Traditional drug treatment for teens often means being sent to an inpatient facility, far from family and friends. The young people might stop abusing drugs but then, soon after they return to their neighborhood they revert to their old ways.
A program developed by the non-profit Vera Institute has been trying to address this problem with a different kind of treatment: short-term therapy, in a teen's home, with the teen's whole family.
In partnership with the Office of Children and Family Services and other New York state and city agencies, Vera has been testing the program, called Adolescent Portable Therapy, with teens in juvenile detention.
" We recognized that there was a population of kids and families whose needs were not being met, who needed a different kind of intervention," said Evan Elkin, the program's director.
Researchers found that one in every five youth admitted to the city's juvenile justice system had been using drugs, usually marijuana, almost every day for the previous month before being admitted to detention. But in detention, many of those teens were not receiving treatment or saw it interrupted when they moved to another placement or returned home. The portable in APT is key: It is designed to be a support that can move with the teen from detention back into the community. The hope is that such portable therapy can help prevent teen drug users from being placed in residential care.
Teens who decide to participate are assigned a therapist who will stick with them no matter where they are placed. The therapists continue to meet with the teens for four or five months after they are discharged from whatever program they're in and readjust to being back in their neighborhood. The program's therapists also meet with the teen's family or other supportive adults and come to the family's home or any other place the teen and family feel comfortable.
" It's family therapy, but we expand the definition of family," said Elkin. "The first thing we do is sketch out a map of the supportive adults in the young person's life."
If a youth is in foster care, a program therapist might work with the foster mother, group home staff or with someone from the birth family.
In addition to its focus on family therapy and treatment wherever the teen is living, what sets APT apart from other programs is its emphasis on the young person's strengths.
" Often kids will be very confused by our approach," Elkin said. "It's not the Alcoholics Anonymous model. We don't want to bring teens in and make them admit that they're powerless. We believe people are inherently able to change and inherently strong."
How It Works
Mike (not his real name), a 17-year-old who entered the program last year, said he liked the individual attention it provided.
" A therapist came to see me, and once I went upstate she called me every week," he said. "She talked to me about how I felt like when I smoked and how I felt now that I was clean, and we compared the two. I realized there was a lot of stuff I'd been missing out on when I was high. And it was just helpful to have someone to talk to."
Eric Kolb, one of the program's therapists, said a lot of the therapy involves figuring out what kinds of situations tempt kids to use drugs and how they can be avoid such situations or cope with in different ways.
" For instance," Kolb said, "say a kid fights with mom at night, and the only way he can get calmed down enough to go to bed is to get high. We'd identify that and then talk about what it is about the fights with mom that get him so upset. And then we'd try to bring mom into that conversation, find out if she could say things differently. We take it moment by moment. We let the family know—these are other things you could try."
Mike was recently discharged to a group home, and his therapist comes to see him there. He said they plan to start family meetings with his biological mom and his little brother, and he'll continue the program for several more months. But he already feels APT has put him on the right track.
" Before, quitting was just something I said," he explained. "I'd tell people, 'Yeah, I'm going to quit,' but I never did. After I started talking with my therapist, I actually wanted to."
This article is adapted from the pages of our partner Youth Communication. Â