Adolescents, representing many different cultures and genders, have substance use problems and treatments need to be adaptable, acceptable, and effective across different cultures and gender.

The A-CRA treatment manual has been translated into four languages by native speakers from different European and South American countries where it has been implemented. In addition, a seven-year, federally-funded dissemination of A-CRA in the U.S. at more than 80 organizations with thousands of adolescents provided the opportunity to study treatment engagement and response by a diverse group of adolescents. There were no differences by race or gender in the number of treatment sessions, which suggests that the A-CRA approach is effective at engaging and retaining diverse youth in treatment. Ninety-six percent of the total group reported being satisfied with treatment during interviews three months after beginning treatment. All racial groups had significant increases in days abstinent from alcohol and other drugs and in the percentage in recovery, but their outcomes did not differ from one another at the six-month follow-up.

While both males and females significantly improved over time, female adolescents were found to have a higher percentage of days abstinent from alcohol and other drugs and were more likely to be in recovery at the six-month follow-up than male adolescents. Overall, the study suggests that A-CRA is effective with diverse race, culture, and gender groups. For more information, see Godley, S.H., Hedges, K., & Hunter, B. (2011).

For more information on cultural and gender relevance in substance use treatment, please see the Multicultural Reference List.