An examination of cognitive changes among youth in community-based and juvenile justice secure residential treatment

Abstract

Researchers recommend increasing clinical attention to cognitive skill development for substance abusing youth to improve treatment outcomes, but little is known about cognitive improvement during standard substance abuse treatment. Also, studies indicate that youth in juvenile justice treatment settings, compared to those in community-based settings, may be at a cognitive disadvantage, but few studies have compared their treatment needs. To address these gaps in the literature, this study hypothesized that (1) cognitive functioning (criminal thinking, urgency, and planning) would improve during treatment, (2) youth in community-based treatment settings would report better cognition than youth in juvenile justice secure treatment, and (3) youth in community-based settings would improve more than youth in juvenile justice secure treatment. Data were collected at 3 time points (intake, 35 days, and 90 days in treatment) from 359 youth in 8 community-based and 2 juvenile justice secure substance abuse treatment programs. Hypotheses were tested by estimating repeated measures structural equation models. Results indicated that youth in both treatment settings showed improvements in decision making (planning) but unexpected increases in their criminal thinking and impulsivity in response to emotions (urgency). Youth in juvenile justice settings reported less planning at intake, a greater increase in cold heartedness, and a smaller increase in power orientation than youth in community-based settings. Findings imply that youth in juvenile justice settings have different treatment needs than those in community-based settings. More research is needed to determine the best policy approach moving forward.