Volume_7_Issue_1_Digest

1 TPC Digest 1 | TPC Digest The Adolescent Substance Use Risk Continuum Alexis Miller, Jennifer M. Cook A Cultural Strength-Based Approach to Case Conceptualization M any theories are used to conceptualize adolescent substance use, yet none adequately assist mental health professionals in assessing adolescents’ strengths and risks, while incorporating cultural factors. The authors reviewed common adolescent substance abuse theories, their strengths and limitations, and offered a new model to conceptualize adolescent substance use: The Adolescent Substance Use Risk Continuum (ASURC). The authors outline three common limitations of previous theories, including lack of specificity in regards to social influences, the use of problematic language and disregarding cultural influences. While previous theories have used the term, social influences in a general sense, types of social influences, such as family, peers, school, sports teams, clubs and religious organizations, have not been differentiated. Problematic language has included terms such as deviant and delinquent behavior , which we believe pathologize and marginalize youth who have made poor choices. Finally, previous models have lacked emphasis on the importance of cultural factors in regards to adolescent substance use. Although prior models have highlighted the importance of social influences on adolescents’ substance use, they have not integrated cultural factors specifically. The ASURC is proposed as a model to conceptualize adolescent substance use that builds on strengths of previous model while addressing their limitations. Our model emphasizes the importance of cultural considerations when conceptualizing adolescent substance use and breaks down social influences into more specific components. Further, the ASURC is a strength-based approach; problematic language expressed in previous models has been eliminated to reduce stigma and shame. Focusing on strengths while using the ASURC can aid clinicians in fostering a sense of hope while working with this population. As the name suggests, the ASURC is a continuum, ranging from minimal risk to high risk. We chose to start the continuum at minimal risk instead of no risk as substance use and addiction can occur in anyone. The components of the model include: caregiver engagement, caregiver-adolescent relationship, family substance abuse history, biological risk, susceptibility to peer influences, childhood adversity, and academic engagement. We explain each component of the model in detail, underscoring how each component can serve as either a protective or risk factor, aiding counselors in case conceptualization. Along with the aforementioned components, cultural factors are integrated into the model. In the ASURC, cultural identities are represented above the model to indicate how they influence all other components listed in the model. We present a case study to illustrate how the model can be used to conceptualize a client case and demonstrate how it can guide clinicians in treatment planning. We conclude with a discussion of the case and suggestions for future research. Alexis Miller, NCC, is a professional counselor for the Dual Diagnosis Partial Hospitalization Program at Rogers Memorial Hospital in Madison, WI. Jennifer M. Cook, NCC, is an Assistant Professor at Marquette University. Correspondence can be addressed to Rogers Memorial Hospital, Attn: Alexis Miller, 406 Science Dr., Suite 110, Madison, WI 53711, alexis.miller626@gmail.com .