This project involves two studies focusing on the engagement and treatment of adolescents diagnosed with substance use disorders. Study 1 will evaluate a promising parent-based engagement intervention, Community Reinforcement Training, designed to facilitate the entry of resistant drug-abusing adolescents in treatment. The approach will be compared with an Engagement As Usual intervention condition. Study 2 involves a controlled clinical trial evaluating the efficacy of an HIV/AIDS prevention intervention embedded in family-based drug abuse treatment for reducing HIV/AIDS risk behaviors and substance use. Adolescents who are successfully engaged in treatment through Study 1 will be randomly assigned to receive either family therapy alone or family therapy with the integrated HIV/AIDS prevention intervention. Both studies are being conducted in Portland, Oregon.

Inclusion Criteria:

• Parents have an adolescent in the ages of 15-20 years.
• Have had contact with the adolescent on at least 40% of the past 90 days.
• Have some knowledge or evidence that the adolescent would meet DSM-IV diagnostic criteria for a substance abuse disorder.
• Adolescent has explicitly refused to attend any intake or therapy sessions.
• All parents' efforts to enter adolescent into treatment have failed, despite therapist's assistance.
• Residence in Portland vicinity.
• Sufficient residential stability to permit probable contact at follow-up. (e.g. not homeless at time of intake)

Exclusion Criteria:

• Evidence of psychotic or organic state of sufficient severity to interfere with understanding of study instruments and procedures.
• Adolescent has received residential drug treatment longer than a 2-week period in the past 90 days.