Document Type

Critically Appraised Topic

Publication Date

2012

Clinical Scenario

Drug and alcohol use by adolescents has been shown to have a myriad of negative effects, including impairments in attention, processing speed, and sleep quality (Jacobus, Bava, Cohen-Zion, Mahmood, & Tarpert, 2009); executive functioning, memory, and visuospatial skills (Thoma et al., 2011) and increasing the risk of sexually transmitted infections (Bryan, Schmiege, & Magnan, 2012). Ultimately, substance use can impair participation and engagement in life, and can have effects on the individual, family, and community levels (Stoffel & Moyer, 2004). Because of the potential for deep and wide effects on functioning, substance abuse is an area of concern and intervention for occupational therapists. The National Institute on Drug Abuse [NIDA] statistics on adolescent drug use show what while there have been declines in use of some substances among 8th-12th graders, there have been increases in others, and that substance use by adolescents continues to be a national concern.

Occupational therapists could see clients with substance abuse disorders in almost any setting, with the resulting impairments being primary or secondary to original referring condition (Stoffel & Moyer, 2004). Stoffel and Moyer’s (2004) review of evidence-based occupational therapy interventions for substance abuse indicated that there are four main categories of interventions used by occupational therapists; brief interventions cognitive-behavioral therapy, motivational strategies, and 12-step treatment programs. These techniques have been shown to be effective as occupational therapy interventions, but there are gaps in understanding how effective these methods are with adolescents. In addition, these interventions are designed more to treat, rather than prevent, substance use disorders. There are many programs outside of occupational therapy that have been developed specially to prevent substance abuse in adolescents, and these programs have been developed and implemented at the national, local, or organizational level. Examples include school-based programs, national awareness campaigns, and community resources. Each of these programs can have different and multiple several components, but one common component featured in many of these programs is adolescent mentoring (Sipe, 2002). Much like substance abuse, mentoring is a complex relationship whose effects are hard to single out and understand, but there do seem to be specific themes (e.g. length and type of mentoring relationship) that correlate with better outcomes (Sipe, 2002). This critically appraised paper was an effort to review the current research on mentoring and substance abuse prevention in adolescents and to examine its potential as a therapeutic intervention for occupational therapists.

Clinical Question

Does mentoring reduce the likelihood of substance abuse in adolescents compared to adolescents who do not receive mentoring?

Clinical Bottom Line

The research presented does not support a clear link between the presence of a mentor and a decreased likelihood of substance abuse in adolescence; however, it does suggest that the quality and duration of mentorship may affect outcomes. Specifically, in several studies, mentors who received training and support were associated with more positive outcomes, as were mentor-youth relationships lasting more than one year. Occupational therapists who wish to use mentoring as an intervention strategy should consider the type of training and support they will provide to mentors as well as length of treatment during the program planning process.

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