Program Description

Washington State Integrated Treatment Model in Juvenile Rehabilitation Administration Facilities

Overview

The Integrated Treatment Model (ITM) is the umbrella term for the combination of approaches utilized by Washington State’s Juvenile Rehabilitation Administration (JRA) within their residential programs and parole aftercare services. The design of the program incorporates best practice interventions for juvenile justice-involved youth, such as Cognitive Behavioral Therapy (CBT) and Functional Family Therapy , into a core two-part approach that addresses the needs of youth and their families from the point of admission through

the completion of parole aftercare. Both treatment approaches have been demonstrated to be effective with mentally ill

and substance

abusing/dependent youth.

JRA’s residential programming includes three institutions (two with a mental health focus), a work camp, a boot camp, and six state community facilities. Youth also participate in parole aftercare services following release to the community. ITM is the overarching service model structuring services to all youth in these settings — it incorporates CBT in residential settings, and Functional Family Parole (FFP), a family-focused parole case management model based on Functional Family Therapy (FFT), in parole aftercare settings.

Youth are screened by staff upon intake to the institution or facility and referred for mental health services if needed. Treatment for youth in residential settings includes engaging and motivating clients, strength identification and skill building as part of CBT. The treatment is modeled after Dialectical Behavioral Therapy (DBT), developed by Marsha Linehan, Ph.D., primarily for complex, difficult-to-treat cases with severe behavior problems. DBT focuses on enhancing a youth’s behavioral skills to deal with difficult situations; motivating the youth to change dysfunctional behaviors; and ensuring that the new skills are used in daily institutional life and generalize back to the community.

Families are invited to learn about their child’s care and treatment, but due to travel and other constraints they may have limited involvement while youth are residing in institutions. However, as the youth moves back to the community, the family becomes the central focus. As part of ITM, youth transition into a Functional Family Parole (FFP) program immediately after release from the institution. FFP has been in place since 2002 and modeled after Functional Family Therapy (FFT) created by James Alexander, Ph.D. and Thomas Sexton, Ph.D., Functional Family Parole addresses the need for families to examine and improve their natural ability to solve problems and access resources in their communities. Counselors also help the youth apply the newly acquired skills and strengths developed in the residential placement. While ITM incorporates two systems of treatment, JRA works to blend them when possible, with families participating in skills groups and family sessions when visiting the institutions, and some parole settings offering DBT skills groups and skills coaching in the community.

Ongoing goals of the ITM include an attempt to link the interventions by providing cross-training to staff; working together with youth and families at all stages of the process; and developing treatment adherence measures and quality improvement processes. Residential treatment based on DBT is being developed for youth with sex offending and substance abuse behavior. One key finding of the ITM is the need for ongoing in-house training to ensure continuous treatment delivery during times of staff turnover. Resources have been allocated to focus on this priority. A core of program administrators has been trained by consultants who have in turn, become trainers for incoming staff. Outside consultants are brought in as necessary.

References

Juvenile Rehabilitation Administration. (2002) Integrated treatment model design report. Olympia, WA: Juvenile Rehabilitation Administration.
Personal communication with Henry Schmidt III, Ph.D., Clinical Director, Juvenile Rehabilitation Administration.

Program Contact

Henry Schmidt, III, Ph.D.
Clinical Director
Juvenile Rehabilitation Administration
Department of Social and Health Services
14th and Jefferson Street
PO Box 47520
Olympia, WA 98504
Phone: 360-902-7637