Using “What Works” to Help Youth Change: From Assessment to Service Planning

and Delivery

National TASC Conference Workshop

It’s all about change…

Workshop Objectives• Describe “what works” with a juvenile

population;• Identify changes to The ASAM Criteria

and DSM 5 that impact work with juvenile clients;

• List components of effective multidimensional assessment and service planning;

• Practice effective intervention strategies to engage and assist youth.

Youth Specific Needs

What’s different?

Youth Specific Needs• Emotional, cognitive, physical, social,

moral development;• Extremely potent influences of family

and peers;• Immaturity in living skills;• Testing limits is normative;• Little capacity to think of future;

impaired abstract thinking.

Addiction• Inability to consistently Abstain• Impairment in Behavioral control• Craving• Diminished recognition• Dysfunctional Emotional response

Youth Specific Needs• Most do not develop classic physical

dependence;• Less physiological deterioration;• Casual to high severity use disorders can be

more rapid;• High degree of co-occurring psychopathology;• Impairment of emotional/intellectual growth;• Need more external support/assistance.

The ASAM Criteria• Updated diagnostic admission criteria

for levels of care (DSM-5);• Combining adult and adolescent

treatment information (separate diagnostic & dimensional criteria);

• Gambling & tobacco use disorders;• Addiction services for persons in

Criminal Justice settings.

An opportunity for change

Juvenile Case Study

Alignment RNR/ASAMRisk - Need – Responsivity• Assess Actuarial

Risk/Needs• Enhance Intrinsic

Motivation• Target Interventions -

RNR• Measure Relevant

Process/Practice• Provide Measurement

Feedback

ASAM Guiding Principles• Multidimensional

Assessment• Participant-directed• Individualized &

Clinically driven• Outcome Informed

Alignment RNR/ASAMAssess Actuarial

Risk/Needs

Develop & maintain a complete system of ongoing risk screening/triage and needs assessment.

Multidimensional Assessment

Treatment that is holistic and able to address multiple needs using the criteria’s six assessment dimensions.

The ASAM Criteria

Relationship is the key

Alliance as highest priority in early phases of intervention

• Assess the quality of the working relationship; especially in initial contacts.

• It is the youth’s perception of the relationship that is most influential, not yours.

• No hope, no confidence, no change.

Alignment RNR/ASAMEnhance Intrinsic

Motivation

Staff should relate to offenders in interpersonally sensitive and constructive ways to enhance intrinsic motivation.

Participant - directed

The individual should be an active participant in treatment planning. Collaboration is helpful in establishing a therapeutic alliance.

What’s important to you?

People are generally better persuaded by the reason

which they have themselves discovered

than by those which have come into the minds of

others. Blaise Pascal

Life areas that lead to program goals

EXERCISE

Alignment RNR/ASAMTarget Interventions

Prioritize supervision and treatment resources, target criminogenic needs, be responsive to individual characteristics.

Individualized & Clinically Driven

The ASAM Criteria supports individualized, person-centered treatment that is responsive to the patient’s specific needs and progress in treatment.

My top three issues

So what’s your plan?

Visualize your future

My first program goal

EXERCISE

Target the interventions…

…to the goal

Characteristics of addiction• Inability to consistently Abstain• Impairment in Behavioral control• Craving; or increased “hunger”

for drugs or rewarding experiences;• Diminished recognition of significant problems;• A dysfunctional Emotional response.

Definition

My specific action steps to reach my goal

EXERCISE

Alignment RNR/ASAMMeasure Relevant

Processes/Practices & Provide Measurement Feedback

Case plans are dynamic and reflect current situation. Measurement information must be used to monitor process and change.

Outcome Informed

Treatment is responsive to the participant’s specific needs and progress in treatment.

Monitor and adjust

What is important to you today?

Are you ready?

EXERCISE

It’s all about change…

Thank You!

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