ILLINOIS
A stabilizing force
Co-occurring care sees 90 percent retention rate
High-risk adolescents in McHenry County have a place to turn when they feel as if they’ve run out of options.
The McHenry County Family Service and Community Mental Health Center recently was one of eight national recipients of the 2010 Innovation in Behavioral Healthcare Services Award. Sponsored by the State Associations of Addiction Services and NIATx, the honor was given for the county’s Integrated Co-occurring Treatment program.
ICT was created during the summer of 2008 to better meet the needs of youth with co-occurring disorders. Often referred to as dual diagnosis, people with co-occurring disorders have both mental health problems and substance abuse addictions. The local program is designed for children ages 11 to 16 and incorporates an intensive home-based method of therapy that focuses on the family as a whole. There are only five such programs in the United States, and ICT is the only one in Illinois, said Chris Gleason, who helps supervise the program.
“I really think it’s changed how we deal with these high-risk adolescents,” said Gleason, also Family Service’s director of substance abuse services. “I think we’re giving them much better services than we ever have.These were always adolescents that slipped through the cracks, who nobody wanted to deal with or take, ... and they’re the most stigmatized kids, as well,” Gleason added.
Of the feedback staff members have received from the nearly 100 children who’ve gone through the program, most said their treatment was more meaningful with the one-on-one therapist interactions, as opposed to being sent to inpatient facilities with a larger group setting. ICT has had about a 90 percent retention rate – much greater than the national rate of about 50 percent for related treatment programs. “They feel more comfortable, and they can share more,” Gleason said. “Because they’re in their own environment, they feel more relaxed.”
A typical week with ICT usually starts with a visit to the child by his or her therapist at school, then at home on an individual basis. At least one family therapy session, then a parenting-only session follows. In between, a lot of phone calls are made to check in on the teen and their family, along with crisis intervention and case management.
Compared with other treatments, the biggest difference with ICT is its family component.
Jessica Zaucha, a licensed clinical social worker and ICT program manager, said most intensive treatments for youth were done in an inpatient or group format, where the focus is on the individual. The children are taken out of their environment, but when released, all those triggers to their problems return. “We manage some of the structures in the family that may have contributed to the youths’ struggles, but that also better supports the family’s recovery,” Zaucha said, adding that in-home treatment is key. “When your family therapy is happening on your living room couch or at your kitchen table, that’s helping at a whole different level.”
Traditionally, teenagers with co-occurring disorders also often get “trapped” in treatments for either disorder with two different providers, Zaucha said. Sometimes, those providers disagree about which treatment should take precedence. “They can’t always agree on where to start, but you have to start with both,” she said.
To qualify for ICT, local children must fit the age requirements and be diagnosed with co-occurring disorders. They also must be at risk of possible placement outside the community, often meaning more hospitalization, residential care or trouble with the juvenile system. About 25 percent of ICT’s participants are there because of court mandates.
The changes ICT instills cover a variety of life areas: family, school, community involvement, and peer groups. Success with each reduces substance abuse and mental health issues, but it isn’t always easy. “The likelihood of relapsing is really high, even with successful treatment,” Zaucha said. “We know that these kids are not at the end of their journey when they are discharged from ICT.”
However, the ICT program doubled its capacity last fall to now employ four full-time in-home therapists who can serve as many as 24 clients at a time. That’s about the number of children in the program at once, completing the average six-month treatment.
About two-thirds of all participants have been successfully treated – with post-placement in residential or other care considered unsuccessful. Some children have even taken on leadership roles after multiple failed past inpatient treatments, and plan to speak to future ICT groups. “One of our youths said that it was the first time he was able to see the strengths and progress he was making,” Zaucha said. “I can’t tell you how many kids going through the program who, in the end, want to become counselors.”
And parents have praised the program for changing their family’s lives.
In the future, Zaucha and Gleason said they hoped to obtain a Spanish-speaking therapist to address the increasing population of local Hispanics with co-occurring disorders seeking treatment. They also want to expand the program’s age range to 17.
A step-down program for less therapy over time also is being explored.
“The program is sustainable past its grant, so we can grow it,” Zaucha said. “We’ve never had a waiting list, and that’s something we want to maintain.”
Amber Krosell
1 August 2010
http://www.nwherald.com/articles/2010/07/29/r_ji50qdqsfs_psmvhnn56g/index.xml
