The illicit use of opioids among young adults (18–25) has resulted in an increase of clients needing substance abuse treatment. Treatment programs are struggling to keep up with the influx of these young adults. Traditional models of care have some impact; however, there are not enough treatment centers that can address the young adult treatment needs, and the treatment community has been challenged to find developmentally appropriate care for this age range. Additionally, clients who enter into care often struggle with a negative self-concept due to feelings of shame and guilt resulting from their addiction. Many have resorted to intravenous heroin use to manage the effects and cost of their daily habit. The purpose of this study was to combine existing research-based treatment with interventions designed to increase self-compassion. The study enlisted young adult clients entering a medically managed suboxone treatment program within a large metropolitan health maintenance organization (HMO). After an initial assessment, participants attended an intake session to determine whether they met the inclusion criteria to enter the study. Once accepted into the study, patients were randomly assigned to one of two conditions: (a) three sessions of treatment-as-usual or (b) three sessions of treatment-as-usual with a focus on self-compassion. Treatment fidelity was examined and confirmed. ANCOVA was used to analyze data within the two groups related to the frequency of change talk. Independent t-tests were used to analyze data from the two groups related to client satisfaction. Results of the study indicated no significant difference between the two groups on both measures. Finally, a series of open-ended questions was asked at the last session of the study to identify common themes regarding client involvement in the self-compassion arm of the study to compare with the control group. The top three primary themes between the two treatment groups were a preference for (a) individual counseling (14/17), (b) structure (13/17), and (c) increased frequency of the program (11/17). The theme that emerged of a preference for individual treatments by the young adults in this study stands in contrast to treatment programs that focus on group-level interventions. A somewhat surprising finding was the willingness to attend more frequently; however, the type of frequency (more than once per week or weekly over a longer period of time) would need to be explored further. Finally, having a supportive place to go to stay out of trouble from temptations to use or hang around using peers was mentioned as important. Addressing unmet or delayed developmental needs for help with job skills, getting help with finishing or continuing their education, finding sober housing, meeting new friends, working on renewing family relationships, and learning how to manage finances are important skills that are often missing with this population. Having a safe place to go that focuses on these important life skills where the clients are accepted could provide the type of structure they need to negotiate these life areas.
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