title: The efficacy of two adolescent substance abuse treatments and the impact of comorbid depression: results of a small randomized controlled trial.
abstract: OBJECTIVE
  The purpose of this randomized trial was to investigate the efficacy of 2 behavioral treatments focusing on different change mechanisms in ameliorating a borderline personality disorder constellation of behaviors and substance use in adolescents referred by juvenile diversion programs.
  
  
  METHODS
  Forty adolescents 14-17 years of age and meeting Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for borderline personality disorder and substance use disorders were randomized to integrative borderline personality disorder-oriented adolescent family therapy (I-BAFT) or individual drug counseling. This design allowed a comparison of 2 manualized interventions, 1 family based and 1 individually oriented. Profiles of clinical change were used to detect impact and estimate treatment effect sizes.
  
  
  RESULTS
  Primary analyses showed that both interventions had a clinically significant impact on borderline personality disorder behaviors 12 months after baseline but with no differential treatment effects. The impact on substance use was more complex. Subgroup analyses revealed that adolescents with depression had significantly more severe profiles of borderline personality disorder and substance use. These youths were the only group to show reductions in substance use, but they only did so if they received the I-BAFT intervention. Study data also documented the high dosage of intensive residential treatment needed by this population.
  
  
  CONCLUSIONS
  Results highlight the intensive treatment needs of juvenile justice-involved youths with co-occurring substance use and borderline personality disorder including depression, the hybrid outpatient and residential treatment often required by this population, and the promise of a family-oriented approach, particularly for youths with severe symptoms and co-occurring depression. (PsycINFO Database Record
authors: Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami.
authors: Daniel A
authors: DA
authors: Santisteban
authors: Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami.
authors: Maite P
authors: MP
authors: Mena
authors: Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami.
authors: Joan
authors: J
authors: Muir
authors: School of Nursing and Health Studies, University of Miami.
authors: Brian E
authors: BE
authors: McCabe
authors: Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami.
authors: Clara
authors: C
authors: Abalo
authors: Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami.
authors: Amanda M
authors: AM
authors: Cummings
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D001883:Borderline Personality Disorder / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D005196:Family Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007604:Juvenile Delinquency; D008297:Male; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome