Childhood and adolescence are not only critical phases for normal development but also periods when various pathological behaviors or disorders including substance use disorders (SUDs) are first recognized. Substance use among American youth rose to alarming rates between 1992 and 1997. Since then it has decreased significantly for alcohol, tobacco, and all drug classes but prescription opiates, the use of which continues to increase (Johnston et al. 2006). There is a concern regarding the short- and long-term physical and mental health outcomes of adolescents who use psychoactive drugs. The use of alcohol and other drugs is a leading cause of morbidity and mortality among adolescents from motor vehicle accidents, suicidal behavior, violence, drowning, and unprotected sexual activity, including unplanned pregnancy and sexually transmitted diseases (Blum and Nelson-Mmari 2004). Lifetime diagnoses of alcohol and drug abuse among adolescents in different states in the United States range from 3% to 10% (Harrison et al. 1998; Lewinsohn et al. 1996). The National Survey on Drug Use and Health reported that 6% and 5.4% of youth ages 12–17 years were classified as needing treatment for alcohol use and illicit drug use, respectively (SAMHSA 2006). Due to lack of motivation among youth, limited resources, lack of a broad consensus on preferred treatment strategies, and inadequate age-appropriate programs, only a small segment of adolescents in need of treatment end up receiving services.