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OVERVIEW
Intervention plans for youth substance abuse problems should be designed and coordinated as a "system of care" using community treatment teams that are family driven, span agency boundaries, and draw upon community-based resources. The intervention plan should include whatever mix of services is appropriate for each youth, perhaps including AOD treatment, educational and preventive services, involvement in pro-social activities, and the assistance of "natural helpers" already known to the youth and his or her family.
LESSONS LEARNED
Youth identified as having AOD problems at the point of assessment should be referred for appropriate services and care coordination, whether the service plan involves only short-term prevention and early intervention programs or more intensive and lengthy outpatient services and residential treatment. Effective service coordination should involve the family directly, be culturally competent, and include a diversity of community resources, even if some resources have to be developed anew. Services should be individualized and designed to allow each youth to achieve a defined set of positive outcomes.
In cases where formalized outpatient substance treatment is warranted, the Reclaiming Futures Model was designed to be consistent with the Washington Circle standards for determining appropriate levels of AOD services. The Washington Circle standards assert that if outpatient substance abuse treatment is indicated, at least four to six clinical sessions conducted by a licensed provider over no less than four weeks would generally be considered effective, not including continuing care (or aftercare). At least one therapeutic (aftercare) contact should occur approximately 90 days after the onset of treatment. Research suggests that success is improved the longer someone stays engaged in treatment. While the Reclaiming Futures Model does not require it, the length of substance abuse treatment should ideally extend to the maximum appropriate for a given level of AOD problems (periods of up to a year including aftercare have been suggested for youth in outpatient services).
REFERENCES
Pumariega, Andres J. and Nancy C. Winters (Eds.) (2003). The Handbook of Child and Adolescent Systems of Care. San Francisco: John Wiley & Sons, Inc.
Kraft, M. Katherine, Kristin Schubert, Anna Pond, and Marliyn Aguirre-Molina (2006). "Adolescent treatment services: The context of care." In Adolescent Substance Abuse - Research and Clinical Advances. Howard A. Liddle and Cynthia L. Rowe (Editors). New York: Cambridge University Press, p. 174.
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