Module 3: Treatment Strategies

Introduction

Twenty years ago, a panel of experts at the National Academy of Sciences found that no treatment was deemed effective for juvenile or adult offenders. As recently as 10 years ago, a noted researcher indicated that "the most well validated treatment for delinquent behavior remains getting older" (Melton et al., 1997). Only in the past 10 years have clinicians and researchers recognized that a high proportion of these youth had co-occurring disorders that were not affected by either traditional juvenile justice sanctions or individually focused mental health and substance abuse interventions. Research also has revealed risk factors and multisystematic treatment strategies that have an impact on youth with co-occuring disorders.

Included in this module are descriptions of traditional mental health interventions and traditional substance abuse interventions that provide background information for those who are not familiar with the historical evolution of treatment that has led to the current emerging treatment approaches for youth with co-occurring disorders.

Special issues for treating youth with co-occurring disorders focus on their barriers to treatment and characteristics that complicate treatment, including complications in using psychotropic medication and differing views of relapse in each system. Special issues also include the importance of maintaining continuity of treatment and collaborative treatment planning. Management strategies for youth with co-occurring disorders are focused on engaging youth and their families as partners in the treatment process and continual reinforcement to stay in treatment.