Most researchers developing psychosocial interventions for drug using teens now accept that just as they must craft combination therapies in the behavioral realm, they need to devise combination therapies of behavioral and psychopharmacological interventions in the treatment of substance abuse as well. In two of our current clinical trials, for instance, clinical teams of substance abuse counselors and psychologist supervisors work with contextually oriented child psychiatrists to determine appropriate, concurrent psychotropic medications for the kids in the treatment protocols. The child psychiatrist, of course, is fully in charge of the diagnosis and determination of the medication to be used, and she closely monitors medication compliance, reaction, and efficacy. At the same time, the clinicians are in close contact with the child psychiatrist while they conduct the multiple systems oriented therapy-family work, school intervention, vocational planning, tutoring, other case management, and naturally, individual work with the adolescent. These different interventions, including the use of medications for the teen or the parent, are coordinated.
Interventions occur in the different realms simultaneously.
It also seems to address the practical, clinical needs of the case quite well. The medications for the teen typically target symptoms such as depression and anxiety, and they can facilitate the adolescent's or parent's participation in the individual, family, or group behaviorally-oriented treatments. Residential treatment falls on the end of the spectrum. It is an intensive intervention and represents a restrictive kind of care. A stay at a residential care facility can interrupt the cycle of drug taking and the deepening of a drug using lifestyle.