Reclaiming Futures: Programa Tratamiento Rehabilitación Consumo de Drogas EE.UU.
Research shows that young people who abuse drugs and alcohol are more likely to behave violently or end up in court. There are more than two million teens in the juvenile justice system, and as many as four out of five of them have drug or alcohol problems. In fact, the incarceration rate for young people ages 10 to 18 for drug-related crimes has skyrocketed 291 percent in the last decade.
These teens in trouble come from many walks of life, are disproportionately from low-income areas and communities of color, and often have other problems besides drug or alcohol abuse, such as coming from abusive or neglectful families. They often suffer from other problems in addition to substance abuse and crime.
The National Center for Mental Health and Juvenile Justice estimates that four out of five teens in contact with the juvenile justice system have diagnosable mental health disorders. At least one out of every five has a serious emotional disturbance that interferes with their ability to function on a day-to-day basis, and often this is coupled with a substance-use disorder.
Allowing one youth to leave high school for a life of crime and drug abuse costs society up to $2.3 million. Right now, putting a young person in jail costs about $40,000 each year. By contrast, giving a teen treatment for drugs or alcohol abuse can cost as little as $3,000. That’s one-thirteenth the cost of keeping repeat offenders in jail.
That’s one-thirteenth the cost of keeping repeat offenders in jail. It’s time to help these teens overcome drug, alcohol, and related crime problems by creating and coordinating all the services they need. It will help reduce crime, it will save all of us money, and it will make communities safer. All teens deserve our help – even those who abuse drugs and alcohol and commit crimes. This is not just a problem for their families; it’s a problem for us all.
Simply locking these teens up won't solve the problem. And while communities need to hold teens accountable for their actions, they must provide drug and alcohol treatment and community support. We know that treatment works. Yet many teens in our nation's juvenile justice system -- some experts estimate the figure is as high as 80 percent -- receive no treatment for drug and alcohol abuse at all. More Treatment, Better Treatment, More than Treatment
To be effective, treatment programs must work in a coordinated fashion and take advantage of the wealth of new evidence-based practices. They also must involve families, address cultural and gender issues, and coordinate with judges, probation programs, and schools. More Treatment, Better Treatment, More than Treatment
Recent studies show effective drug and alcohol treatment requires a “network” of community support for the young person’s success in the community. Teens with substance-abuse issues who receive care through this network fare much better than those not receiving it. After 12 months, less than half as many of these youth are back in confinement and more than twice as many are abstaining from subsequent drug and alcohol use. More Treatment, Better Treatment, More than Treatment
<ul><li>"…successful efforts…have a number of things in common: </li></ul><ul><li>They are preventative, rather than simply reactive; </li></ul><ul><li>they emphasize building the strengths and capabilities of young people and their families, rather than simply treating their deficiencies or preaching virtue at them; </li></ul><ul><li>they encourage productivity and responsibility; </li></ul><ul><li>and, they tackle concrete, real-world problems that undercut life chances and breed hostility, stress, and demoralization. </li></ul>
Most of the successful programs are comprehensive--or what some would call 'ecological': they address the multiple problems of children, youths, or families wherever they arise--in the family, the community, the health-care and school systems, and the housing and labor markets. They tend, insofar as possible, to deal with the roots of those problems, rather than just the symptoms, and they are typically inspired by some of the best thinking we have on the causes of violent crime, delinquency, of child maltreatment.“ Excerpted from Currie, E. (1998). Crime and punishment in America: Why the solutions to America's most stubborn social crisis have not worked - and what will. New York: Henry Holt and Company.
To succeed, network members also must take 10 key steps. Critical Components: 1. Develop interagency collaborations among a variety of agencies such as juvenile justice, substance abuse, mental health, primary health care, education, employment, youth development, faith communities, recreation, and others. 2. Use effective screening techniques to identify at-risk youth.
Critical Components: 3. Conduct a comprehensive assessment that evaluates the youth's risks, needs, strengths, and motivation. 4. Based on the assessment, develop an individualized service/treatment plan that considers the youth's age, culture, and gender. 5. Use treatment methods that have been found effective, based on research and evaluation, with substance-abusing juvenile offenders.
Critical Components: 6. Involve family in all aspects of the youth's treatment, including participation in assessment and treatment planning, and offering services for families. 7. Provide comprehensive case management across systems and over time. 8. Structure a system of care that encompasses a youth's transition from institutions to the community.
Critical Components: 9. Implement a management information system that can be used to share information across programs and systems, thus reducing redundant data collection and improving screening and assessment capabilities. 10. Implement a quality assurance system that ensures quality services in a managed care era and that provides effective and efficient documentation. Excerpted from: Strategies for Integrating Substance Abuse Treatment in the Juvenile Justice System: A Practice Guide (1999). Nissen, L., Vanderburg, J., Embree-Bever, J. and Mankey, J. Washington, D.C.: Center for Substance Abuse Treatment.
Results of existing studies indicate that adolescent substance abuse is a complex, but treatable problem. Although there is evidence for the efficacy of both inpatient and outpatient substance abuse treatment, no one specific modality of treatment has demonstrated consistent efficacy in promoting lasting long-term decreases in adolescent substance use. Rather than advocating for a specific modality of treatment, research findings suggest that the inclusion of specific elements of treatment is essential for positive treatment outcomes.
Several promising approaches to adolescent chemical dependency exist. Regardless of the setting, inpatient or outpatient, programs that use comprehensive assessment procedures, address multiple problems, use a team case-management approach, stress family involvement, use cognitive-behavioral techniques, deliver services in the home, and provide continuing care appear to be the most effective in treating substance abuse.
Three national model programs (Escambia County Juvenile Drug Court program in Pensacola, Florida, Denver Juvenile Justice Integrated Treatment Network in Denver, Colorado, and the Bridge Program in South Carolina, have in common the same principles which contribute to increasingly successful outcomes:
<ul><li>results from a comprehensive assessment procedure drive the treatment plan </li></ul><ul><li>treatment is tailored to meet the individual's needs, providing therapeutic, academic, and medical services; a team approach to treatment is taken </li></ul><ul><li>all individuals on the treatment team are experienced with adolescent substance-abuse treatment and are enthusiastic about the program </li></ul>
<ul><li>treatment is at least a year in duration with frequency of contact decreasing over time </li></ul><ul><li>family involvement is stressed </li></ul><ul><li>there are frequent home visits for therapy and monitoring of progress </li></ul>
<ul><li>therapy is strength-based and utilizes a variety of techniques including individual and group therapy, cognitive-behavioral interventions, supportive therapy, and even inpatient treatment if warranted </li></ul>
There are to date, no published outcome studies in these programs, but a 74 percent abstinent rate for treatment completers was reported for the Bridge Program. For the Escambia Drug Court Program, re-arrest rates were reported at 5 percent 18 months after treatment. The Denver program reported a 19 percent recidivism rate over one year for treatment completers
“ I have the right to be viewed as a person capable of changing, growing, and becoming positively connected to my community no matter what types of delinquent behavior I have committed. I have a right to participation in the selection of services that build on my strengths. I have a right to contribute things I am good at and other strengths in all assessment and diagnostic processes. I have a right to have my resistance viewed as a message that the wrong approach may be being used with me.
I have the right to learn from my mistakes and to have support to learn that mistakes don't mean failure. I have the right to view past maladaptive or antisocial behaviors as a lack of skills that I can acquire to change my life for the better. I have the right to experience success and to have support connecting previous successes to future goals. I have the right to have my culture included as a strength, and services which honor and respect my cultural beliefs.
I have the right to have my gender issues recognized as a source of strength in my identity. I have the right to be assured that all written and oral, formal and informal communications about me include my strengths as well as needs. I have a right to surpass any treatment goals which have been set too low for me, or to have treatment goals that are different than those generally applied to all youth in the juvenile justice system.
I have a right to be served by professionals who view youth positively, and understand that motivating me is related to successfully accessing my strengths. I have a right to have my family involved in my experience in the juvenile justice system in a way which acknowledges and supports our strengths as well as needs. I have a right to stay connected to my family no matter what types of challenges we face.
I have the right to be viewed and treated as more than a statistic, stereotype, risk score, diagnosis, label, or pathology unit. I have a right to a future free of institutional or systems involvement and to services which most centrally and positively focus on my successful transition from institutions. I have the right to service providers who coordinate their efforts and who share a united philosophy that the key to my success is through my strengths.
I have the right to exercise my developmental tasks as an adolescent -- to try out new identities, to learn to be accountable and say I'm sorry for the harm I've caused others -- all of which is made even more difficult if I'm labeled a "bad kid." I have the right to be viewed and treated as a redeemable resource, potential leader and success of the future.” Developed by Laura Burney Nissen, Ph.D., MSW, CAC III, 1998