A-CRA includes many treatment components that have been found effective in the treatment of other behavioral health problems. When clinicians are trained in A-CRA, they also learn how to use these components to address other problems that a youth might have.

A study compared whether A-CRA participants who had co-occurring problems were as likely to stay in treatment, and have similar outcomes as those who had substance use disorders only. At the beginning of treatment, adolescents who had co-occurring disorders not only reported more emotional problems, but also reported more substance use than adolescents with substance use problems only.

Adolescents in both groups attended an equivalent number of treatment sessions, which suggests that the A-CRA approach is effective at engaging and retaining these youth in treatment. During follow-up interviews 12 months after they started treatment, both groups showed significant improvement. Adolescents with externalizing disorders (e.g., conduct disorder, attention deficit-hyperactivity disorder) or both externalizing and internalizing disorders (e.g., generalized anxiety disorder, depression, post-traumatic stress disorder) showed a higher rate of improvement in their alcohol and drug use relative to adolescents with substance use disorders only. Also, adolescents with co-occurring problems were more likely to report improvement with their emotional problems. This study suggests that A-CRA is a promising treatment for adolescents with substance use and mental health disorders. For more information, see Godley, S.H., Hunter, B.D., Fern├índez-Artamendi, S.F., Smith, J.E., Meyers, R.J., & Godley, M.D. (2014).