Examining potential iatrogenic effects of group treatment for incarcerated adolescents
Rates of substance use among juvenile offenders are disproportionately high and frequently associated with deviant and criminal behavior (Mulvey, Schubert, & Chassin, 2010). Despite the prevalence of group-based treatment for adolescent substance abuse (Young, Dembo, & Henderson, 2007), some authors caution that aggregation of high-risk youth may increase rather than decrease antisocial behavior, thus producing iatrogenic effects. The current study sought to identify the extent to which various group processes as rated by counselors, observers, and adolescents mediate the relationship between type of group treatment received while incarcerated and adolescents' substance use and conduct problems following their release. Of the group processes investigated, only deviancy training (i.e., peers reinforcing each others' antisocial acts during group sessions) was differentially impacted by treatment type as rated by counselors and observers. Treatment differences were not found when using adolescent ratings, suggesting that adolescents may be less able to meaningfully assess their own behaviors during group treatment. Using multiple mediation, simple mediation, and moderated mediation analyses, no evidence was found in support of the claim that deviancy training during group treatment is related to poorer outcomes, or iatrogenic effects. This finding remained consistent across the three different perspectives (i.e., observers, counselors, adolescents) of deviancy training for all substance use outcomes examined at 3- and 6-months post-release. The indirect effect of treatment type was insignificant across all models examined. Findings indicate the effect of treatment on substance use outcomes post-release is not mediated by deviancy training, or any of the other group processes investigated.^
Shayna S Bassett,
"Examining potential iatrogenic effects of group treatment for incarcerated adolescents"
Dissertations and Master's Theses (Campus Access).