a The National Center on Addiction and Substance Abuse at Columbia University.
J Clin Child Adolesc Psychol. 2014;43(5):695-720. doi: 10.1080/15374416.2014.915550. Epub 2014 Jun 13.
This article updates the evidence base on outpatient behavioral treatments for adolescent substance use (ASU) since publication of the previous review completed for this journal by Waldron and Turner ( 2008 ). It first summarizes the Waldron and Turner findings as well as those from more recent literature reviews and meta-analytic studies of ASU treatment. It then presents study design and methods criteria used to select 19 comparative studies subjected to Journal of Clinical Child & Adolescent Psychology level of support evaluation. These 19 studies are grouped by study category (efficacy or effectiveness) and described for sample characteristics, methodological quality, and substance use outcomes. Cumulative level of support designations are then made for each identified treatment approach: ecological family-based treatment, group cognitive-behavioral therapy, and individual cognitive-behavioral therapy are deemed Well Established; behavioral family-based treatment and motivational interviewing are deemed Probably Efficacious; drug counseling is deemed Possibly Efficacious; and four integrated treatment models combining more than one approach are deemed Well Established or Probably Efficacious. The remainder of the article (a) articulates fidelity, mediator, and moderator effects reported for evidence-based approaches since 2008 and (b) recommends four enhancements to the prevailing business model of ASU outpatient services to accelerate penetration of evidence-based approaches into the underserved consumer base: pursue partnerships with influential governmental systems, utilize web-based technology to extend reach and control costs, adapt effective methods for linking services across sectors of care, and promote uptake and sustainability by emphasizing return on investment.
本文更新了自 Waldron 和 Turner（2008 年）为该期刊完成上一次综述以来，针对青少年物质使用（ASU）的门诊行为治疗的证据基础。它首先总结了 Waldron 和 Turner 的发现，以及最近的 ASU 治疗文献综述和荟萃分析研究的结果。然后介绍了选择 19 项经过比较研究并进行了《临床儿童与青少年心理学杂志》支持评估的研究设计和方法标准。这 19 项研究按研究类别（疗效或有效性）分组，并描述了样本特征、方法质量和物质使用结果。然后为每个确定的治疗方法指定累积支持等级：生态家庭为基础的治疗、小组认知行为治疗和个体认知行为治疗被认为是成熟的；行为家庭为基础的治疗和动机访谈被认为是可能有效的；药物咨询被认为是可能有效的；而四种综合治疗模式结合了一种以上的方法被认为是成熟的或可能有效的。本文的其余部分（a）阐述了自 2008 年以来针对循证方法报告的保真度、中介和调节效应，（b）建议对 ASU 门诊服务现行商业模式进行四项改进，以加速将循证方法渗透到服务不足的消费者群体中：与有影响力的政府系统建立伙伴关系，利用基于网络的技术扩大服务范围并控制成本，适应跨护理部门连接服务的有效方法，以及通过强调投资回报来促进采用和可持续性。
