Clinical Course and Relapse among Adolescents Presenting for Treatment of Substance Use Disorders: Recent Findings

Purpose of Review: This narrative review provides a 10-year update of an earlier review of empirical literature examining the clinical course of substance use disorders (SUDs) for adolescents seeking treatment. It begins with a conceptualization of SUD clinical course after treatment initiation as multi-dimensional, including processes of remission, relapse, and recovery. Next, theory development and research on predictors of clinical course are summarized. Recent Findings: Despite movement in theoretical models from a focus on either discrete outcomes (e.g., return to any use) or processes (e.g., return to problematic use) toward conceptualizing SUD clinical course as multifaceted (e.g., including aspects of functioning), a review of 59 studies (not all independent samples) indicated that most empirical research focused on single-dimension outcome variables (i.e., substance use only) with limited theory specifically on processes of behavior change guiding research. Summary: Our findings suggest that research is needed to advance theory and understanding of behavior change and maintenance after treatment initiation. Future research may benefit from both conceptualizing this line of research within an addiction Research Domain Criteria (RDoC) framework and an evolving bio-psychosocial model, and from employing more intensive data collection methods, which would allow for examination of the change processes over different time scales.