The impact of social support and self-esteem on adolescent substance abuse treatment outcome

Although poor social resources and low self-esteem have been implicated in the development of teenage drug abuse, the role of these factors in the remission of adolescent addiction remains unclear. This study examines social support characteristics and self-esteem in relation to outcome following adolescent chemical dependency treatment. Adolescents and their parents completed self-report questionnaires and a research interview during treatment and at 6 and 12 months post-treatment. Two types of outcome were assessed at follow-up: (1) alcohol and drug use, and (2) functioning in major life domains (e.g., family, school/work, peers). Results indicate that the quality of social resources (i.e., drug-use patterns of supports) reported during treatment was related to alcohol- and drug-use status post-treatment, with abstainers reporting more nonusing supports than teens who returned to heavy drug use. Self-esteem and the degree of satisfaction with social support during treatment were negatively correlated with the number of major life problems during the 6 months following discharge. Altogether, inpatient measures of self-esteem, number of high-quality supports, and social support satisfaction accounted for 16% of the variance in 6-month substance use outcome and 25% of the variance in psychosocial functioning 6 months post-treatment. Six-month social support and self-esteem measures were similarly related to 1-year outcome. The implications of these findings for adolescent drug abuse treatment are discussed.