Adolescent substance misuse - problems, prevention and treatment
By Phil Harris

To see sections of this book in a PDF, please click here.

Work with young people on issues of substance misuse has for too long been based on adult-oriented research and adapted from adult-focussed practice. Introducing and assessing the evidence base that is being developed around work with children and young people, Youthoria provides startling and compelling conclusions that revise not only our understanding of problematic young substance users, but also of young people in all contexts of need. It:
  • explains how young people's problematic substance use is not a random occurrence, but is entwined in adolescent development itself
  • offers new directions in which to assess young people, in ways that are truly developmentally informed, so as to implement effective prevention and treatment efforts.

  • Youthoria will help anyone working with young people and families, not only to develop a framework for learning and practice that makes sense of the complexity of young people's needs... but to do so in ways which make sense to young people too. It:
  • offers guided access to an extraordinarily wide range of published research, evidence and practice wisdom - unprecedented in a single volume, accessible to specialists and generalists alike
  • integrates multidisciplinary research from sociology, history, family studies, addiction and adolescent mental health research into a single framework for understanding young people's needs
  • describes the key factors, causes, influences and evolution of use and misuse, in ways that support effective assessment and intervention planning
  • provides insights from research into which young people are most prone to substance misuse, and their divergent responses to prevention and treatment
  • describes both effective and ineffective prevention strategies, and considers why the former's promising outcomes are not recognised
  • explores the evidence base for what interventions work best for which young people and how best to measure this
  • offers a clear framework for the implementation of a developmentally informed adolescent treatment system.

  • A stimulating challenge to academics and practitioners alike, it will help them:
  • increase their knowledge and range of skills to support young people and their families, across the full spectrum of their needs
  • map the complexity of young people's substance use to ensure that those who need it receive optimal support
  • improve outcomes especially while working with the most vulnerable, marginalised and excluded of young people.

  • Large format. 280 pages. 9781905541829. Published 2013. £27.95.

    To see a question and answer session with the author, Phil Harris, about issues raised in Youthoria, please click here.


    Available direct from RHP only by phoning 01297 443948 or by e-mailing

    20 copies - £40.46 each, with free delivery
    30 copies - £38.21 each, with free delivery
    50 copies - £35.96 each, with free delivery

    Discounts on larger quantities can be made by arrangement with RHP.


    Substance misuse youth workers, youth workers, criminal justice workers, teachers, social workers, housing workers and officers, family workers, counsellors, families, adult drug and alcohol workers, commissioners.



    Who is this book for?
    How common is substance use in young people?
    Historical trends
    Prevalence rates of tobacco, alcohol and drugs
    Prevalence of drug and alcohol problems
    Variation in substance use across cultures
    Informal cultural control of use
    Young people's use and the media
    Variation within cultures
    How young people acquire drugs and alcohol
    What is adolescent development?
    The evolution of the modern family
    Perspectives on adolescent development
    Parent and adolescent interactions
    Developmental processes of adolescence
    Puberty: physical changes
    Puberty: cognitive changes
    Life tasks
    Identity formation
    Changing relationships
    Developmental delay and substance use
    Adolescent mental health
    How do substance use problems develop?
    Models of cause and effect
    Risk and protection factors
    Key issues in risk and protection theory
    Age of initiation
    Gateway Theory
    Substance abuse trajectories
    Trajectories and mental health
    Identifying sub-trajectories
    What is problematic use in young people?
    Origins of diagnosis
    Substance abuse
    Young people and diagnostic criteria
    The rate of acquisition of substance-related problems
    Comprehensive assessment: overview
    Comprehensive assessment: dependence
    Comprehensive assessment: social functioning
    Comprehensive assessment: treatment planning
    Future developments in diagnostic criteria
    Can substance use be prevented in young people?
    Prevention and education controversies
    Defining drug and alcohol prevention and education
    School-based approaches to prevention and education
    College and university based approaches
    Family based prevention approaches
    Mass media campaigns
    Diversionary programmes
    Multilevel community programmes
    Target interventions
    The outcomes of prevention and education programmes
    Core elements of effective programmes
    Does treatment work for young people?
    Treatment outcomes with young people
    What really matters in treatment?
    Comprehensive treatment pathways
    Specific modalities: Pharmacotherapy
    Specific modalities: controlled drinking programmes
    Specific modalities: Motivational Interviewing
    Specific modalities: Cognitive Behavioural and Behavioural approaches
    Specific modalities: The Twelve Step Approach
    Treatment matching interventions
    Treatment for externalized disorders
    Treatment for depression
    Treatment for anxiety disorders
    Treatment for Post-Traumatic Stress Disorders
    Treatment for suicidal young people
    Family involvement and treatment
    Family involvement: motivating young people for treatment
    Family involvement: family therapy
    Family involvement: Family Conferencing and Network Therapy


    Phil Harris
    is an independent writer who has worked in direct access drug services for over twenty years. He has designed and delivered internationally recognised treatment programmes and accredited training courses throughout the UK & Europe. Having worked as a drugs treatment advisor to DST's, Criminal Justice Services and Youth Services, he has also managed several organisations and implemented innovative, practical and effective approaches to addressing people's problems with misuse of drugs and alcohol. He continues to practise in the south west of England.


    "The author does a remarkable job in synthesising extensive research findings to provide a comprehensive and coherent framework for understanding and effectively responding to substance use by today's youth.

    "The strength of the book lies in:
  • The breadth and depth of analysis of youth-oriented research which sheds light on the interplay between young people's drug and alcohol consumption, problematic use and the wider cultural, social and developmental factors affecting their decisions and behaviour.
  • Its fresh and compelling insights into the specific substance abuse trajectories of young people and the implications of these for optimal prevention and treatment interventions.
  • The way it combines sophisticated theoretical analysis with a strong focus on practice issues, integrating ideas and learning in a way that will enhance the knowledge and range of skills of staff working with young people and families across the spectrum of need.

  • "Refreshingly, the book ignores policy and political agendas and instead focuses on the natural history of young people's drug and alcohol use as it actually evolves, establishes itself and the recedes in their lives. In this way, the author achieves what he clearly sets out to deliver - a clear, authoritative framework that articulates developmentally-informed interventions which directly address the realities and complexities of young people's lives.

    "Youthoria is a highly readable and engaging book that provides invaluable insights, strategies and tools for commissioners of services and for staff involved in supporting young people and their families. It will also be of immense help to academics and social work/care students alike." Professional Social Work

    "Phil Harris' experience and wisdom provides new perspectives on the complexities of adolescent drug use, and effective and ineffective intervention strategies... His compelling results... will be helpful for youth workers, families with adolescents and anyone curious about the mysterious functions of the adolescent brain." YFX Magazine, Australian Clearing House of Youth Studies

    "The recent NTA (2012) report shows a reduction in numbers of young people in treatment which is consistent with an overall decline in drug use for that age group. But, for those 20,000 or so young people with issues surrounding substance use, the picture is complex and such use is often a symptom of wider issues in their lives.

    "This book is a very welcomed monograph on this subject. The strange (yet enticing) title of this book makes sense when coupled with the subtitle of the book, Adolescent Substance Misuse: Problems, Prevention and Treatment.

    "I think this is a unique book which is arguably unrivalled in its scope. Phil Harris weaves together a range of perspectives on adolescence substance use in a highly readable text. This is a work of wisdom and scholarship cleverly combined with a great deal of useful and practical information. It is intellectually challenging but always an easy read. The clarity of the argument is aided by a tight focused structure.

    "Chapter 1 provides commentary on the patterns of alcohol and other drug use by young people across and within cultures. In doing so, Harris demonstrates that consumption and problems are best understood within a wider context of the dynamic, historical and cultural forces which exert huge influence over the type, range and frequency of problems that young people experience. This, in turn, Harris argues in Chapter 2, actually defines the structure of adolescent development itself. Perhaps the most controversial section of the book, this chapter charts the distinct elements of adolescent development including psychological and biological maturation, life task achievement, identity formation and the shifting patterns of relationships. It examines how substance misuse can disrupt these processes and potentially curtail a young person's preparation for adult life.

    "Chapter 3 extends the argument regarding the relationship between substance misuse and adolescent development. Harris convincingly offers the proposition that substance misuse does not happen at random points in a young person's life, but occurs at key moments within the life course. At this point, the book offers a radically different perspective in arguing that problematic substance using youth are not a homogenous group-they are part of a sub-population with distinct clinical profiles. Accepting this obviously has implications for any subsequent treatment options and this is explored in Chapter 4. Here, the author identifies specific differences between adult and young people's problematic substance use and highlights why an adult diagnostic criterion represents a 'poor fit' for young people. In doing so, Harris returns to his key theme-how young people's use evolves through clearly identifiable phases. This, in turn, logically means a move to more appropriate assessment and care planning which will provide a more accurate understanding of young people's needs which will lead to an enhanced treatment outcome.

    "Chapter 5 continues the theme regarding adopting an 'adult perspective', when Harris turns his attention to the effectiveness (or otherwise) of prevention and education programmes. Offering a historical angle on such provision, it is argued, these operated on adult assumptions regarding young people's drug and alcohol use. With regard to such programmes, Harris acknowledges that we have come a little way. However, it is still the case that the lack of credibility surrounding many such approaches taints the reputation of a lot of prevention and education work. We get a gentle reminder here of the fact that young people most vulnerable to problematic drug use share a number of divergent risk profiles. This all leads very smoothly to Chapter 6, which examines the impact of treatment on young people. Not surprisingly, Harris is generally critical of a number of treatment models because (highlighting the recurrent theme) they are not specifically developed for young people.

    "There is no index but you do not need one; you can easily find your way around. The book features a variety of figures, tables, graphs, etc. and each chapter is broken up appropriately with headings and sub-headings-the detailed text flows smoothly and effortlessly, making for an engaging, informative and essential read for all professionals working with adolescents." British Journal of Social Work.