For those who show heavier patterns of drinking, frequent binge drinking, regular nicotine intake, or early onset of substance use, interventions are required to prevent serious consequences of problem use and alter the path toward substance use disorder (SUD).2 Such interventions include practices shown to delay substance use initiation in adolescents and reduce substance misuse and its associated consequences in young adulthood. Effective prevention practices address factors that place young adults at increased risk for substance misuse-or protect them from substance misuse-and often focus on youth who may be more vulnerable due to their life circumstances, sexual orientation, and preexisting health conditions.

Motivation is key to substance use behavior change. Counselors can support clients' movement toward positive changes in their substance use by identifying and enhancing motivation that already exists. Motivational approaches are based on the principles of person-centered counseling. Counselors' use of empathy, not authority and power, is key to enhancing clients' motivation to change. Clients are experts in their own recovery from SUDs. Counselors should engage them in collaborative partnerships. Ambivalence about change is normal. Resistance to change is an expression of ambivalence about change, not a client trait or characteristic. Confrontational approaches increase client resistance and discord in the counseling relationship. Motivational approaches explore ambivalence in a nonjudgmental and compassionate way.

This guide was created to promote the early identification of children and adolescents with mental health and substance use problems as well as to provide guidance, tools, and resources for early identification-including a compendium of the most developmentally, culturally, and environmentally appropriate screening instruments. SAMHSA developed the guide using the input of the members of the Federal/National Partnership* (FNP) Early Identification Workgroup, chaired by representatives from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA).

Misuse of alcohol, tobacco, and other drugs is a problem throughout the United States. Communities vary greatly in the specific problems they face, the groups affected by those problems, and the events that rouse people to take action. In addition to having different problems and priorities, some communities have more resources and experience with locally based prevention activities than others. Yet, with a "can do" approach and a bit of guidance, any community can have success in implementing strategies and programs to prevent substance use. This is where Focus on Prevention can help. The U.S. Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA), has developed this guide as a starting point to help a wide range of groups and communities move from concerns about substance use to proven and practical solutions.

Presents information on identifying, screening, and assessing adolescents who use substances. This report focuses on the most current procedures and instruments for detecting substance abuse among adolescents, conducting comprehensive assessments, and beginning treatment planning. Presents appropriate strategies and guidelines for screening and assessment. Explains legal issues concerning Federal and State confidentiality laws. Provides guidance for screening and assessing adolescents in juvenile justice settings. Summarizes instruments to screen and assess adolescents for substance and general functioning domains.

The Substance Abuse and Mental Health Services Administration funded the multisite Young Adults in the Workplace (YIW) initiative to study the effectiveness of diverse approaches to workplace-based prevention of substance abuse. Six teams adapted evidence-based programs to target young employees and then implemented the programs in retail, restaurant, health care, construction, skilled trade, and transportation industry workplaces. This book describes the programs, the adaptation and implementation processes, and the YIW cross-site evaluation.