use and crime (Gehshan, 2000). Complicating matters even further is the fact that many adolescents who abuse substances have a diagnosable mental health disorder. According to the National Comorbidity Study, 41 to 65% of individuals with a lifetime substance abuse disorder also have a lifetime history of at least one mental health disorder and about 51% of those with one or more lifetime mental health disorders also have a lifetime history of at least one substance use disorder (U.S. Department of Health and Human Services, 1999). These rates are highest in the 15 to 24 year-old age group (Kessler et al., as cited by the U.S. Department of Health and Human Services). One theory suggests that individuals in this age group may abuse drugs in an effort to self-medicate for a co-occurring mental disorder. In 2004, it was estimated that 1.4 million youth nationwide were in need of substance abuse treatment and fewer than 10% of them received services (Hills, 2007). Numerous methods are used to treat children and adolescents with a substance use disorders. For this review, Numerous methods are used to treat children and adolescents with a substance use disorders. For this review, The goal of Cognitive Behavioral Therapy (CBT) is the identification and modification of maladaptive thinking patterns to reduce negative thoughts, feelings and behavior. For substance abusers, the focus of this intervention is generally relapse prevention (National Institute on Drug Abuse [NIDA], 1999). CBT can help the adolescent develop greater self-control, identify environmental and internal triggers leading to relapse, and develop strategies for dealing with stressors, triggers, and lapses into substance use. The role of clinicians is to aid the youth in anticipating the problems that they are likely to meet and to help them to develop effective coping strategies. CBT also includes elements directed toward substance use, such as relapse prevention, but also addresses...
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