title: Defining engagement in adolescent substance abuse treatment.
abstract: Youth engagement in substance use treatment is an important construct for research and practice, but it has been thinly and inconsistently defined in the literature. Most research has measured engagement by initiation, attendance, and retention in treatment. Because youth generally enter substance use treatment as a result of compliance with external requirements, defining engagement in this way might be insufficient. This qualitative participatory research study describes five focus groups with 31 adults working with youth in substance use treatment. Focus groups were designed and conducted by youth researchers in collaboration with university-based partners. We categorized participants' descriptions of engagement into five domains, identified as "CARES": Conduct, Attitudes, Relationships, Empowerment, and Social Context. These domains represent a comprehensive and ecologically-based definition of engagement that situates engagement in the context and trajectory of youth development, has clear implications for assertive clinical practice, and provides a foundation for developing an operationalized measure.
authors.affiliation: Division of Public Behavioral Health and Justice Policy, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 2815 Eastlake Avenue East, Seattle, WA, 98102, USA, Pullmann@u.washington.edu.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Pullmann
authors.forename: Starcia
authors.initials: S
authors.lastname: Ague
authors.forename: Tamara
authors.initials: T
authors.lastname: Johnson
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lane
authors.forename: Kevon
authors.initials: K
authors.lastname: Beaver
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Jetton
authors.forename: Evangejalynn
authors.initials: E
authors.lastname: Rund
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D055812:Community-Based Participatory Research; D003299:Cooperative Behavior; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D011209:Power, Psychological; D011369:Professional-Patient Relations; D013811:Psychotherapeutic Processes; D036301:Qualitative Research; D012931:Social Environment; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*