Substance use disorders (SUDs) in children and underage adolescents are a major issue nowadays. SUDs consist of multiple “cognitive, behavioral, and physiological symptoms” and are associated with changes in cognition and behavior (American Psychiatric Association [APA], 2013, p. 484; National Institute on Drug Abuse, 2016). Various solutions to the issue are being tested (Liddle et al., 2018), and individual cognitive-behavioral therapy (ICBT) is one of them.
According to the premise of cognitive-behavioral therapy (CBT), by changing patients’ thinking processes, CBT can have an impact on their behaviors (Winters et al., 2018). CBT involves determining SUD-reinforcing factors and developing the behaviors and skills that can assist in combating them (Martin, Volkmar, & Bloch, 2018). The emphasis on skill training is a primary feature of this approach to SUD treatment.
CBT is effective in treating various addictions and substance use disorders (Martin et al., 2018; Sadock, Sadock, & Ruiz, 2015). Both individual and group CBTs have been applied to adolescents with SUDs, but ICBT has more consistent evidence to indicate its effectiveness (Martin et al., 2018). The quality of evidence in favor of CBT varies, but, as shown by Martin et al. (2018), there are randomized clinical trials demonstrating its effectiveness despite the lack of recent studies on the topic.
Use with the Child/Adolescent Patient Population
When treating children and adolescents for substance use disorders, CBT is usually used to maintain abstinence (National Institute on Drug Abuse [NIDA], 2014; Sadock et al., 2015). Consequently, ICBT requires motivation for participation, which may be considered an eligibility requirement. However, motivation can be promoted, and ICBT fits the described population by being focused on determining individual difficulties and strengths (Martin et al., 2018), which is essential for underage people with SUDs (NIDA, 2014).
ICBT therapists need to be trained in CBT and working with the described population (Sadock et al., 2015). Furthermore, it is important to ensure that the treatment considers the use of particular substances (NIDA, 2014). Consequently, training is a major consideration when discussing ICBT for SUDs in youths. The specialists who can apply ICBT to the described population are not very numerous and may not be available for all regions, but Internet-based treatment can help to resolve the latter problem (Sadock et al., 2015).
The effectiveness of SUDs ICBT is evaluated through its key outcomes: abstinence and its maintenance. Drug use should be tested throughout the treatment period, and follow-ups are important (NIDA, 2014). However, SUDs tend to be chronic (APA, 2013; Nash, Marcus, Engebretson, & Bukstein, 2015), and prolonged or repeated treatment should be viewed as a reasonable requirement for positive outcomes.
To summarize, ICBT is an approach to SUDs treatment that can be employed with children and adolescents. Its key outcomes should be used for its evaluation, and it is evidenced to be effective with the described population. However, there is a shortage of the people who can perform ICBT, which can restrict its application.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders; DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.
Liddle, H., Dakof, G., Rowe, C., Henderson, C., Greenbaum, P., Wang, W., & Alberga, L. (2018). Multidimensional Family Therapy as a community-based alternative to residential treatment for adolescents with substance use and co-occurring mental health disorders. Journal of Substance Abuse Treatment, 90, 47-56. Web.
Martin, A., Volkmar, F., & Bloch, M. (Eds.) (2018). Lewis’s child and adolescent psychiatry (5th ed.). Philadelphia, PA: Wolters Kluwer.
Nash, A., Marcus, M., Engebretson, J., & Bukstein, O. (2015). Recovery from adolescent substance use disorder: Young People in recovery describe the process and keys to success in an alternative peer group. Journal of Groups in Addiction & Recovery, 10(4), 290-312. Web.
National Institute on Drug Abuse. (2014). Principles of adolescent substance use disorder treatment: A research-based guide. Web.
National Institute on Drug Abuse. (2016). Alcohol. Web.
Sadock, B., Sadock, V., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Philadelphia, PA: Wolter Kluwer/Lippincott Williams & Wilkins.
Winters, K. C., Botzet, A. M., Stinchfield, R., Gonzales-Castaneda, R., Finch, A. J., Piehler, T. F.,… Hemze, A. (2018). Adolescent substance abuse treatment: a review of evidence-based research. In C. Leukefeld & T. Gullotta (Eds.), Adolescent substance abuse (pp. 141-171). Cham, Switzerland: Springer.