The United States continues to present the highest rate of illicit drug use among adolescents and young adults in the industrialized world. Despite increasing attention to the problem, the lack of a coherent theoretical framework from which to conceptualize adolescent substance abuse has limited our therapeutic response. The main difficulty in developing a systematic model of inquiry and practice relates to the complexity and multidimensionality of the addictive process. This study investigated the issue of teenage substance abuse and addiction using an integration of cognitive-developmental and narrative theory. The dissertation was guided by the assumption that a clinically relevant understanding of the problem requires a holistic approach that explores the meanings of a person's lived experience rather than a reductionistic approach that identifies the complex interaction of external variables and precipitants. With this primacy on "local" knowledge, emphasis was placed on exploring the epistemology of addiction and how these meanings were conveyed through stories. Consequently, the fundamental task of the study was to identify the common themes in the stories of teenage drug users and integrate them into a local theory of adolescent addiction that would facilitate personally relevant treatment interventions. The sample population consisted of twelve consenting young people with histories of substance abuse who were selected from a public high school and a residential rehabilitation facility. Each subject participated in a structured interview based on Allen Ivey's Developmental Therapy. This cognitive-developmental approach provided a useful framework from which to assess and organize the complex cognitive dimensions that comprised the adolescents' experience. Narrative methods, on the other hand, were used to elicit common themes in their stories. Based upon this combination of approaches, this dissertation presented a theory of adolescent substance abuse that was "grounded" in the interview data. The theory represented a sequence of phases in the addictive process that emerged from the sample group's common experiences. The treatment implications of this integrated approach to addiction theory was then discussed with an emphasis on developing relevant interventions based on treatment matching according to the person's cognitive-developmental profile and unique story.
| Identifer | oai:union.ndltd.org:UMASS/oai:scholarworks.umass.edu:dissertations-2820 |
| Date | 01 January 1997 |
| Creators | Boyer, David Royce |
| Publisher | ScholarWorks@UMass Amherst |
| Source Sets | University of Massachusetts, Amherst |
| Language | English |
| Detected Language | English |
| Type | text |
| Source | Doctoral Dissertations Available from Proquest |
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