What works, why, and for whom? Evaluating live-in substance use treatment for youth in British Columbia

Justification of research project

This project was developed to advance practical and theoretical understanding of youth substance use treatment, with significant academic and community-level implications. Given that substance use centers are administered and delivered through the charitable sector, this research further seeks to disseminate findings throughout the philanthropic sector to grantmaking foundations working in the area of youth mental health. Advancing our understanding of how to maximize the impact of youth substance use treatment is highly pertinent given the urgent and evolving nature of youth substance use and the critical need for evidence-based, developmentally informed treatment approaches. While live-in treatment programs offer a uniquely supportive environment that provides safety, stability, and opportunities for intensive therapeutic engagement, there remains a striking lack of empirical understanding regarding which program components are most effective, why they work, and for whom. By partnering with a leading charitable organization to conduct a longitudinal, multi-informant evaluation, this study directly addresses these knowledge gaps and responds to calls from clinicians and policymakers for data-driven insights to guide practice.

Importantly, the project moves beyond traditional outcome measures of abstinence to consider individualized definitions of success, reflecting the diversity of youth experiences, backgrounds, and goals. In doing so, it stands to generate meaningful contributions to both the scientific literature and the practical improvement of youth live-in treatment programs, ultimately supporting more responsive, equitable, and effective pathways to recovery for youth and safer communities for all citizens. For the philanthropic sector, this partnership research provides an empirical and theoretical understanding of best practices, donation strategry, etc… to address issue of youth mental health.

Research question

To address these limitations, our research team has partnered with a prominent community organization and registered charity to take on a multi-stage, multi-informant, and longitudinal evaluation of live-in youth substance use treatment programming. Our goals extend beyond simply evaluating whether or not the program is associated with decreased substance use. Instead, we aim to provide a substantial contribution to the literature, field, local community, and the charitable sector at large by taking a holistic approach in asking: What works, why, and for whom?

Research purpose

In light of these aims, we have developed the following specific objectives:

1. Develop a detailed typology of success: Through this objective, we plan to analyze which patterns emerge in how youth conceptualize “success”, and how this may evolve through program completion.

2. Evaluate program components: Through a deep investigation of program engagement, we will empirically evaluate which mechanisms of program involvement are significantly associated with youth-defined success.

3. Interrogate individual differences: We aim to analyze and describe how youth characteristics, such as ethnic or racial background, housing status, family background, socioeconomic status, substance use history, previous substance use treatment, and gender interact with program mechanics to influence success attainment.

4. Build philanthropic networks: Finally, our empirical and theoretical findings will inform a practitioner-facing knowledge dissemination strategy (e.g., report, infographic, podcast) to inform philanthropic actors about the value of these programs, and to establish networks with our community partner org.

Research approach

This project will unfold across the following key stages: 

• Stage 1: Literature review. First, our team will conduct an extensive literature review to determine the full extent of the evidence for live-in substance use treatment. This review will provide an important foundation for our project, however, it will also create an important resource for the community and a valuable academic paper. It will also serve as the basis for a brief report/infographic targeting philanthropic foundations working in this area disseminated through the PhiLab network. 

• Stage 2: Interviews. We will conduct structured qualitative interviews with youth currently attending, and who have recently graduated from, the Youth Recovery House. These interviews will be transcribed and coded, providing an organizational framework through which to interpret and organize youth definitions of success.  

• Stage 3: Program Mechanisms and Individual Differences. In order to determine which elements of the program are associated with youth success, and how youth differences influence these effects, we will collaborate with the Bridge to develop quantitative accounts of youth engagement from staff (e.g., how many sessions youth attend, how engaged youth are in session, etc) and from youth (e.g., how connected youth feel to program staff, how engaged and satisfied they are with the program, how safe they feel, etc). Reviews of youth intake files will be used to detail youth demographics and histories.