Adolescent Outpatient Substance Abuse Program

The purpose of this program is to create an outcome based program for delivery of effective cognitive restructuring and social skills training to adolescent substance abuse offenders (13 to 18 years of age). While this program is a stand alone model (Criminal Conduct and Substance Abuse-Pathways to Self Discovery and Change). It can also serve as an additional service component that can be nestled within an existing treatment model that relies on one or more different cognitive behavioral therapy (CBT) curricula. The agency will utilize this model as it is recognized as the standard of care for substance abusing offenders by the Colorado Alcohol and Drug Abuse Division, the Department of Corrections, and the Office of Probation Services. This model attempts to pinpoint those at greatest risk by taking up the challenge of identifying psychological, biological, and socio-cultural, economic and political factors that contribute the onset of teenage behavior problems. This model is researched based for adolescents who manifest multiple and severe behavior problems. The cognitive behavioral treatment platform presented in the manual utilizes a holistic approach to identify, reduce, buffer, and address risk factors for the development of adolescent problem behavior.

The agency has adopted the following fundamental principles for criminal conduct and substance abuse treatment which has been integrated into the curriculum for treatment.

Multi dimensional assessment-identifies the multiple conditions of a adolescent's problems and strengths, including emotional, cognitive, behavioral, socio-cultural, and biological factors; Differential assessment-designed to develop individually focused treatment plans; Rapport building in the therapeutic alliance-utilizes the principles of therapeutic support and motivation to develop trust in the therapeutic alliance; Motivational enhancement-through mutual respect, feedback, advice, emphasis on personal responsibly, multiple treatment options, empathy, and support for self management; Integration of correctional and therapeutic approaches-addresses both the needs of society as well as the needs of the individual; Cognitive-Behavioral therapy-focuses on cognitive restructuring and social skills training as the key to initiate change; Relapse and recidivism prevention-develops individualized plans for maintaining recovery when released back to the community; Strengths based orientation-capitalizes on the strengths already present within the client, as well as enriching other personal qualities that may aid in lasting improvements and change; and Stages of change-clients and therapy groups generally proceed through identifiable stages of change during recovery, which must be acknowledged and addressed as integral to the treatment process (Milkman & Wanberg 2005).

Overview of program

The program is divided into three phases of treatment: 15 chapters and 32 treatment sessions. Phase 1 (Challenge to Change), Phase II (Commitment to Change: Strengthening Skills for Self Improvement, Change and Responsible Living), and Phase III Taking Ownership of Change-Lifestyle Balance and Healthy Living. Phase I is comprised of 5 chapters and 10 sessions; Phase II comprises five chapters and 10 sessions; and Phase III comprises five chapters and 12 sessions. Consumers will attend 3 sessions a week in Phase I and two sessions a week in Phase II and III. Services will be provided in the community (individual and family therapy for 2 hours a week) and office (group therapy-2 1.5 hour sessions during phase I and 1 1.5 session in phase II, III). A discrete group for each phase will be implemented. Consumers would complete one phase before entering the next phase. A consumer's ability to proceed to the next phase would be determined by the consumer, practitioner, family member, and/or probation officer. Mutual or unilateral decisions might be made that a consumer would not proceed to Phase II because of unsuccessful, disruptive or incomplete participation in Phase I. This decision would be based on clinical judgment. The treatment mode (group, individual, and family) and frequency can be adjusted to meet the individual consumer's need. Group size must be a minimum of 6 consumers and shall have no more than 12 consumers at a given time. Individual and family therapy will be provided in the community (home, school, residential facility). Each consumer will have a primary counselor who is responsible for providing services in the community.