From the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine (Dr. Welsh and Ms. Mataczynski); Division of Alcohol, Drugs and Addiction, McLean Hospital, Belmont, MA (Ms. Nguyen and Dr. McHugh); Harvard Medical School (Dr. McHugh).
Harv Rev Psychiatry. 2020 Sep/Oct;28(5):305-315. doi: 10.1097/HRP.0000000000000272.
A growing evidence base supports the use of medication to treat opioid use disorder (OUD) in adolescents, but little is known about behavioral therapies for adolescents with OUD. A systematic review using PRISMA methodology was conducted on behavioral therapy for adolescent OUD. Only three studies were identified. Combined evidence from two studies indicates initial efficacy of the Adolescent-Community Reinforcement Approach, motivational enhancement therapy, and cognitive-behavioral therapy for reducing opioid use. The only group therapy identified, which involved adolescents and their parents, demonstrated improvement in participants' knowledge of relapse-prevention strategies, drug-refusal skills, and overall psychosocial functioning. Additional studies that included behavioral therapy but that did not specifically test its efficacy are also highlighted to expand the understanding of the small literature base. This review highlights the sparse evidence base for these therapies in this population. In addition, we highlight promising areas for future research and include evidence from the adult literature that may inform that research. Studies on behavioral therapies that utilize randomized, controlled trials for this population are imperative.
越来越多的证据支持使用药物治疗青少年阿片类药物使用障碍（OUD），但对于青少年 OUD 的行为疗法知之甚少。采用 PRISMA 方法对青少年 OUD 的行为疗法进行了系统评价。仅确定了三项研究。两项研究的综合证据表明，青少年社区强化治疗、动机增强治疗和认知行为疗法在减少阿片类药物使用方面具有初步疗效。唯一确定的团体治疗涉及青少年及其父母，该治疗显示参与者对预防复发策略、拒绝药物技能和整体心理社会功能的知识有所提高。此外，还突出了其他包含行为疗法但未专门测试其疗效的研究，以扩大对这一小文献基础的理解。这篇综述强调了这些疗法在该人群中的证据基础薄弱。此外，我们还突出了未来研究的有希望的领域，并纳入了可能为该研究提供信息的成人文献证据。对于该人群，利用随机对照试验进行行为疗法的研究至关重要。
