Program Description

Integrated Co-Occurring Treatment Program, Akron, Ohio

Overview

The Integrated Co-Occurring Treatment Program (ICT) is a treatment model specifically designed to serve justice-involved youth with co-occurring mental health and substance use disorders. ICT was developed with support from the Ohio Department of Mental Health and the Summit County Alcohol, Drug Addiction, and Mental Health Services (ADM) Board. A collaborative workgroup representing the state and local mental health, juvenile justice, and substance abuse authorities; families and consumers ; treatment providers; and researchers from the University of Akron developed the ICT model. Information collected through focus groups with youth and their families, as well as mental health and substance abuse providers, and education and juvenile court professionals , was also incorporated into the design. The model was piloted in 2001, utilizing funds from a Juvenile Accountability Incentive Block Grant (JAIBG) administered by the Ohio Department of Youth Services. In 2003, piloting of the ICT model continued, utilizing Byrne grant funds made available through Ohio’s Office of Criminal Justice Services. Co-developers of the model are Dr. Richard Shepler of the Center for Innovative Practices, and Dr. Helen Cleminshaw of the University of Akron.

Since its inception in 2001, ICT, which is implemented by the Akron Child Guidance Center/Family Solutions, has served 84 youth 13–18 years of age and their families. The program focuses on youth who have a long history of being involved with unsuccessfully with multiple child-serving systems. To be eligible for ICT, youth must have specific substance use (DSM-IV criteria for abuse or dependency) and mental health diagnoses (mood, psychotic, or anxiety-related disorders). Many of the youth who participate in ICT also experience significant difficulty with school success and functioning.

The model is an integrated treatment approach, grounded in System of Care service principles, that uses an intensive home-based model of service. The ICT program is both a reintegration program (for youth returning home from placement) as well as a diversion program for youth referred from the court as a condition of probation. Youth who are referred to the program undergo comprehensive screening and assessment, using standardized instruments, to determine mental health and substance abuse status and needs. Program clinicians are available to youth (and their families) 24 hours a day, 7 days a week and use a treatment stage approach, geared toward meeting the youth and family’s primary presenting needs prior to proceeding to more complex needs. Assessment and intervention services are delivered in the home, school, and community. Program clinicians use individual and family therapy interventions, and individual treatment focuses on skill and asset building, while simultaneously focusing on risk reduction. Family interventions include building parenting skills and rebuilding family relationships.

The program developers have conducted an initial evaluation of ICT, with some promising results. The outcomes tracked include mental health, substance abuse, and juvenile justice outcomes, and functioning in relevant life domains. The recidivism and commitment rates at discharge from ICT average 25 percent, which is significantly lower than the recidivism rate for usual services in the same community. In addition, youth showed improvement in functioning and behaviors, but the small sample size and lack of randomization limits the conclusions that can be drawn at this time. The program systematically collects data and has an evaluation component built in so more in-depth analysis is underway.

Reference

Personal communication with Helen Cleminshaw, Director, University of Akron Center for Family Studies.
Site visit to program on June 30, 2004.

Program Contact

Patrick J. Kanary
Director, Center for Family Studies
University of Akron
Schrank Hall South, Suite 210
Akron, OH 44325-6103
Phone: 330-972-8885