Drug refusal skills training does not enhance outcomes of African American adolescents with substance use problems

Douglas C. Smith, Karen M. Tabb, Darnell Fisher, Leah Cleeland

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


In prior research by Witkiewitz and colleagues, African American adults receiving refusal skills training (RST) had fewer heavy drinking days and were categorized as having more successful outcomes. This study extends findings to adolescents receiving the Adolescent Community Reinforcement Approach (A-CRA). Propensity score matching was used to create three groups equivalent on baseline characteristics, including: African Americans receiving refusal skills training (AA + RST; n= 214), African Americans not receiving RST (AA-RST; n= 212), and Caucasians receiving RST (CA + RST; n= 214). In propensity weighted regression models that controlled for overall A-CRA exposure, racial group by RST status was not a significant predictor of substance use frequency or abstinence/early remission outcomes. Higher exposure to A-CRA, however, was a significant predictor of both outcomes. Universal receipt of RST may not improve the outcomes of African American adolescents with substance use problems, and outcomes may be driven more by the overall number of A-CRA procedures received.

Original languageEnglish (US)
Pages (from-to)274-279
Number of pages6
JournalJournal of Substance Abuse Treatment
Issue number2
StatePublished - Feb 2014

Bibliographical note

Funding Information:
Author’s Note: Drs. Smith and Tabb are Assistant Professors of Social Work. Darnell Fisher and Leah Cleeland are MSW and PhD students, respectively. Correspondence should be directed to Douglas C. Smith, University of Illinois at Urbana-Champaign, School of Social Work, 1010 West Nevada Street; MC-082; Urbana, IL, 61801, smithdc@illinois.edu . The development of this article was supported by NIAAA grant # K23AA017702 (Smith-PI). The views, however, are those of the authors and do not reflect official positions of the US government.


  • Adolescents
  • African Americans
  • Cultural competence
  • Drug abuse
  • Propensity matching
  • Psychotherapy


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