Adolescent Substance Abuse and Family Therapy Outcome

A Review of Randomized Trials
  • Holly B. Waldron
Part of the Advances in Clinical Child Psychology book series (ACCP, volume 19)


Family therapy as a treatment for substance abuse was embraced in community mental health agencies and other clinical settings in the 1970s and came to be viewed as a viable treatment alternative for many at-risk populations, including adolescents (Coleman & Davis, 1978; Kaufman & Kaufman, 1992). In the clinical literature, the importance of family-based interventions for substance abuse has remained widely accepted (Craig, 1993), and family therapy is frequently implemented with adolescent abusers (cf. Selekman & Todd, 1991). As in the broader family therapy literature, however, treatment approaches have been derived primarily from theories of family functioning and clinical experience, rather independently from research (Bry, 1988), and with little attention to systematic evaluation.


Family Functioning Family Therapy Adolescent Substance Adolescent Drug Adolescent Substance Abuse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Alexander, J. F., Holtzworth-Munroe, A., and Jameson, P. (1994). The process and outcome of marital and family therapy: Research review and evaluation. In S. L. Garfield and A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change ( 4th ed., pp. 595–630 ). New York: Wiley.Google Scholar
  2. Alexander, J. F., and Parsons, B. V. (1982). Functional family therapy. Moneterey, CA: Brooks/ Cole.CrossRefGoogle Scholar
  3. Akers, R. L., Krohn, M. D., Lanza Kaduce, L., and Radosevich, M. (1979). Social learning and deviant behavior: A specific test of a general theory. American Sociology Review, 44, 636–655.CrossRefGoogle Scholar
  4. Andrews, J. A., Hops, H., Ary, D., Lichtenstein, E., and Tildesley, E. (1991). The construction, validation and use of a Guttman scale of adolescent substance use: An investigation of family relationships. Journal of Drug Issues, 21, 557–572.Google Scholar
  5. Azrin, N. H., Donohue, B., Besalel, V. A., Kogan, E. S., and Acierno, R. (1994). Youth drug abuse treatment: A controlled outcome study. Journal of Child and Adolescent Substance Abuse, 3, 1–16.CrossRefGoogle Scholar
  6. Bailey, G. W. (1989). Current perspectives on substance use in youth. Journal of the American Academy of Child and Adolescent Psychiatry, 28 151–162.PubMedCrossRefGoogle Scholar
  7. Barnes, G. M. (1984). Adolescent alcohol abuse arid other problem behaviors: Their relation- ships and common parental influences. Journal of Youth and Adolescence, 13, 329–348.CrossRefGoogle Scholar
  8. Barnes, G. M., and Welte, J. W. (1986). Patterns and predictors of alcohol use among 7–12th grade students in New York State. Journal of Studies on Alcohol, 71, 59–69.Google Scholar
  9. Barton, C., and Alexander, J. F. (1981). Functional family therapy. In A. S. Gurman and D. P. Kniskern (Eds.), Handbook of family therapy (pp. 403–443 ). New York: Brunner/Mazel.Google Scholar
  10. Baumrind, D. (1985). Familial antecedents of adolescent drug use: A developmental perspective. In C. L. Jones and R. J. Battjes (Eds.), Etiology of drug abuse: Implications for prevention (pp. 13–44). National Institute on Drug Abuse Research Monograph 56. Rockville, MD: Department of Health and Human Service.Google Scholar
  11. Baumrind, D. (1991). The influence of parenting style on adolescent competence and substance use. Journal of Early Adolescence, 11, 56–95.CrossRefGoogle Scholar
  12. Bentler, P. M. (1992). Etiologies and consequences of adolescent drug use: Implications for prevention. Journal of Addictive Diseases, 11, 47–61.PubMedCrossRefGoogle Scholar
  13. Brook, J. S., Whiteman, M., and Gordon, A. S. (1982). Qualitative and quantitative aspects of adolescent drug use: Interplay of personality, family, and peer correlates. Psychological Reports, 51, 1151–1163.PubMedCrossRefGoogle Scholar
  14. Brook, J. S., Whiteman, M., Gordon, A. S., and Brook, D. W. (1988). The role of older brothers in younger brother’s drug use viewed in the context of parent and peer influences. Journal of Genetic Psychology, 151, 59–75.CrossRefGoogle Scholar
  15. Bry, B. H. (1988). Family-based approaches to reducing adolescent substance use: Theories, techniques and findings. In E. R. Randert and J. Grabowski (Eds.), Adolescent drug abuse: Analyses of treatment research (pp. 39–68). National Institute on Drug Abuse Research Monograph 77. Rockville, MD: Department of Health and Human Services.Google Scholar
  16. Bry, B. H., and Krinsley, K. E. (1992). Booster sessions and long-term effects of behavioral family therapy on adolescent substance use and school performance. Journal of Behavior Therapy and Experimental Psychiatry, 23, 183–189.PubMedCrossRefGoogle Scholar
  17. Bry, B. H., McKeon, P., and Pandina, R. J. (1982). Extent of drug use as a function of number of risk factors. Journal of Abnormal Psychology, 91, 273–279.PubMedCrossRefGoogle Scholar
  18. Bukstein, O. G., Brent, D. A., and Kaminer, Y. (1989). Comorbidity of substance abuse and other psychiatric disorders in adolescents. American Journal of Psychiatry, 146, 1131–1141PubMedGoogle Scholar
  19. Clayton, R. R. (1992). Transitions in drug use: Risk and protective factors. In M. Glantz and R. Pickens (Eds.), Vulnerability to drug abuse (pp. 15–51 ). Washington, DC: American Psychological Association Press.CrossRefGoogle Scholar
  20. Coleman, S. B., and Davis, D. T. (1978). Family therapy and drug abuse: A national survey. Family Process, 17, 21–29.PubMedCrossRefGoogle Scholar
  21. Craig, R. J. (1993). Contemporary trends in substance abuse. Professional Psychology: Research and Practice, 24, 182–189.CrossRefGoogle Scholar
  22. Diamond, G., and Liddle, H. A. (1996). Resolving a therapeutic impasse between parents and adolescents in multidimensional family therapy. Journal of Consulting and Clinical Psychology, 64, 481–488.PubMedCrossRefGoogle Scholar
  23. Dishion, T. J., Patterson, G. R., and Reid, J. R. (1988). Parent and peer factors associated with drug sampling in early adolescence: Implications for treatment. In E. R. Randert and J. Grabowski (Eds.), Adolescent drug abuse: Analyses of treatment research (pp. 69–93). National Institute on Drug Abuse Research Monograph 77. Rockville, MD: Department of Health and Human Services.Google Scholar
  24. Donovan, J. E., and Jessor, R. (1985). Structure of problem behavior in adolescence and young adulthood. Journal of Consulting and Clinical Psychology, 56, 890–904.CrossRefGoogle Scholar
  25. Duncan, T. E., Duncan, S. C., and Hops, H. (1994). The effects of family cohesiveness and peer encouragement on the development of adolescent alcohol use: A cohort-sequential approach to the analysis of longitudinal data. Journal of Studies on Alcohol, 55, 588–599.PubMedGoogle Scholar
  26. Ellickson, P. L., Hays, R. D., and Bell, R. M. (1992). Stepping through the drug use sequence: Longitudinal scalogram analysis of initiation and regular use. Journal of Abnormal Psychology, 101, 441–451.PubMedCrossRefGoogle Scholar
  27. Elliott, D. S., Huizinga, D., and Ageton, S. S. (1985). Explaining delinquency and drug use. Beverly Hills, CA: Sage.Google Scholar
  28. Epstein, E. E., McCrady, B. S., Miller, K. J., and Steinberg, M. N. (1994). Attrition from conjoining alcoholism treatment: Do dropouts differ from completers? Journal of Substance Abuse, 6, 249–265.PubMedCrossRefGoogle Scholar
  29. Farrell, A. D., Danish, S. J., and Howard, C. W. (1992). Relationship between drug use and other problem behaviors in urban adolescents. Journal of Consulting and Clinical Psychology, 60, 705–712.PubMedCrossRefGoogle Scholar
  30. FeCaces, M., Stinson, F. S., and Hartford, T. C. (1991). Alcohol use and physically risky behavior among adolescents. Alcohol Health and Research World, 15, 228–233.Google Scholar
  31. Flay, B. R., and Petraitis, J. (1994). The theory of triadic influence: A new theory of health behavior with implications for preventive interventions. Advances in Medical Sociology, 4, 19–44.Google Scholar
  32. Fleischman, M. J., Home, A. M., and Arthur, J. L. (1983). Troubled families: A treatment program. Champaign, IL: Research Press.Google Scholar
  33. Friedman, A. S. (1989). Family therapy vs. parent groups: Effects on adolescent drug abusers. American Journal of Family Therapy, 17, 335–347.CrossRefGoogle Scholar
  34. Gold, M. S., and Slaby, A. E. (Eds.). (1991). Dual diagnosis in substance abuse. New York: Marcel Dekker.Google Scholar
  35. Grant, K. A., Tonigan, J. S., Sr Miller, W. R. (1995). Comparison of three alcohol consumption measures: A concurrent validity study. Journal of Studies on Alcohol, 56, 168–172.Google Scholar
  36. Haley, J. (1976). Problem-solving therapy. San Francisco: Jossey-Bass.Google Scholar
  37. Hansen, W. B., Graham, J. W., Sobel, J. L., Shelton, D. R., Flay, B. R., and Johnson, C. A. (1987). The consistency of peer and parent influences on tobacco, alcohol, and marijuana use among young adolescents. Journal of Behavioral Medicine, 10, 559–579.PubMedCrossRefGoogle Scholar
  38. Hawkins, J. D., Catalano, R. F., and Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin, 112, 64–105.PubMedCrossRefGoogle Scholar
  39. Henggeler, S.W., Borduin, C. M., Melton, G. B., Mann, B. J., Smith, L. A., Hall, J. A., Cone, L., and Fucci, B. R. (1991). Effects of multisystemic therapy on drug use and abuse in serious juvenile offenders: A progress report from two outcome studies. Family Dynamics of Addition Quarterly, 1, 40–51.Google Scholar
  40. Hops, H., Tildesley, E., Lichtenstein, E., Ary, D., and Sherman, L. (1990). Parent-adolescent problem-solving interactions and drug use. American Journal of Drug and Alcohol Abuse, 16, 239–258.PubMedCrossRefGoogle Scholar
  41. Hughes, S. O., Power, T. G., and Francis, D. J. (1992). Defining patterns of drinking in adolescence: A cluster analytic approach. Journal of Studies on Alcohol, 53, 40–47.PubMedGoogle Scholar
  42. Joanning, H., Thomas, F., Quinn, W., and Mullen, R. (1992). Treating adolescent drug abuse: A comparison of family systems therapy, group therapy, and family drug education. Journal of Marital and Family Therapy, 18, 345–356.CrossRefGoogle Scholar
  43. Johnston, L. D., Bachman, J. G., and O’Malley, P. M. (1991). Monitoring the future: Questionnaire responses from the nation’s high school seniors 1990. Ann Arbor: Institute for Social Research, University of Michigan.Google Scholar
  44. Kandel, D. B. (1975). Stages in adolescent involvement in drug use. Science, 190, 912–914.PubMedCrossRefGoogle Scholar
  45. Kandel, D. B. (1982). Epidemiological and psychosocial perspectives on adolescent drug use. Journal of American Academic Clinical Psychiatry, 21, 328–347.CrossRefGoogle Scholar
  46. Kandel, D. B., Kessler, R. C., and Margulies, R. S. (1978). Antecedents of adolescent initiation into stages of drug use: A developmental analysis. Journal of Youth and Adolescence, 7, 13–40.CrossRefGoogle Scholar
  47. Kandel, D. B., Yamaguchi, K., and Chen, K. (1992). Stages of progression in drug involvement from adolescence to adulthood: Further evidence for the gateway theory. Journal of Studies on Alcohol, 53, 447–457.PubMedGoogle Scholar
  48. Kaufman, E., Sr Kaufmann, P. (1992). Family therapy of drug and alcohol abuse ( 2nd ed. ). Needham Heights, MA: Allyn and Bacon.Google Scholar
  49. Koss, J. G., and Baca, L. (in press). A new group therapy for Hispanic adolescents: A fourth life-space. Journal of Clinical Child Psychology.Google Scholar
  50. Kouzis, A. C., and Labouvie, E. W. (1992). Use intensity, functional elaboration, and contextual constraint as facets of adolescent alcohol and marijuana use. Psychology of Addictive Behaviors, 6, 188–195.CrossRefGoogle Scholar
  51. Krinsley, K. E. (1991). Behavioral family therapy for adolescent school problems: School performance effects and generalization to substance use (Doctoral dissertation, Rutgers University). Dissertation Abstracts International, 52, 1725b.Google Scholar
  52. Labouvie, E. W. (1986). The coping function of adolescent alcohol and drug use. In R. K. Silbereisen, K. Eyferth, and G. Rudinger (Eds.), Development as action in context: Problem behavior and normal youth development (pp. 229–240 ). New York: Springer-Verlag.CrossRefGoogle Scholar
  53. Leccese, M., and Waldron, H. B. (1994). Assessing adolescent substance abuse: A critique of current measurement instruments. Journal of Substance Abuse Treatment, 11, 553–563.PubMedCrossRefGoogle Scholar
  54. Lewis, R. A., Piercy, F. P., Sprenkle, D. H., and Trepper, T. S. (1990). Family-based interventions for helping drug-abusing adolescents. Journal of Adolescent Research, 5, 82–95.CrossRefGoogle Scholar
  55. Liddle, H. A., and Dakof, G. A. (1995a). Family-based treatment for adolescent drug use: State of the science. In E. R. Randert and D. J. Czechowicz (Eds.), Adolescent drug abuse: Clinical assessment and therapeutic interventions (pp. 218–254). National Institute on Drug Abuse Research Monograph 156. Rockville, MD: Department of Health and Human Services.Google Scholar
  56. Liddle, H. A., and Dakof, G. A. (1995b). Efficacy of family therapy for drug abuse: Promising but not definitive. Journal of Marital and Family Therapy, 21, 511–544.CrossRefGoogle Scholar
  57. Liddle, H. A., Dakof, G. A., Parker, K., Barrett, K., Diamond, G. S., Garcia, R., and Palmer, R. (1995). Multidimensional family therapy of adolescent substance abuse. Manuscript submitted for publication.Google Scholar
  58. Maisto, S. A., and Conners, G. J. (1990). Clinical diagnostic techniques and assessment tools in alcohol research. Alcohol Health and Research World, 14, 232–238.Google Scholar
  59. McCrady, B. S., Noel, N. E., Abrams, D. B., Stout, R. L., Newlson, H. F., and Hay, W. M. (1986). Comparative effectiveness of three types of spouse involvement in outpatient behavioral alcoholism treatment. Journal of Studies on Alcohol, 47, 459–467.PubMedGoogle Scholar
  60. McGee, L., and Newcomb, M. D. (1992). General deviance syndrome: Expanded hierarchical evaluations at four ages from early adolescence to adulthood. Journal of Consulting and Clinical Psychology, 60, 766–776.PubMedCrossRefGoogle Scholar
  61. Miller, W. R., Brown, J. M., Simpson, T. L., Handmaker, N. S., Bien, T. H., Luckie, L. F., Montgomery, H. A., Hester, R. K., and Tongan, J. S. (1995). What works? A methodological analysis of the alcohol treatment outcome literature. In R. K. Hester and W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: Effective alternatives ( 2nd ed., pp. 12–44 ). Boston: Allyn and Bacon.Google Scholar
  62. Miller, W. R., and Rollnick, S. (1991). Motivational interviewing. New York: Guilford Press.Google Scholar
  63. Miller, W. R., Westerberg, V., and Waldron, H. B. (1995). Evaluating alcohol problems in adults and adolescents. In R. K. Hester and W. R. Miller (Eds.), Handbook of alcoholism treatment approaches: Effective alternatives ( 2nd ed., pp. 17–53 ). Boston: Allyn and Bacon.Google Scholar
  64. Minuchin, S. (1974). Families and family therapy. Cambridge, MA: Harvard University Press.Google Scholar
  65. National Institute on Alcohol Abuse and Alcoholism. (1990). Alcohol and health: Seventh special report to the U.S. Congress. Rockville, MD: Department of Health and Human Services.Google Scholar
  66. Needle, R., McCubbin, H., Lorence, J., and Hockhauser, M. (1983). Reliability and validity of adolescent self-reported drug use in a family-based study: A methodological report. International Journal of Addiction, 18, 901–912.Google Scholar
  67. Newcomb, M. D., Sr Bentler, P. M. (1989). Substance use and abuse among children and teenagers. American Psychologist, 44, 242–248.Google Scholar
  68. Newcomb, M. D., and Felix-Ortiz, M. (1992). Multiple protective and risk factors for drug use and abuse: Cross-sectional and prospective findings. Journal of Personality and Social Psychology, 63, 280–296.PubMedCrossRefGoogle Scholar
  69. O’Farrell, T. J., Cutter, H. S. G., and Floyd, F. J. (1985). Evaluating behavioral marital therapy for male alcoholics: Effects on marital adjustment and communication from before to after treatment. Behavior Therapy, 16, 147–167.Google Scholar
  70. O’Farrell, T. J. and Maisto, S. A. (1987). The utility of self-report and biological measures of alcohol consumption in alcoholism treatment outcome studies. Advances in Behavior Research and Therapy, 9, 91–125.CrossRefGoogle Scholar
  71. Penning, M., and Barnes, G. E. (1982). Adolescent marijuana use: A review. International Journal of Addictions, 17, 749–791.Google Scholar
  72. Petraitis, J., and Flay, B. R., and Miller, T. Q. (1995). Reviewing theories of adolescent substance use: Organizing pieces in the puzzle. Psychological Bulletin, 117, 67–86.PubMedCrossRefGoogle Scholar
  73. Patterson, G. R., Reid, J. B., and Dishion, T. J. (1992). Antisocial boys. Eugene, OR: Castalia.Google Scholar
  74. Ravels, V. H., and Kandel, D. B. (1987). Changes in drug behavior from middle to late twenties: Initiation, persistence, and cessation of use. American Journal of Public Health, 77, 607–611.CrossRefGoogle Scholar
  75. Santisteban, D. A., Szapocznik, J., Perez-Vidal, A., Kurtines, W. M., Murray, E. J., and LaPerriere, A. (1996). Efficacy of interventions for engaging youth/families into treatment and some factors that may contribute to differential effectiveness. Journal of Family Psychology, 10, 35–44.CrossRefGoogle Scholar
  76. Scopetta, M. A., King, O. E., Szapocznik, J., and Tillman, W. (1979). Ecological structural family therapy with Cuban immigrant families. Report to the National Institute on Drug Abuse, Grant No. H81DA 01696.Google Scholar
  77. Selekman, M. D., and Todd, T. C. (1991). Family therapy approaches with adolescent substance abusers. Needham Heights, MA: Allyn Sr Bacon.Google Scholar
  78. Shedler, J., and Block, J. (1990). Adolescent drug use and psychological health: A longitudinal inquiry. American Psychologist, 45, 612–630.PubMedCrossRefGoogle Scholar
  79. Snow, D. L., Tebes, J. K., and Arthur, M. W. (1992). Panel attrition and external validity in adolescent substance use research. Journal of Consulting and Clinical Psychology, 60, 804–807.PubMedCrossRefGoogle Scholar
  80. Sobell, L. C., and Sobell, M. B. (1992). Timeline follow-back: A technique for assessing self-reported alcohol consumption. In R. Z. Litten and J. P. Allen (Eds.), Measuring alcohol consumption: Psychosocial and biochemical methods (pp. 41–72 ). Totowa, NJ: Humana Press.CrossRefGoogle Scholar
  81. Spitzer, R. L., Endicott, J., Fleiss, J. L., and Cohen, J. G. (1970). The psychiatric status schedule: A technique for evaluating psychopathology and impairment in role functioning. Archives of General Psychiatry, 23, 41–55.PubMedCrossRefGoogle Scholar
  82. Stanton, M. D., and Shadish, W. R. (in press). Outcome, attrition, and family/marital treatment for drug abuse: A meta-analysis and review of the controlled, comparative studies. Psychological Bulletin.Google Scholar
  83. Stanton, M. D., Todd, T.C., and Associates. (1982). The family therapy of drug abuse and addiction. New York: Guilford Press.Google Scholar
  84. Szapocznik, J., Kurtines, W. M., Foote, F. H., Perez-Vidal, A., and Hervis, O. (1983). Conjoint versus one-person family therapy: Some evidence for the effectiveness of conducting family therapy through one person. Journal of Consulting and Clinical Psychology, 51, 889–899.Google Scholar
  85. Szapocznik, J., Kurtines, W. M., Foote, F. H., Perez-Vidal, A., and Hervis, O. (1986). Conjoint versus one-person family therapy: Further evidence for the effectiveness of conducting family therapy through one person with drug-abusing adolescents. Journal of Consulting and Clinical Psychology, 54, 395–397.PubMedCrossRefGoogle Scholar
  86. Szapocznik, J., Perez-Vidal, A., Brickman, A. L., Foote, F. H., Santisteban, D., Hervis, O, and Kurtines, W. M. (1988). Engaging adolescent drug abusers and their families in treatment: A strategic structural systems approach. Journal of Consulting and Clinical Psychology, 56, 552–557.PubMedCrossRefGoogle Scholar
  87. Thompson, K. M., and Wilsnack, R. W. (1987). Parental influence on adolescent drinking: Modeling, attitudes, or conflict? Youth and Society, 19, 22–43.CrossRefGoogle Scholar
  88. von Bertalanffy, L. (1948). General systems theory: Foundation, development, applications. New York: Braziller.Google Scholar
  89. Waldron, H. B. (1992). Families of alcohol-abusing adolescents. National Institute on Alcohol Abuse and Alcoholism, Grant No. R01 AA08718.Google Scholar
  90. Waldron, H. B. (1994). Drug abuse treatments for adolescents. National Institute on Drug Abuse, Grant No. R01 DA09422.Google Scholar
  91. Welte, J. W., and Barnes, G. M. (1985). Alcohol: The gateway to other drug use among secondary-school students, Journal of Youth and Adolescence, 14, 487–498.CrossRefGoogle Scholar
  92. White, H. R., and Labouvie, E. W. (1989). Toward the assessment of adolescent problem drinking. Journal of Studies on Alcohol, 50, 30–37.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Holly B. Waldron
    • 1
  1. 1.Department of PsychologyUniversity of New MexicoAlbuquerqueUSA

Personalised recommendations