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. 2020 Jun 18;15(1):42.
doi: 10.1186/s13011-020-00284-4.

Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers

Andrea Acevedo  1 , Nellie Harvey  2 , Maureen Kamanu  2 , Shalini Tendulkar  2 , Sasha Fleary  3
Affiliations

Barriers, facilitators, and disparities in retention for adolescents in treatment for substance use disorders: a qualitative study with treatment providers

Andrea Acevedo et al. Subst Abuse Treat Prev Policy. .

Abstract

Background: Retention in substance use treatment is one of the strongest predictors of improved outcomes among adolescents, making retention an important goal of treatment. We examined treatment providers' perspectives on barriers and facilitators to treatment retention among adolescents, and their views on contributors to racial/ethnic disparities in retention including ways to address disparities.

Methods: Semi-structured interviews were conducted with 19 providers at state-licensed detoxification, residential, and outpatient facilities serving adolescents for substance use disorders in Massachusetts. Interviews were coded by at least two independent coders.

Results: Providers identified barriers and facilitators at the policy/systems, facility, family, and client levels. Some of the barriers included insurance limits on sessions/length of stay and low reimbursement (policy/systems), staff turnover (facility), low family engagement (family), and low internal motivation (client). Some facilitators mentioned were support from state's substance use agency (policy/systems), flexibility with meeting location (facility), family participation (family), and high internal motivation and presence of external motivators (client). Barriers that contributed to racial/ethnic disparities included lower socio-economic status, language barriers, and mistrust. Having bilingual/bicultural staff and multi-lingual materials, and facilitating transportation were identified as strategies for reducing disparities in treatment retention.

Conclusions: It is critical that adolescents who access substance use services remain and complete treatment and that there is equity in treatment retention. Provider perspectives in factors associated with retention can inform the development of comprehensive interventions and policies to help improve retention and reduce disparities.

Keywords: Adolescents; Disparities; Retention; Substance use treatment.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. National Institue on Drug Abuse. Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide 2017 [Available from: https://www.drugabuse.gov/publications/principles-adolescent-substance-u....
    1. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health. Rockville, MD. 2018. Available from: Retrieved from https://www.samhsa.gov/data/.
    1. Tanner-Smith EE, Wilson SJ, Lipsey MW. The comparative effectiveness of outpatient treatment for adolescent substance abuse: a meta-analysis. J Subst Abus Treat. 2013;44(2):145–158. doi: 10.1016/j.jsat.2012.05.006. - DOI - PMC - PubMed
    1. Williams RJ, Chang SY. A comprehensive and comparative review of adolescent substance Abuse treatment outcome. Clin Psychol Sci Pract. 2000;7(2):138–166. doi: 10.1093/clipsy.7.2.138. - DOI
    1. Winters K, Botzet A, Fahnhorst T. Advances in adolescent substance Abuse treatment. Curr Psychiatry Rep. 2011;13(5):416–421. doi: 10.1007/s11920-011-0214-2. - DOI - PMC - PubMed

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