Psychosocial interventions among children and adolescents

Substance use disorders in children and adolescents are a significant cause of concern as they can have long term implications in practically every sphere. The etiological factors that contribute to substance use disorders are complex and the formulation must amalgamate and synthesize all the different factors including the predisposing, perpetuating, precipitating and protective factors in order to plan management. Interventions must stem from this comprehensive formulation and must be child-focused, multidisciplinary, multisystemic, with strong family participation and community involvement. The treating team must actively collaborate with the young person and help him/her understand the rationale for treatment in order for them to engage in it. Assessment and treatment of comorbidities are an important part of intervention package. Skill training for problem solving, emotional regulation, social skills, and communication are an essential part of the treatment for substance use disorders in adolescents. Relapse prevention strategies, including how to seek help when there is a lapse must be part and parcel of the interventions delivered to the young person. Substance use disorder interventions must be part of a larger plan that addresses other areas of concern in the young person's life. While there are few studies, and so a relatively weak and preliminary evidence base for pharmacotherapeutic interventions, early evidence shows that their combination with psychosocial interventions may have a synergistic effect on substance use reduction. Substance use disorders affect the entire family and the community at large and thus must be treated holistically, but by individualising the treatment to suit the needs of that particular child and family.