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A recent study conducted by SAMHSA reveals that treatment for substance use disorders significantly reduces substance use and criminal activity (SAMHSA, 1998b). Administering treatment to adolescents, then, could greatly prevent future substance use related-problems as the adolescent transitions into adulthood. Understanding the relationship between substance use and adolescent development is crucial for designing effective interventions and treatment strategies. Treatment efforts that approach young people as "little adults" are bound to fail. Rather, the treatment process must incorporate the nuances of the adolescent's experience--including cognitive, emotional, moral, and social development--so that treatment providers can begin to grasp why substance use becomes a part of the identity of these young people.
Adolescence is a time when interpersonal relationships are transformed and new cognitive abilities emerge. The adolescent is for the first time forming an individual sense of self. The psychosocial changes associated with the passage into adult society occur within the context of the significant physiological changes of puberty. Social relationships move from a predominant attachment to family to an increased bonding and identification with peers. Teenagers also begin joining and identifying with institutions outside the family--schools, churches, Boy and Girl Scouts, political groups, and fan clubs. The extra familial bonding often has a very pluralistic character, with peer groups being only a visible and influential part.
Adherence to the family's values evolves into independent thinking and the development of a personal belief and value system. Abstract thinking, propositional logic (the ability to form hypotheses and consider possible solutions), and meta cognition (the ability to think about the thought process itself) are essential abilities that develop during the adolescent years. It stands to reason that these cognitive functions are vital to the process of establishing therapeutic relationships between therapist and client, and for the client to gain insight into the adverse course of substance use, as well as to engage in behavioral change strategies.
Not all young people who experiment with substances develop clinical problems. In fact, some degree of experimentation with drugs is technically normative; that is, most adolescents have tried alcohol or illicit drugs at least once by the time they turn 18 (Johnston et al., 1995). The formidable task faced by every adolescent--to become an independent and responsible adult--is undertaken with strategies that may include exploration, experimentation, risk taking, limit testing, and questioning of established rules and sources of authority. Experimentation with substances may be among these usually functional strategies, despite the potential harm and hazard associated with this behavior. However, substance use can lead to an abusive and addictive pattern that requires more active, firm, and constant intervention.
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