Alcohol treatment goal choice predicts longitudinal drinking outcomes in adolescent substance users

Social cognitive theory suggests that when individuals select their own goals, they work harder to achieve them as compared to clinician-imposed goals. Moreover, achieving goals during the course of treatment may increase self-efficacy, which could positively predict outcome. Research in clinical samples of adults with alcohol use disorder supports the utility of treatment goal choice in predicting longitudinal outcomes; a total abstinence (TA) goal choice has been associated with better clinical outcomes (e.g. greater percentage of days abstinent, more days to relapse to heavy drinking) compared to a controlled use (CU) goal choice. Treatment of adolescents presents unique challenges, because adolescents tend to be resistant to treatment and often enter treatment in response to external pressures (e.g. parent, school system). Data from 110 adolescents aged 14 to 18 were collected upon admission to outpatient substance use disorder treatment. A series of hierarchical linear regressions was used to test the utility of the alcohol treatment goal choice variable in predicting drinking outcomes at 6-, 12-, and 24-month follow-ups. Separate models were run to examine binge drinking days, percentage of days abstinent, and drinks per drinking day at each time point. Goal choice significantly predicted drinking outcomes at the 12-month follow-up, but not at the 6- or 24-month time points, such that TA goal choice was associated with better clinical outcomes. These findings are relevant to treatment planning, as they suggest that goal choice may have clinical utility as a predictor of alcohol use disorder clinical course in adolescents.