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Combining Alcohol and Other Drug Abuse Treatment With Diversion for Juveniles in the Justice System
Treatment Improvement Protocol (TIP) Series 21

Exhibits

Exhibit 2-1 The Assessment Process

The Assessment Process

Exhibit 2-2 Accountability Approach

Accountability-based sanctions and supervision may best be described as "reparative," "fair and proportionate," or "active."
Reparative: Drawing upon an ancient tradition of justice that long predates very recent concerns with victims' rights and criminals' "just desserts," the accountability approach gives first priority to the requirement that offenders act to restore loss and repair damages resulting from their offenses. Ultimately, the goal of the justice system is to reconcile victims, offenders, and the community. This reparative or restorative goal is an end in itself. While reducing recidivism and providing rehabilitation are desirable outcomes (and may be the results of the reparative process), justice for both victims and the community is its own reward.
Fair and Proportionate: While compassion and concern for the individual needs of the offender and the underlying causes of the offense may receive attention, primary emphasis is placed upon the offense, its severity, and the circumstances surrounding it rather than on the personal characteristics of the offender. Fairness demands that, to the greatest extent possible, sanctions be proportionate to the degree of harm resulting from the offense(s).
Active: Unlike both treatment and punitive approaches, which view the offender as a passive recipient of help (treatment) or of unpleasant consequences as a result of confinement (punishment), accountability demands the offender's active engagement. Whereas punishment gives the message to offenders that something will be done "to you" and treatment gives the message that something will be done "for you," an accountability approach asks the offender what he or she will do to "make it right" in the eyes of the victim(s) and the community.
In this view, it is the responsibility of juvenile justice professionals and the JJS to provide the monitoring and support services necessary to ensure that offenders are held accountable. This requirement often involves providing offenders with work and community service experience which ultimately increases the likelihood of their future responsible and accountable behavior.
Source: Accountability in Dispositions for Juvenile Drug Offenders, 1992.

Exhibit 2-3 Risk Factors

Community
Availability of drugs
Community laws and norms favorable to drug use and crime
Media portrayals of violence
Transitions and mobility
Low neighborhood attachment and community disorganization
Economic and social deprivation
Family
Family history of the problem behavior
Family management problems
Family conflict
Favorable parental attitudes and involvement
School
Early antisocial behavior
Academic failure in elementary school
Lack of commitment to school
Individual/Peer
Alienation, rebelliousness
Friends who engage in the problem behavior
Favorable attitudes towards the problem behavior
Early initiation of the problem behavior
Constitutional factors
Source: Adapted from Communities That Care: Risk-Focused Prevention Using the Social Development Strategy, 1994.

Exhibit 2-4 City of Norfolk's CAPES Program Community Services Board

Chemical Abuse Prevention Through Educational Services (CAPES)
The CAPES Program, a community-based early intervention program, is designed to divert first-time offenders of substance abuse (ages 8-18) from the Norfolk Juvenile and Domestic Relations Court by the provision of educational/counseling services. This program was originally proposed by the Community Services Board in 1984; however, Family Services was selected to implement CAPES and had responsibility for its operation until recently. The program is now back with Norfolk Community Services Board's Office of Prevention and Information Services.
Educational groups are conducted for 20 hours with a maximum of 9 participants per group. They are closed ended. The groups meet for 2 hours, 5 times a week for 2 weeks. Youth are placed in age appropriate groups, i.e. young groups ages 8-13, older groups ages 14-18. The subject material includes drug specific information; drugs and health related information; drugs and the law; decision-making; self-esteem; communication skills; peer pressure, alternatives to drugs; coping with emotions and change to include anger management/conflict resolution; social responsibility; cultural issues, etc. The format is experiential in nature, requiring active participation.
The CAPES Program provides 6 parent support/education groups during the 2-week period. Parents are required to participate in at least 4 groups. Two communication building group sessions requiring the simultaneous participation of both parents and youth are also provided.
Three individual counseling sessions are provided to each student. Youth in need of more than 3 sessions are referred to the Adolescent Substance Abuse Outpatient Program. The schools reinforce the diversion into CAPES by making it mandatory that satisfactory completion of this program is required prior to re-entry into the school and insure that all first offenders are reported to the youth bureau.
The CAPES Program has proven effective in diverting first-time offenders from the courts and successfully returning them to school. With the Student Assistance Program in all Norfolk High Schools and 3 Middle Schools, the Student Assistance Counselors are able to provide long-term followup, further increasing the effectiveness of the CAPES Program. Early intervention by the CAPES Counselors and Student Assistance Counselors will have a positive affect on adolescent first-time users in the City of Norfolk.

Exhibit 2-5 Family Involvement

When possible, parents should participate in all the required phases of their child's treatment. Since most AOD-abusing adolescents live in problematic families, these families should also agree to enter treatment. Parental education groups and nuclear family therapy should be part of the adolescent treatment program. AOD abuse, sexual abuse, violence, and criminality are intergenerational and should be treated as such in an attempt to stop dysfunctional patterns. Parents should be helped to deal with their own AOD abuse, sexual abuse, and other issues that perpetuate family dysfunction. Parents must be engaged, empowered, and helped to see their roles as part of the solution, not just as part of the problem. They must relearn parenting skills in the context of proactive parenting designed to best help the adolescent with AOD problems.
Source: CSAT TIP, Screening and Assessment of Alcohol- and Other Drug-Abusing Adolescents, 1993.

Exhibit 2-6 Gender-Specific AOD Abuse Treatment

Treatment programs serving pregnant, AOD-abusing adolescents include the following services, or support active outreach to and linkage with appropriate service resources already available in the community:
  • Comprehensive inpatient and outpatient treatment on demand.
  • Comprehensive medical services.
  • Gender-specific services that are also ethnically and culturally sensitive. These services must respond to women's needs regarding reproductive health, sexuality, relationships, and all forms of victimization. Services should be offered in a nonjudgmental manner and in a supportive environment.
  • Transportation services, including cab vouchers, bus tokens, and alternatives for women who live in communities where public transportation is cumbersome, unreliable, or unsafe.
  • Child care, baby-sitting, and therapeutic day care services for children.
  • Counseling services, including individual, group, and family therapy.
  • Vocational and educational services leading to training for meaningful employment, the General Equivalency Diploma (GED), and higher education.
  • Drug-free, safe housing.
  • Financial support services.
  • Case management services.
  • Pediatric followup and early intervention services.
  • Services that recognize the unique needs of pregnant, adolescent, substance users.
Source: CSAT TIP, Pregnant, Substance-Using Women, 1993.

Exhibit 2-7 Indicators for Assessment

  • Physical or sexual abuse
  • Parental AOD abuse
  • Parental incarceration
  • Poor school performance or attendance
  • Physical symptoms of AOD abuse or adverse consequences of AOD abuse
  • Peer involvement in AOD use or serious crime
  • Marked changes in physical health
  • Involvement in serious delinquency or crimes
  • Dysfunctional family relationships
  • Serious problems at work (e.g., losing a job) or in school
  • HIV high-risk activities (e.g., injecting-drug use; sex with injecting-drug user)
  • Indicators of serious physical problems (e.g., suicidal ideation, severe depression).

Exhibit 2-8 Continuum of Service

  • Prevention
  • Early Intervention
  • Outpatient Treatment
  • Intensive Outpatient Treatment
  • Residential Services

Exhibit 3-1 The Systems View of Collaboration To Design and Implement Juvenile AOD Diversion

The Systems View of Collaborati on To Design and Implement Juvenile AOD Diversion

Exhibit 4-1 Points for Youth Diversion to AOD Abuse Treatment

  • Before referral to the court: A youth may be referred to AOD screening and assessment before coming to the attention of the juvenile court. For example, a community-oriented police officer may identify a youth at risk of becoming an alcoholic or heavy user of other drugs and refer that youth for AOD screening and assessment.
  • Juvenile court intake, before filing a petition: A youth may be referred to the juvenile court on a minor charge and then be referred by the juvenile court services to AOD screening and assessment prior to, or even in lieu of, the filing of a formal petition.
  • Juvenile court intake after petition has been filed but before an adjudication hearing has been scheduled: If the youth is referred to the juvenile court for an offense that is moderately serious, such as grand larceny, or has appeared before the juvenile court several times on minor offenses, the juvenile court may hold an official petition in abeyance pending successful completion of AOD abuse treatment.
  • After adjudication in lieu of formal disposition: For serious but nonviolent offenders or chronic minor offenders, the court may hold its disposition (such as weekend detention or commitment to training school) in abeyance pending successful completion of AOD abuse treatment.

Exhibit 4-2 The Written Report

The written report should identify
  • The severity of the AOD abuse
  • Factors that contribute to or relate to AOD abuse
  • A corrective action plan to address problem areas
  • A detailed plan to ensure that the treatment plan is implemented and monitored to its conclusion.
The written report should be careful to
  • Not reduce a youth to a test score
  • Emphasize the youth's strengths as well as problems
  • Capture the full range of issues, strengths, and concerns relevant to the youth
  • Integrate previous workups when they indicate progression of symptoms and problems
  • Not include opinions and descriptions from previous reports without thought and research--the report can follow the youth for years.
The written report should be distributed
  • On a "need-to-know" basis only in accordance with Federal and State confidentiality rules
  • Only with the signed approval of the adolescent (and, in some States, of the parent or guardian), as required by Federal or State laws.
The report should serve as a basis for linking youth with needed services.
  • It should specify treatment placement recommendations.
  • It should recommend posttreatment support services.
Note: The report should be written so that it can be understood by the youth and all parties concerned.

Exhibit 5-1 Juvenile AOD Abuse Treatment Diversion Program Checklist

Task 1 - Identify participants and key leaders
Task 2 - Secure funding
Task 3 - Identify lead agency
Task 4 - Develop goals and objectives
Task 5 - Establish interagency linkages
Task 6 - Establish interagency dispute resolution guidelines
Task 7 - Develop selection criteria
Task 8 - Develop grievance procedures
Task 9 - Establish information sharing and confidentiality guidelines
Task 10 - Provide for timely access
Task 11 - Establish continuum of services
Task 12 - Develop accountability measures
 



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