Table 1.
Evidence-based psychotherapy and pharmacotherapy treatments for adolescent cannabis use disorder
| Individual-Focused Therapies | Description |
|---|---|
| A-CRA | An individual-focused intervention that aims to increase an adolescent’s engagement in their community and activities that are incompatible with substance use to reinforce and support recovery. Consists of weekly sessions over 12–14 wk that include 10 adolescent, 2 caregiver, and 2 family sessions and case management |
| CBT | An individual-focused, structured approach that concentrates on identifying patterns of substance use and learning and applying skills and strategies to reduce use. Treatment typically entails 12–20 weekly sessions |
| CM | Behavioral intervention typically delivered as an adjunct component along with other evidence-based interventions (ie, MET/CBT) in which rewards are provided for positive behaviors (eg, abstinence, attendance). Delivery of CM with adolescents includes clinic-delivered and/or caregiver-delivered CM, and CM methods include the Fishbowl method, voucher method, or point-and-level system |
| MET/CBT | An individual-focused intervention that combines CBT and MET, which involves the use of motivational interviewing to resolve ambivalence and increase motivation to reduce substance use. Treatment ranges from 5 to 12 weekly sessions in individual and/or group formats |
| Family-Based Therapies | Description |
| BSFT | Family-based intervention that focuses on improving family functioning to reduce adolescent substance use and other problems. Consists of 12–16 family sessions with services delivered in the home, clinic, and other community settings |
| FFT | Family-based intervention that entails modifying maladaptive family patterns and cognitive behavioral techniques. Treatment includes around 12–14 weekly sessions that can be delivered in the clinic or home |
| Family-based I-CBT | Family-based, integrated intervention for co-occurring substance use disorder and suicidality. Treatment includes adolescent, caregiver, and family sessions. Session delivery and length vary depending on adolescent clinical presentation and insurance |
| MDFT | Family-based intervention that focuses on 4 treatment domains: adolescent, parent, family environment and relationships, and extrafamilial. Sessions are conducted 1 to 3 times per week over 3–6 mo and include adolescent, caregiver, and family sessions |
| MST | Family-based intervention in which individual, family, peers, school, and community factors are addressed to reduce adolescent substance use. Treatment is intensive with sessions delivered one to several times per week in home and community settings across 3–5 mo and therapists available 24/7 to families |
| RRFT | An integrative treatment that addresses co-occurring trauma-related symptoms and risk behaviors (eg, substance use, risky sexual behavior). Treatment includes 16–20 weekly individual sessions with caregiver and family sessions conducted as needed |
| Pharmacotherapiesa | Description |
| NAC | A well-tolerated antioxidant derived from l-cysteine used in combination with other therapeutic interventions to reduce cravings and withdrawal symptoms |
Abbreviations: A-CRA, adolescent community reinforcement approach; BSFT, brief strategic family therapy; CBT, cognitive behavioral therapy; CM, contingency management; CUD, cannabis use disorder; FDA, US Food and Drug Administration; FFT, functional family therapy; I-CBT, integrated CBT intervention; MDFT, multidimensional family therapy; MET/CBT, motivational enhancement therapy/cognitive behavioral therapy; MST, multisystemic therapy; NAC, N-acetylcysteine; RRFT, risk reduction through family therapy.
a
There are currently no FDA-approved pharmacotherapies for CUD in adolescents.