Mental Health, Substance Abuse, and Co-Occurring Disorders
Sexually Maladaptive Youth
Individualized Case Planning
Family Engagement and Participation
There is no question that working with this population of youth is both challenging and rewarding. Those of us in the field live by the success stories. Meanwhile, researchers and practitioners alike work to identify promising and evidence based practices in what practitioners do. These practices are those that are proven to work when used as they were designed to be used. While the positivity we receive from the "stories" of success is the reason we do what we do, the data and research heavily informs how we shape our programs.
Evidence based practice (EBP) has come to mean a lot of things throughout the field. The standards we look for are those practices that have been evaluated in one or more longitudinal studies and are shown within data to be effective in producing the expected outcomes.
While a core set of EBPs have emerged as particularly effective for youth generally, programs, treatment modalities and delinquency interventions that are best suited for a facility are customized to age range, gender, risk level, disorder diagnosis, or other characteristics of the given population of a facility to most appropriately respond to needs.
The statistics are clear and pervasive. Youth exposed to adverse childhood experiences (ACEs) are significantly more likely to abuse alcohol and drugs, have mental health issues, suffer chronic health problems, engage in delinquent behaviors, and act violently toward others. Further, disproportionate numbers of youth involved in the justice system have dual system involvement, meaning, youth exposed to trauma, abuse and neglect are at increased risk for becoming system involved.
Our staff serve as leaders, mentors, and trusted partners to youth in their recovery. Being trauma-competent increases our chances of starting off on a positive foot in our relationship with the kids who often have barriers to trust. By promoting a safe and nurturing environment we can be more effective in connecting with the youth in meaningful and impactful ways.
YOI assumes universal precautions as it related to trauma, meaning that, unless case history information, intake and assessments, and clinical interviews or screens show no sign of trauma in the youth's history, we assume the youth has been exposed to trauma either directly or indirectly. By using this approach, we work to ensure the youth's facility commitment does not further traumatize them and hinder treatment progress. From the moment a youth is committed, the environment of care is safe and therapeutic.
Our treatment model for youth with mental health disorders, substance abuse issues, or both, is built upon best practice frameworks including Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT).
One of the most important factors in a youth's success in that their family remains constantly engaged during the commitment or detention process. All too often, the system makes youth and their families feel like they are being alienated from one another. Our philosophy and practice are to do everything we can to maintain and build the family connection, and to engage parents or legal guardians in treatment planning and execution. Through family educational sessions, visits, calls and use of technology, family therapy sessions, and special events, we emphasize effective family communication and coping skills. Ultimately, kids leave our facilities and the most critical support they will receive is that of their loved ones.
Individualized Case Planning
Every youth has had their own personal experiences and difficulties that have impacted their belief systems, choices, and behaviors. While we know the statistics and can identify patterns, every youth is unique, with their own strengths and weaknesses. To develop a treatment plan most responsive to their needs, we begin with comprehensive assessment that deeply identifies the factors that brought them to us and the challenges they face. From there, we build a treatment and case management plan that specifically addresses their needs, along with the creation of goals and action steps required to reach those goals. Everyone has a role to play in ensuring the plan is executed, and we hold everyone accountable to the plan.
Cognitive Behavior Therapy (CBT) is a type of psychotherapeutic treatment that helps youth understand the thoughts and feelings that influence behaviors. CBT is commonly used to treat a wide range of disorders including addictions, phobias, depression, and anxiety. CBT helps identify negative thinking patterns that trigger substance abuse and other behavior issues, to help positively change those thinking processes.
DBT is also a cognitive behavioral treatment that helps youth who have difficulty managing their emotions by helping them learn new skills for effective coping and improved relationships. DBT focuses on four sets of behavioral skills:
Youth exhibiting sexually maladaptive/abusive behaviors also benefit from cognitive behavioral based treatment approaches and CBT is shown to be beneficial for the youth as well as for parents of children with sexual behavior problems. Parents of these youth will need to support and continue to hold the youth accountable, and ensure safety plans put into place are managed appropriately after discharging the youth to the home. In addition to addressing problematic cognitive and behavioral patterns, a key element to treatment planning for youth with these issues are the "invitations" to address their own trauma, as well as to accepting responsibility of their actions.
Every youth's plan must also address the supports and resources required to maintain stability once the youth goes home, and ensure the progress made in custody has established the foundation needed to be successful in the years to come.
YOI believes that gender specific considerations and programming is critical to successful treatment of both boys and girls. Once a term predominately associated with treating at-risk girls, gender specific programming has come to reference a broader meaning as it relates to applied interventions that carefully consider the experiences a child has had and through which gender and emotional filter they may process or internalize those experiences. A comparatively traumatic event with all facts being similar - age of child, type of trauma, duration of trauma - whether the child is male or female has been shown to matter, more often than not, when it comes to how that child behaviorally manifests the trauma and prepares/develops their behavioral and emotional defense.
Society also places expectations on individuals through norms and assumptions regarding gender based behaviors which heavily influence youth behaviors when they are so impressionable.
Research and literature and gender specific considerations and programming and treatment is growing and evolving, and our clinical programming leadership actively consumes new information and evidence as it develops in order to provide the most effective programming we can. For both boys and girls, our core principles in our treatment programming accounts for developing and protecting these factors: