Which statement best describes common indicators of a substance use problem in adolescence and the typical initial counseling approaches?

• A. Decreased frequency of use with improved school performance; counseling focuses on self-monitoring.
• B. Regular school attendance with no impairment and no counseling required.
• C. Increased frequency/quantities, impairment, neglect of activities, school problems; initial approaches include motivational interviewing, brief intervention, family involvement, and referral for specialized care.
• D. Substance use indicators are unrelated to treatment planning.

Answer: (C)

Adolescents showing a substance use problem typically exhibit rising frequency and amounts of use, clear impairment in functioning, neglect of important activities, and school problems. This pattern signals the need for early, proactive counseling. The initial approaches—motivational interviewing to explore readiness to change, a brief intervention to address concerns in a concise, targeted session, involving the family to support and monitor changes, and referral for more specialized care if indicated—are standard first steps in teen substance-use treatment. This combination focuses on understanding ambivalence, supporting small, doable changes, leveraging family support, and connecting to deeper resources as needed. The other options describe scenarios that don’t reflect a problem or don’t align with how treatment planning starts, so they don’t fit as well.