Module 3: Treatment Strategies

6A. Strategies to Engage Youth and Their Families in Treatment

Engagement strategies must be designed to maintain motivation and a sense of hope and optimism. The specific techniques used will depend on the specifics and severity of the co-occurring disorder, the degree to which family involvement is possible, and the skills of the staff working with the youth. The following are actions to take to maintain youth in treatment programs (Griffin, Hills, & Peters, 1996).

• Disclose expectations of each system and the resulting consequences if those expectations are not met
• Clarify what treatment "is" and "is not"
• Help set recovery goals that are realistic and meaningful to youth and their family
• Create positive and negative incentives that are meaningful to youth and their family
• Provide immediate and appropriate responses to positive and negative behavior
• Follow through on all promises made to youth and their family
• Treat youth and their family with respect at all times
• Acknowledge/attempt to address other problems with which the youth and family are concerned
• Mental health, substance abuse, and juvenile justice staff should speak with a single voice on critical issues
• One system’s response to key incidents should be supported by the other two systems

Written Treatment Agreements To help the youth and their family understand exactly what they are agreeing to when they enter treatment, it is important to have a written treatment agreement. The more treatment goals are established and written with full participation of families, the more likely they will be attained. A written agreement makes miscommunication about treatment expectations less likely and also can be used at a later date if miscommunication should arise. To assess the level of understanding and commitment, it is important to review all written material verbally with the youth and family as well.

Written treatment agreements should include the following components (Griffin, Hills, & Peters, 1996):

• Demands of treatment and recovery
• Outcomes expected after treatment completion
• Limitations of treatment
• Description of the recovery process
• Information about relapse and related behaviors

Additional Ways to Engage the Youth and Family The following are additional suggestions to ensure youth obtain needed services:

• Provide assistance in gaining economic benefits, housing, and other basic living needs
• Remove barriers to treatment
• Increase incentives to participation and make treatment more accessible and acceptable
• Provide indirect services such as appropriate educational opportunities, childcare, vocational and recreational services
• Require youth to participate in treatment (i.e., coercion)
  –involuntary commitment
  –involuntary detoxification
  –court-mandated treatment