Stress and Length of Stay in Therapeutic Community Treatment for Adolescents With Substance Use Disorders

Objectives: Time in treatment is consistently associated with successful outcomes for adolescents in therapeutic community (TC) treatment for substance use disorders. Adolescents have higher treatment dropout and relapse rates than their adult counterparts. The objectives of the study were: (1) to explore the relation between stress and length of stay in an adolescent TC and (2) to determine the utility of instruments to measure frequency and severity of adolescent stress. Methods: This cross-sectional pilot study examined the relation between stress and length of stay in a residential TC for adolescents. All 31 residents of the program completed the Symptoms of Stress Inventory (SOSI) and the Adolescent Stress Questionnaire on the same day regardless of how long they had been in the program. Results: Correlation analysis indicated a significant inverse relationship between length of stay and the Habitual Patterns subscale of the SOSI (r= - 0.39, P= 0.04) and similar nonsignificant associations between the total SOSI mean and those of other subscales. Conclusions: The results, though preliminary, suggest an association between stress and length of stay, which is consistent with an earlier study of adults in TC treatment. This finding highlights the need for further study of this phenomenon and the potential need for interventions that may reduce stress and improve retention in adolescent TCs.