Delta PROMISE: Positive Reinforcement for Youth to Build Self-Esteem and Reduce Substance Use

1. Delta PROMISE Positive Reinforcement Of Minors to Increase Self Esteem

2. Delta PROMISE • A positive program for adolescents using substances in Lee, Phillips and St. Francis Counties • Collaboration between UAMS Psychiatric Research Institute/Department of Psychiatry and Counseling Services of Eastern Arkansas • Funded by SAMHSA grant • Substance Abuse Mental Health Services Administration • Program duration: September 30, 2006 through September 29, 2009

3. Goals and Outcomes • Decrease youth substance use in Lee, Phillips and St. Francis Counties • Increase youth potential for positive long-term outcomes (academically, occupationally, socially, legally, etc) • Increase positive caregiver involvement in youth lives

4. Target Population • Youth ages 12-17 • Who admit to using any type of alcohol or substance within the past 3 months • The youth does not have to have a diagnosed substance disorder • The youth must agree to participate in all aspects of the program

5. Philosophy of the Program • The program strives to be community-based in all aspects: • Referrals are obtained through community collaboration • Emphasis on building relationships with schools, law enforcement, juvenile judges, faith-based organizations and all youth serving providers in the community • Treatment is community-based: • In order to ensure treatment participation, services are is provided in community locations including schools, homes and recreation areas • Program oversight is community-based: • Advisory Board consists of representatives from Lee and Phillips counties and various community agencies • The program strives to be family-driven • The program strives to be youth-guided

6. Treatment Components • Uses a standardized treatment that has been demonstrated through controlled studies to produce positive outcomes • Initial Assessment via a structured interview • Ten individual sessions with the youth: • Teach youth to identify triggers, consequences of use, and motivation for use • Identify areas of life youth is unhappy with and develop goals to improve • Teach youth to derive satisfaction and positive consequences from pro-social recreational activities • Teach communication and problem-solving skills • Two caregiver only sessions and two family sessions to enlist support

7. Treatment Components (continued) • Case management: • Coordinates group recreational activities • Conducts outreach to obtain referrals • Encourages participation in the program • Provides transportation when needed • Follow-up for three months: • Therapist meets with youth in the community to reinforce learned skills

8. Progress Report • Certification in the evidenced-based practice: • One certified local clinical supervisor; one certified clinician • Two additional clinicians in training • Certification for structured interview • Two certified local trainers; one certified site administrator • Advisory Board actively participates in quarterly meetings to assess and discuss ways to improve the program • Youth Advisory Board provides input related to the program process and procedures

9. Adolescent Data • 45 adolescents enrolled through 2/18/08 • 46 Intakes completed • 26 discharges since beginning of program • Reasons for discharge • 9 moved from area • 9 non-compliant • 2 never started program • 2 moved to long-term residential programs • 2 were discharged at caregiver’s request • 2 transferred to other academic programs (Job Corp/National Guard’s Youth Challenge)

10. Adolescent Data • Education • 48% have completed 8th grade or less • 42% in 9th/10th grade • Legal Status • 38% have been arrested at least once • Age at First Use • 11% less than 10 years of age • 63% 10 to 14 years of age • 26% 15 to 17 years of age

11. Adolescent Data • Family History of Substance Use • 84%have a family history of substance use • Adolescent Primary Substance Used at Intake • 76% Marijuana • 22% Alcohol • 2% Heroin/Other Opioids • Severity of Use • 62% met criteria for past year dependence or abuse of substances

12. Adolescent Data • Co-Morbidity: (percent scoring above cut-off on symptom counts) • 41% ADD/ADHD • 46% Conduct Disorder • 16% Major Depression • 14% Post-Traumatic Stress Disorder • 8% Generalized Anxiety

13. Follow-up Data *Participated in recovery support group or interacted with friends or family supportive of recovery

14. Stories of Success

15. Summary • Evidence-based treatment for substance use • First outpatient substance use treatment available through a community mental health center that targets adolescents between the ages of 12-17 • Emphasizes the principles of a System of Care