Module 3: Treatment Strategies

6C. Responding to Problems in Complying with Treatment

The following are suggested ways to respond when youth do not comply with the treatment plan:

• Reexamine requirements of treatment and juvenile justice systems
• Restructure requirements:
  –Increased interaction with treatment provider/check-ins
  –Increased structure
  –Decreased structure
  –Different transportation arrangements
  
• Reexamine role of youth’s family in treatment
• Examine what else is happening in the youth’s life

Collaboration regarding consequences and graduated sanctions is essential. Basic guidelines should be developed with representatives from all three systems regarding specific categories of noncompliant behavior and the associated consequences that follow.

It is easy to become narrowly focused on emotional and drug use problems and to forget about what else may be occurring in the youth’s life. For example, are the youth’s family or friends trying to convince the youth that they do not have a problem? Are school requirements so time-consuming that they are interfering with the youth’s ability to attend treatment sessions, or vice versa?

Because the youth are likely to have requirements placed on them from both the treatment and juvenile justice systems, it is important not to overburden them. Work with the youth to prioritize goals that are appropriate and meaningful to all parties involved. Keep in mind, many of these youth have had difficulty maintaining responsible behavior or consistently committing to something in the past. It is important to set the youth up to succeed and to remember that success is the goal.

Think About What positive incentives are used in your particular system to influence the behavior of youth with co-occurring disorders? How effective are these strategies? What negative sanctions are used in your particular system to influence the behavior of youth with co-occurring disorders? How effective are these strategies?