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Dissertation

A transtheoretical approach to the treatment of substance-abusing adolescents and their families

24 July 1998

Abstract

An outpatient substance abuse treatment program for adolescents and their families is developed, based on the transtheoretical model of behavior change (Prochaska, DiClemente, & Norcross (1992). This.model introduces a framework for understanding the process of behavior change, whether a person is involved in therapy or is a "self changer." It delineates five distinct stages that people pass through when changing a behavior, and defines ten corresponding change processes that people use to facilitate movement between stages, in the progression toward change. Five conceptual levels of change, ranging in hierarchy from situational/symptomatic to intrapersonal are described, which represent the different content areas that define the focus of change. The inclusion of motivational interviewing is discussed as a critical and natural adjunct to this model, in that motivational readiness is a key component of change. Empirical support for this approach is reviewed. The applicability of the transtheoretical approach in the treatment of adolescents is discussed, with particular attention to the treatment needs of this . population as compared to adults. Family involvement is considered of paramount importance in treatment with this population. The clinical, administrative, and evaluative components of the program are presented, and integrated into a functional program complete with program forms and therapeutic handouts for clinical operation.


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