Although drug problems are common among teenagers, very few get treatment—and the treatment they are getting probably isn't adequate, say researchers at the nonprofit institute Drug Strategies and Cornell University.

What the researchers wanted to know: How effective are the best drug treatment programs for adolescents?

What they did: The researchers asked directors of all 50 state alcohol and drug abuse agencies, as well as the District of Columbia's agency, to recommend five outstanding adolescent treatment programs in their state and combined those with recommendations from national organizations such as the American Medical Association to come up with a list of 144 outstanding programs that treat only adolescents. They also put together an advisory panel of experts who identified nine elements that should be part of every program—such as involving parents in treatment, building trust between the adolescent and the therapist, and keeping track of outcomes (like whether kids stayed off drugs). Then a researcher interviewed someone, usually a director, from each program about their practices and scored the programs.

What they found: Most of the programs didn't do that well. Out of nine elements, there was only one element (having qualified staff) on which the majority of programs scored 4 out of 5. They did somewhat worse on the other elements; for example, most didn't have a standardized way to assess new clients— which means they couldn't tailor their programs to each kid's needs, the researchers write. Only a little over a third of the programs had different content for boys and girls. The worst element of all was outcomes, for which the average score was 1.2 out of 5. Nearly half of the programs said they didn't collect data on whether their clients turned out OK.

What the study means to you: These are supposed to be the best programs in the country—and they're not doing the basic things that should be part of any adolescent treatment plan, the researchers say. Many aren't even collecting the data they'd need to find out whether they're curing the adolescents who go through their programs.

Caveats: The researchers depended on program directors to report on their own programs—but if anything, you'd expect them to make their programs sound better than they actually are. And while the nine elements were picked by a group of experts and based on research, more research is needed to decide if those are in fact the best way to evaluate programs.

Find out more: Drug Strategies, which employs two of the four authors on this study, publishes a "Guide to Adolescent Drug Programs" based on this research, including information on all 144 programs surveyed. But you'll have to pay for it. They also have a website on drugs for teens with very odd animation.

Read the article: Brannigan, R., Schackman, B.R., Falco, M., and R.B. Millman. "The Quality of Highly Regarded Adolescent Substance Abuse Treatment Programs." Archives of Pediatrics and Adolescent Medicine. September 2004, Vol. 158, pp. 904–909.

Abstract online: http://archpedi.ama-assn.org/