Adolescent Substance Abuse Treatment

Give teens a microphone or a paintbrush, and they'll often tell you they want to be a music star, become the next Picasso, or produce multi-platinum records.
Maybe they'll achieve that dream and maybe they won't, but I find that giving kids the chance to be creative helps them achieve something even more powerful: healing. And it's lasting, too. 
That's why I think one of the most powerful ways to help youth be successful in (and after) substance abuse treatment is to help them express themselves creatively. 
That's the goal of A.R.T.C., "Achieving Recovery Through Creativity,” a program of Preferred Family Healthcare (PFH), a nonprofit treatment agency based in Missouri. 
A.R.T.C. is a therapeutic creative arts program integrated into our substance abuse and behavioral health programs. It identifies and incorporates the strengths, needs, abilities and preferences of our young clients into their individualized treatment plans.

• White House May Rethink its Juvenile Justice Spending Plan
  In mid-February, Youth Today reported that President Obama's budget contained a proposal to radically change federal juvenile justice funding for the states. Now, Youth Today's John Kelly reports that it may be reconsidering, after strongly negative reactions from juvenile justice advocates.
• VIDEO: Mississippi County Sued After Video Reveals "Hogtied" Youth and Other Abuse
  The Southern Poverty Law Center has sued Forrest County, Missisissippi, over revelations of numerous instances of juvenile detention center personnel physically abusing youth in their care (many documented on surveillance video cameras) and force them to allow youth access to lawyers and civil rights advocates, in accord with federal law. Follow the link to see the video coverage. (Hat tip to sparkaction.)

When it comes to assessing young people in the juvenile justice system, does the difference between “risk assessment” and “needs assessment” seem overly academic or technical to you?
It's actually very important.
Why? Because the lack of clarity about this distinction, and the tendency to conflate risk of delinquency with treatment need are obstacles to establishing a more strength-based and therapeutically informed attitude and process in juvenile justice systems around the country.

How many juvenile drug courts are there in the United States?  The Center for Substance Abuse Treatment (CSAT) at the Substance Abuse and Mental Health Services Admininstration (SAMHSA) wants to know by March 17, 2011.
Here's the announcement -- please note that you do not need to be a CSAT grantee to qualify or participate:

We are writing to request your help with an important data inquiry. In order to enhance SAMHSA/CSAT’s programmatic and advocacy efforts concerning adolescent substance abuse treatment and recovery, we are seeking to update our knowledge concerning the number of juvenile drug courts in the United States.
 
To help us close this knowledge gap, we are asking all of our current JTDC grantees to reply to this email with a listing of any juvenile drug courts that you and your organization are aware of. Please complete and return the attached template with your reply.
 
The term “juvenile drug court” means a specially designed court calendar or docket within a juvenile court to which youth having problems with alcohol and/or other drugs are referred; a separate or special jurisdiction court is neither necessary nor encouraged. The juvenile drug court judge maintains close oversight of each case, and both leads and works as a member of a team that comprises representatives from treatment, juvenile justice, social services, school and vocational training programs, law enforcement, probation, the prosecution and the defense.
 
Please complete the attached document and send your replies to (adlist@jbsinternational.com) no later than March 17, 2011. Thank you in advance for any assistance with this important inquiry that you and your agency can provide!

(Hat tip to Christa Myers.)

Kevin Jennings, Assistant Deputy Secretary for Safe and Drug-Free Schools at the Department of Education
March 17, 2010 at 10am PT / 1pm ET

Mr. Jennings will reprise his plenary presentation from the 2010 Joint Meeting on Adolescent Treatment Effectiveness (JMATE)on the efforts by the Department of Education and the federal government to reach out to youth currently in recovery.
 
As part of this work Mr. Jennings will discuss how the Department of Education is hoping to increase the number of recovery schools, including programs designed for students and families committed to achieving success in both education and recovery.
 
To learn more about Mr. Jennings you can read his bio.

Register now »

A few weeks ago, my colleague, Jeff Butts, discussed here the implications of our recent study of rates of psychiatric disorder in almost 10,000 young persons at various levels of penetration of the justice system. (Here's the original study: "Psychiatric Disorder, Comorbidity, and Suicidal Behavior in Juvenile Justice Youth.")
He drew attention to our finding that, when evaluated in a standard way, approximately 35% of young persons at system entry (i.e., entering the juvenile justice system via probation or family court processing) met criteria for a mental health or substance use disorder.

In that work, we relied on a well-validated, computerized, instrument which aggregates a youth’s answers to specific questions about symptoms to generate a set of provisional psychiatric disorders (the DISC-IV). But what happens about identifying mental health problems in settings where such research activities are not in place?

• Justice for an Awful Judge
  Columnist Leonard Pitts, Jr. writes eloquently about the irony that one of the judges in the "kids-for-cash" scandal got what the youth who passed through his juvenile court did not get: due process.
• Positive Youth Development: Training Youth to be EMTs
  A unique program in Alameda County, CA, trains young men in the juvenile justice system to become EMTs - could a program like that work in your community?  (H/t Jennie Day-Burget.)
• Systems of Care That Serve Youth in the Juvenile Justice System - Funding and Sustainability
  This report came out in September 2010 and a lot of things have changed since then, but its strategic approach is timeless. (Hat tip to Mark Fulop.)

Multidimensional Family Therapy (MDFT) is an evidence-based practice for working with adolescents struggling with substance abuse – the manual can be downloaded from SAMHSA for free. (SAMHSA is the Substance Abuse and Mental Health Services Administration.) One of five treatment protocols developed and tested in the past decade by SAMHSA, it has been shown to be clinically and cost-effective.
As it happens, the creator of MDFT, Dr. Howard A. Liddle, Ed.D., will be doing a webinar for us on family engagement on April 30, 2011, at 11 am PST / 12 pm CST / 2 pm EST. You can learn more and register for it on our webinars page.
Dr. Liddle told me recently that there was an MDFT program operating in Portland, Oregon, where I live, so I set up an interview with Deena Corso, who is a clinical supervisor in the Juvenile Treatment Services unit at the Department of Community Justice (DCJ) in Multnomah County, Oregon. (Deena and I were co-workers when I was employed there between 2000 and 2007.)
 

Benjamin: What are the top reasons to implement MDFT?
Deena: We picked MDFT as our treatment model because it's an evidence-based practice, effective at reducing substance abuse and delinquent behavior for populations that looked like ours. We’d had a Multi-Systemic Therapy [MST] program for many years with good outcomes, but budget cuts forced us to look for an alternative, and once we looked at the research, we decided on MDFT. 

Maybe it's just me, but I don't hear very often about hip hop in services aimed at youth in the juvenile justice system or in prevention programming. If it is rare, that's strange, since hip hop matters to a lot of youth, not least because it's a key avenue for self-expression.
So here's a couple examples I'm aware of, where hip hop is a key part of the intervention.
First, you may have heard about H.Y.P.E. hip hop therapy (Helping Young People Thru Empowerment), a curriculum in which a mental health therapist in Stone Mountain, Georgia, incorporates hip hop into counseling sessions with African-American teen males. Her approach -- which has been turned into a book you can buy for $20 (click on the image on the far left)-- has been featured in JET magazine, on NPR, and on television. I'm not certain if it's been evaluated. (Hat tip to the Juvenile Justice Information Exchange.)
Second, when I was at the Joint Meeting on Adolescent Treatment Effectiveness (JMATE) in Baltimore in December 2010, I I saw a presentation on a substance abuse and HIV prevention curriculum that was built around hip hop. Aimed at middle-school youth, the Hip-Hop to Prevent Substance Abuse and HIV (H2P) curriculum has been listed in the National Registry of Evidence-based Programs and Practices (NREPP), run by Substance Abuse and Mental Health Services Administration (SAMHSA).  
Anyone aware of any other interventions for teens -- particularly for youth in trouble with the law -- that build on hip hop in a significant way?  Drop Drop me an email, leave a comment below, leave a comment in our discussion group on LinkedIn called "Juvenile Justice Reform and Adolescent Substance Abuse", and I'll post what I learn.
[Update March 3, 2011: Check out the comments below for at least two resources. Also, it looks like we'll be able to post a lot more information here soon. Stay tuned.]
 

As you make your resolutions for 2011, be sure to add "Join the ACTION Campaign webinars" to your list.
The NIATx ACTION Campaign offers two free webinars per month. In the next six months, most of our webinars will focus on helping substance abuse treatment agencies of all sizes learn how to create or improve their billing systems. We’ll be working to bust some of the myths that keep agencies from working with third-party payers.
In the ACTION webinars, experts and peers will share their experiences that show that you don't need:

• a contract with an insurance provider to submit a bill for services
• a large billing department; or 
• to purchase an expensive electronic billing system.