In the Bradley family episode four, the social worker is hesitant to enroll Tiffany in a Narcotics Anonymous program that is based on the 12-step approach. Existing evidence indicates that the 12-step approach is effective in addressing the problem of substance abuse among adolescents. Adolescent substance abuse treatment is, in most cases, based on the 12-step approach of Alcoholics Anonymous. Although studies conducted to assess the intervention are few, the ones conducted indicate that they are effective in adolescents with substance abuse disorders. Kelly et al. (2016) developed a systematic TSF treatment for outpatient substance abuse adolescents. An iTSF intervention that comprised twelve-step facilitation, motivational enhancement, and cognitive behavioral therapy was developed and implemented on thirty-six adolescents diagnosed with a substance disorder. The researchers conducted assessments at baseline and after the first three and six months.
Significant treatment components were in-services conducted by Marijuana Anonymous, parents in some parts of the sessions conducted to give a rationale for TSF, and application of the Socratic therapeutic approach (Kelly et al., 2016). Results of the study indicate that the iTSF intervention was acceptable among adolescents and feasible. Satisfaction levels were high among participants (a score of 4.49 out of 5). In line with the TSF framework, the intervention significantly improved participation. Besides, high participation was positively associated with greater abstinence. Therefore, iTSF is an effective manualized approach that can be executed in treating adolescents with substance abuse disorder in outpatient settings. It is highly compatible with the existing adolescent treatment, easy to adopt, and sustainable.
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In implementing TSF on Tiffany, the social worker is required to consider several factors for the approach’s effectiveness. Compared to adults with substance abuse disorders, adolescents have less adverse and less complicated clinical histories. In addition, they have reduced intrinsic motivation to engage in the treatment, continuing care, and change their drug use behaviors (Kelly et al., 2016). Also, according to (Kelly et al., 2016), most adolescents lack independent transportation and the liberty to attend the 12-step sessions at their will, even in cases when they want to. They encounter barriers in participating in 12-step programs because most members are older. The average age for Alcoholics Anonymous is 47 years old, while that of Narcotics Anonymous is 43 years old. Only less than two percent of members are below the age of twenty-one years. This creates a barrier to identity and a sense of belonging for adolescents (Kelly et al., 2016). As a result, it would be essential for social workers to consider engaging clients such as Tiffany in TSF programs specifically tailored for adolescents to address their needs and berries. Counseling skills are needed for the approach.
Existing evidence on the effectiveness of Cognitive-behavioral therapy (CBT) for adolescents with substance disorder is limited. However, the few studies conducted indicate that the intervention is promising and it is effective even when implemented alone for adolescent substance abuse. The intervention can help manage co-occurring mental health problems as well as behavioral issues related to substance abuse among adolescents (Kaminer & Waldron, 2015). It is critical that the social worker understands that his/her role is to help Tiffany overcome skill deficits and improve her coping strategies so that she is able to address high-risk circumstances that can cause a relapse. Training in cognitive therapy is needed to implement CBT intervention. As a beginning researcher, I have adequate knowledge to benefit from researching evidence-based practices. I have developed skills such as critical thinking, analytical skills, and scientific mindedness skills needed to identify and integrate practices supported by empirical evidence. The research conducted supports the implementation of the interventions on adolescents, and the interventions are replicable in Tiffany’s case. Besides, the information provided is adequate to make a decision on the intervention because it incorporates all essential aspects of conducting research.
References
Kaminer, Y., & Waldron, H. B. (2015). Evidence-based cognitive–behavioral therapies for adolescent substance use disorders: Applications and challenges. Adolescent Substance Abuse , 396-420.
Kelly, J. F., Yeterian, J. D., Cristello, J. V., Kaminer, Y., Kahler, C. W., & Timko, C. (2016). Developing and testing twelve-step facilitation for adolescents with substance use disorder: Manual development and preliminary outcomes. Substance Abuse: Research and Treatment , 10 , SART.S39635.
