The Adolescent Treatment Models program was developed to evaluate, document, and disseminate effective adolescent substance abuse treatment models. Ten exemplary adolescent treatment programs in the United States were evaluated. Adolescents in these programs participated in an intake assessment and follow-up assessments at some or all of the 3, 6, 9, and 12-month post-baseline follow-up points. With follow-up rates averaging over 90 percent for all 10 sites, treatment outcomes can be compared within each program and across the 10 exemplary treatment programs. An overview examines trends in adolescent substance use and treatment approaches and the need for developing and evaluating adolescent substance abuse treatment programs. Three exemplary outpatient treatment programs are described, including program design, treatment issues, and client characteristics. The multidimensional family therapy approach (MDFT), a family-oriented outpatient treatment model, is described. Three exemplary residential treatment models are examined, including a 30 to 60 day program based on a medical model but incorporating a therapeutic community model. The special treatment issues of American Indian youth and a bicultural approach are described. A residential step-down approach to treatment is discussed, including a 1-month residential component, a 2-month intensive aftercare component, and a 2-month non-intensive aftercare component. Issues of gender differences in drug use and experiences of trauma are also explored. The last section of the book identifies the adolescent therapeutic community model employed by Phoenix House; a multiphase, step-down approach to treatment embedded within the therapeutic community model; and Thunder Road’s hybrid residential approach that is primarily based upon a therapeutic community approach incorporating elements of the medical model. Index