Page 90 - Age of onset of disruptive behavior of residentially treated adolescents -Sjoukje de Boer

ways of ending treatment. After all, to prevent dropout, it may be advisable to approach potential withdrawals and potential pushouts differently.
While cannabis usage prior to treatment turned out to be a predictor of dropout, usage by itself was not a contra-indication for treatment, unless there were severe addiction problems that needed primarily substance abuse related treatment. In the Netherlands, cannabis usage is not a criminal offence and is fairly common among adolescents. Research showed that 27% of all 16 year olds and 29% of all 17 year olds have used cannabis occasionally. These percentages are higher for 17 year old adolescents admitted in judicial institutions, as about 70% of them was reported to use cannabis (Van Laar et al., 2014). In our sample, about two thirds used cannabis prior to treatment, which is just a little lower than in adolescents admitted to judicial institutions. Among the participants who dropped out, this percentage was higher (77.9%) compared to those who completed treatment (57.8%). During treatment, extra attention should thus be given to the group that is familiar with cannabis usage, in order to reduce the risk of dropout.
Limitations
While studies in naturalistic settings carry substantial clinical relevance because of their ecological validity, methodological limitations hamper interpretation of findings. It affects the representativeness and replicability of the study and it makes it virtually impossible to draw causal inferences. The main limitation of this study relates to the assessment of variables. Data were derived from files, and collected by several clinicians. Also, we do not know to what extent the inclusion of youths in the clinic has influenced our results.
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