Rationale and design of a brief substance use intervention for homeless adolescents

The rationale and design for a brief feedback and motivational intervention for substance use among homeless adolescents is described. Homeless adolescents use substances at extremely high rates compared to other youth, and experience considerable negative consequences as a result. Yet homeless adolescents are not reached by, or are not responsive to, traditional prevention and treatment programs for substance use and abuse. The rationale for the use of brief feedback interventions is reviewed, and one such program that was designed to reduce substance use risk among homeless youth is described. The intervention is consistent with tenants of harm reduction in its effort to encourage engagement via its structure, minimal demands, and flexible clinical strategies and goals. Modifications made to the intervention based on lessons learned from an initial trial are described, and highlight the importance of tailoring harm reduction programs to facilitate engagement based on clients’ life circumstances, availability, and motivation.