McKay, Ian T and Nadorff, Danielle K (2025) The business of recovery: a novel pilot study psychosocial intervention to build self-efficacy and reduce relapse risk in adolescent substance use treatment. Addictive Behaviors, 171, 108473. https://doi.org/10.1016/j.addbeh.2025.108473.
External website: https://www.sciencedirect.com/science/article/pii/...
INTRODUCTION: Relapse rates following adolescent substance use disorder (SUD) treatment remain high, highlighting a need for innovative interventions that improve engagement and target key psychosocial mechanisms of recovery. Drawing on Social Cognitive Theory, this pilot study evaluated a novel, strength-based Entrepreneurial Education Program (EEP) designed to reduce relapse risk by increasing self-efficacy, positive affect, and emotion regulation.
METHODS: Twenty-seven adolescent males (M age = 15.18) in residential SUD treatment were assigned to either the EEP intervention (n = 15) or a treatment-as-usual control group (n = 12). The EEP consisted of four weekly sessions integrating entrepreneurial skill-building with Dialectical Behavior Therapy (DBT) principles. Validated measures of self-efficacy, affect, emotion regulation, depression, anxiety, and stress were administered at baseline and post-intervention (4 weeks).
RESULTS: Between-group analyses showed the EEP group had a significantly greater improvement in self-efficacy (p = 0.019) and greater reductions in anxiety (p < 0.001) and stress (p = 0.04) compared to the control group. Between-group differences for emotion regulation and positive affect were not statistically significant.
CONCLUSIONS: A brief, entrepreneurship-focused psychosocial intervention can effectively target critical antecedents of relapse in adolescents with SUD. By building self-efficacy and improving affect regulation in an engaging, non-traditional format, the EEP shows promise as an adjunctive therapy to enhance treatment outcomes. Future research should include larger, more diverse samples and long-term behavioral follow-up.
A Substance use and dependence > Personal history of substance use (pathway) > Relapse / Recurrence
B Substances > Substances in general
G Health and disease > Substance use disorder (addiction) > Drug use disorder
HJ Treatment or recovery method > Psychosocial treatment method
J Health care, prevention, harm reduction and treatment > Residential facility
T Demographic characteristics > Adolescent / youth (teenager / young person)
VA Geographic area > International
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