Childhood sexual victimization as a factor in the treatment of substance misusing adolescents.

The impact of childhood sexual abuse on the treatment for substance misuse of 194 adolescents was examined. At treatment onset, adolescents reporting sexual abuse, when compared to those reporting no sexual abuse, demonstrated more serious involvement with substances, a greater incidence of physical abuse and parental substance misuse, and, among males, increased suicidal ideation and school failure. The two groups did not differ on rate of treatment completion nor on change scores obtained from an assessment battery administered at the beginning and end of treatment. There were no differences between the two groups on adolescent ratings of treatment effectiveness. Therapists, however, rated adolescents who reported sexual abuse as showing greater improvement in two areas. Implications for treatment are discussed.