Best Practices -- Early Intervention, Outreach and Community Linkages for Youth with Substance Use Problems

2008
ISBN: 978-0-662-48417-2
Cat. No.: H128-1/08-531E
HC Pub.: 4980

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Table of Contents

• Executive Summary
• 1. Introduction
  • 1.1 Methodology
  • 1.2 Scope and Limitations
• 2. Literature Review
  • 2.1 Patterns of Youth Substance Use
    • 2.1.1 General Prevalence
    • 2.1.2 Gender-Specific Considerations
    • 2.1.3 Age of Initiation
    • 2.1.4 Alcohol
    • 2.1.5 Cannabis
    • 2.1.6 Volatile Substances/Inhalants
    • 2.1.7 Non-Medical Use of Prescription and Over-the-Counter Drugs
    • 2.1.8 Ecstasy and Other Amphetamines
    • 2.1.9 Opiate, Cocaine and Injection Drug Use
    • 2.1.10 Alcohol Abuse and Dependence
  • 2.2 Client-Related Characteristics
    • 2.2.1 Pregnant or Parenting Youth
    • 2.2.2 Youth and Sexual/Gender Orientation
    • 2.2.3 Poly-Substance Using Youth
    • 2.2.4 Youth Living with or at Risk for Blood-Borne Pathogens
    • 2.2.5 Homeless and Transient Youth
    • 2.2.6 Youth with Concurrent Mental Health Disorders
    • 2.2.7 Aboriginal Youth
    • 2.2.8 Youth Who Use Volatile Substances/Inhalants
    • 2.2.9 Youth in Conflict with the Law
    • 2.2.10 Diverse Ethnicity and Culture
    • 2.2.11 Rural Youth
  • 2.3 Early Intervention
    • 2.3.1 Introduction to Early Intervention
    • 2.3.2 Screening for Substance Use
    • 2.3.3 Screening Formats
    • 2.3.4 Screening for Stages of Use and Readiness to Change
    • 2.3.5 Brief Interventions
    • 2.3.6 Aspects of Brief Intervention
    • 2.3.7 Motivational Interviewing
    • 2.3.8 Evidence for Brief Interventions and Motivational Interviewing
    • 2.3.9 Group Interventions
    • 2.3.10 Parent/Guardian and Family-Focused Intervention Efforts
    • 2.3.11 Student Assistance Programs
    • 2.3.12 Internet-Based Interventions
  • 2.4 Outreach
    • 2.4.1 Introduction to Outreach
    • 2.4.2 Assessing the Need and Targeting Outreach Services
    • 2.4.3 Outreach Staff and Activities
    • 2.4.4 Peer Helpers in Outreach Activities
    • 2.4.5 Evaluation of Outreach Programs
  • 2.5 Community Linkages
    • 2.5.1 Introduction to Community Linkages
    • 2.5.2 Essential Community Linkages
    • 2.5.3 Barriers to Community Linkages
    • 2.5.4 Case Management
    • 2.5.5 Step Care Methods
    • 2.5.6 Coordinating Mental Health and Problem Substance Use Services
    • 2.5.7 Creating Linkages Among Service Providers
    • 2.5.8 Implementing Community-Wide Approaches
• 3. Key Informant Interviews
  • 3.1 Selection of Key Experts
  • 3.2 Key Expert Interview Process
  • 3.3 Key Client Considerations
    • 3.3.1 Circumstances Faced by Youth with Substance Use Problems
    • 3.3.2 Key Actions for Working with Youth Who Have Substance Use Problems
    • 3.3.3 Important Considerations for Specific Youth Populations
  • 3.4 Early Intervention and Outreach Approaches
    • 3.4.1 Theoretical or Applied Orientations for Early Intervention and Outreach
    • 3.4.2 Structuring Early Intervention Approaches
    • 3.4.3 Implementing Early Intervention Screening Approaches
    • 3.4.4 Internet-Based Intervention Support Materials
    • 3.4.5 Outreach Approaches
    • 3.4.6 Outreach Workers
    • 3.4.7 Supporting Early Intervention and Outreach
    • 3.4.8 Evaluation of Early Intervention and Outreach Strategies
  • 3.5 Community Linkages
    • 3.5.1 Essential Community-Based Services and Supports
    • 3.5.2 Service Delivery Challenges
    • 3.5.3 Policy and Service Gaps
    • 3.5.4 Coordinated and Integrative Service Delivery Approaches
• 4. Focus Groups
  • 4.1 Introduction
  • 4.2 Participant Demographics
  • 4.3 Challenges Faced by Youth with Substance Use Problems
    • 4.3.1 Feelings of Desperation and Loss of Control
    • 4.3.2 Peer Influences
    • 4.3.3 History of Abuse, Trauma and Complex Family Issues
    • 4.3.4 Disengagement from School or Work Activities
    • 4.3.5 Exposure to Substance Abuse by Family Members or Older Individuals
    • 4.3.6 Decreased Hope and Self-Esteem
    • 4.3.7 Gender-Based Stigma
  • 4.4 Early Intervention
    • 4.4.1 Provide Opportunities for Open and Supportive Interactions About Substance Use
    • 4.4.2 Engage Youth in High-Interest Recreation and Leisure Activities
    • 4.4.3 Ensure Access to Positive Sources of Social Support
    • 4.4.4 Intervene with Younger Adolescents
    • 4.4.5 Focus on Youths' Strengths
  • 4.5 Outreach Approaches
    • 4.5.1 Convey a Genuine Interest
    • 4.5.2 Sustain Supportive and Problem-Solving Interactions
    • 4.5.3 Take Time to Build a Relationship
    • 4.5.4 Provide Timely Assistance to Youth
    • 4.5.5 Avoid Use of Sanctions Alone
    • 4.5.6 Go Where Youth Are
  • 4.6 Community Services and Linkages
    • 4.6.1 Provide Safe and Positive Meeting Places for Youth
    • 4.6.2 Ensure Practical and Meaningful Educational Experiences
    • 4.6.3 Build Positive Peer Support Networks
    • 4.6.4 Ensure Youth-Focused Transition Support and Treatment Options
    • 4.6.5 Increase Community Members' Understanding and Appreciation of Youth
• 5. Best Practice Statements
  • 5.1 Strengthening Service Delivery Orientations
    • 5.1.1 Readiness to Change Model
    • 5.1.2 Strength-Based Methods
    • 5.1.3 Youth Perspectives
    • 5.1.4 Youth-Specific Services
    • 5.1.5 Inclusive vs. Exclusionary Policies
  • 5.2 Client-Focused Considerations
    • 5.2.1 Histories of Abuse and Trauma
    • 5.2.2 Basic Needs
    • 5.2.3 Peer Influences
    • 5.2.4 Concurrent Mental Health Disorders
    • 5.2.5 Cultural Sensitivity
    • 5.2.6 Aboriginal Youth
    • 5.2.7 Youth in Conflict with the Law
  • 5.3 Screening Processes
    • 5.3.1 Role of Community-Based Service Providers
    • 5.3.2 Areas of Inquiry for Screening
  • 5.4 Early Intervention
    • 5.4.1 Early Intervention with Young Adolescents
    • 5.4.2 Brief Interventions
    • 5.4.3 Group Interventions
  • 5.5 Outreach
    • 5.5.1 Outreach Locations and Times
    • 5.5.2 Outreach Worker Competencies
    • 5.5.3 Preliminary Outreach Activities
    • 5.5.4 Follow-Up Outreach and Intervention Activities
  • 5.6 Relevant Community-Based Supports
    • 5.6.1 Youth-Focused Agencies
    • 5.6.2 Housing Options and Policies
    • 5.6.3 Family Collaboration
    • 5.6.4 School-Based Strategies
    • 5.6.5 Youth Mentorship
    • 5.6.6 Recreational and Leisure Activities
• 5.7 Coordinating and Integrating Community Approaches
  • 5.7.1 School-Based Service Collaboration
  • 5.7.2 School Engagement Strategies
  • 5.7.3 Information Exchanges
  • 5.7.4 Case Management Practices
  • 5.7.5 Coordinated and Collaborative Service Delivery Approaches
  • 5.7.6 Consultation and Community Awareness
  • 5.7.7 Evaluation
• 6. Future Research
• References
• Appendix A: Community-Readiness Strategies
• Appendix B: Document Sections Supporting the Best Practice Statements
• List of Tables
  • Table 1: Prevalence (%) of Alcohol and Cannabis Use by Students
  • Table 2: Prevalence (%) of Other Drug Use in the Past Year by Students
  • Table 3: Stages of Use and Corresponding Intervention
  • Table 4: Geographic Distribution of Key Experts
  • Table 5: Professional Roles of Key Experts
  • Table 6: Educational Backgrounds of Key Experts
  • Table 7: Focus Group Participant Demographics