A meta-analysis of drug abuse outcome studies 1 involving 1 571 cases and an estimated 3500 patients and family members that family therapy was more effective than individual counselling, peer group therapy or family psychoeducation. Family therapy was as effective for adults as for adolescents and appeared to be a cost-effective adjunct to methadone maintenance.
A technology assessment report 2 assessing the effectiveness of programmes for serious adolescent mental and substance abuse problems was abstracted in the Health Technology Assessment Database. The review was based on profound literature searches. The authors conclude that present evidence favours the use of family therapy over individual therapy in adolescents with mental illness. This evidence is stronger for adolescents with anorexia nervosa than those with other diagnoses. There was no sufficient evidence on the effectiveness of day-care programmes for adolescents with mental illness. Day programmes appeared to be effective in reducing substance abuse and improving educational outcome.
Comment: The quality of evidence is downgraded by heterogeneity of interventions and outcomes.
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