Drug & Alcohol Treatment - Individual and Group

I. Program Description
Male and female youth accepted at MVJRC who have been identified with alcohol and drug issues will be provided with drug and alcohol treatment as determined by the results of a Chemical Dependency Assessment administered once in placement.

II. Assessment
A Chemical Dependency Assessment is provided to each youth identified with drug and alcohol issues. This assessment is performed by the counselor assigned to the youth; Albert Cowen M. Ed/LSW, Lucianna Horstman MSW/LSW or James Crafton BA/LSW. Included as part of each assessment is a self reported history of drug and alcohol use and relevant family information, collateral information from other sources, and administration of the Substance Abuse Subtle Screening Inventory. The purpose of this evaluation is to determine if the youth has a Substance Abuse or Substance Dependency Disorder and whether treatment intervention is needed.

III. Treatment Planning
Treatment plans are developed to be as individual and comprehensive as possible. Typically, if a youth is found to have either a Substance Abuse or Substance Dependency Disorder, then encouraging the youth to establish a drug-free lifestyle would be the first priority. It is also be important for the youth to increase their understanding of the dynamics and consequences of drug abuse and dependency. Lastly, development of a sober support system is critical for the youth to be able to avoid the high risk situations which may put their sobriety in jeopardy.

IV. Program Milieu
In the daily program provided to all youth placed at MVJRC, it is recognized that acceptance of personal responsibility and other aspects of character development are central to the treatment of each youth. This perspective particularly reinforces principles that underlie drug and alcohol treatment.

V. Treatment
Every youth in the program is generally provided individual counseling once a week and family counseling once a month. If the youth are found to need drug and alcohol treatment, they are also placed in a twice weekly drug and alcohol therapy group co-led by Albert Cowen M. Ed/LSW, Lucianna Horstman MSW/LSW and James Crafton BA/LSW. Additionally, when the youth spend time in the community without direct staff supervision, they must submit to urine screening in order to verify that they have not used substances during the time they were away from the program.

The philosophy behind the drug and alcohol treatment that is delivered in the program is largely based on the research of Terrence Gorski, a recognized expert in the field of adolescent relapse prevention. The developmental nature of adolescent substance abuse and dependency is recognized within this model. An effort is made to consider the changeable and dynamic quality of adolescence when developing strategies and objectives for working with the youth. This orientation is in contrast to basing treatment on an adult model in which one typically has experienced periods of significant losses in one’s life. This approach to treatment is based on three main points: 1) breaking through the youth’s denial, 2) creating personal insight, and 3) encouraging behavioral changes. It is further recognized that at some point the youth must arrive at their own realization of the negative impact their use of substances may have had in their lives. Cognitive-behavioral strategies are implemented to help restructure the thinking processes of the youth. Due to the chronic relapsing nature of addiction, typically not all of the youth completing alcohol and drug treatment will be able to maintain their avoidance of all substances upon permanent release. Consequently, in an effort to reinforce the positive progress that the youth achieve in treatment, a Relapse Prevention Plan is developed by the youth. In this plan the youth identifies high risk situations they will need to avoid as well as warning signs that could lead again to their using substances. The youth puts into place an action plan to respond in a positive way to each warning sign. Hopefully, the plan provides the kind of personalized roadmap that the youth needs to live a sober and drug-free lifestyle.

Many of the materials used in treatment, such as manuals, workbooks, and videos are those available through the Hazelden Foundation. These materials are specifically designed for work with adolescents who are at risk for, in recovery from or otherwise affected by chemical dependency. Typically, youth are provided with workbooks that provide direction for quitting whatever particular substances they have been abusing or upon which they have become dependent. Also, some workbooks help to explain twelve-step support group principles. The youth’s responses are then discussed and processed during individual counseling sessions.

Once youth reach third stage of the four stage daily program, they can start the Transition Release process. This involves youth visiting their home every other weekend starting with an 8-hour release, then successively for 2 days, 3 days, and 5 days. Before a youth may begin visiting home, a decision has to be made by the his/her counselor concerning the readiness of the youth to be in the community without direct staff supervision. By this point, the youth must be able to demonstrate a lowered risk for relapse and can articulate how they will stay drug-free while in the community. The Transition Release process then provides an opportunity for the youth to meet the challenge of spending time with family in the community and to demonstrate the recovery skills needed to be successful once released from the program.

VI. Aftercare
Several weeks before being discharged from the program, a Wrap Around meeting is held to review aftercare planning. For this meeting to occur, the counselor, a parent or guardian, and the probation officer must be in attendance, otherwise the meeting will be rescheduled. Also invited but not required would be other program staff, school officials, social service workers, and community resource providers. During the meeting, the youth will be expected to explain the Relapse Prevention Plan that he/she has developed. Also at this meeting, a clearly written and documented aftercare plan is developed and should contain the following:
Identified positive family and/or adult support

• Arrangement for a risk-free community living situation
• A required, specific level of community supervision
• Continued drug and alcohol counseling on an outpatient basis
• Random urine screening
  

In some cases, twelve-step meeting involvement may be encouraged whether it be Alcoholics Anonymous, Narcotics Anonymous, Alateen or Al-Anon but any actual referral should occur by agreement of the youth and the outpatient counselor. In the end, aftercare planning should require the agreement of all parties and should support relapse prevention. An overall expectation of aftercare planning is that when taken into account with the Relapse Prevention Plan, the youth has been provided with the tools needed to be successful once permanently released from the program.