The business of recovery: A novel pilot study psychosocial intervention to build self-efficacy and reduce relapse risk in adolescent substance use treatment

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INTRODUCTION: Relapse rates following adolescent substance use disorder (SUD) treatment remain high, highlighting a need for innovative interventions that improve engagement and target key psychosocial mechanisms of recovery. Drawing on Social Cognitive Theory, this pilot study evaluated a novel, strength-based Entrepreneurial Education Program (EEP) designed to reduce relapse risk by increasing self-efficacy, positive affect, and emotion regulation. METHODS: Twenty-seven adolescent males (M age = 15.18) in residential SUD treatment were assigned to either the EEP intervention (n = 15) or a treatment-as-usual control group (n = 12). The EEP consisted of four weekly sessions integrating entrepreneurial skill-building with Dialectical Behavior Therapy (DBT) principles. Validated measures of self-efficacy, affect, emotion regulation, depression, anxiety, and stress were administered at baseline and post-intervention (4 weeks). RESULTS: Between-group analyses showed the EEP group had a significantly greater improvement in self-efficacy (p = 0.019) and greater reductions in anxiety (p < 0.001) and stress (p = 0.04) compared to the control group. Between-group differences for emotion regulation and positive affect were not statistically significant. CONCLUSIONS: A brief, entrepreneurship-focused psychosocial intervention can effectively target critical antecedents of relapse in adolescents with SUD. By building self-efficacy and improving affect regulation in an engaging, non-traditional format, the EEP shows promise as an adjunctive therapy to enhance treatment outcomes. Future research should include larger, more diverse samples and long-term behavioral follow-up.

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