Intervening with High Risk Youth: A Program Model
Davis, Ruth B., Wolfe, Howard, Orenstein, Alan, Bergamo, Peg, Buetens, Karen, Fraster, Beth, Hogan, Jim, MacLean, Annette, Ryan, Maureen, Adolescence
CASPAR, Inc. is a not-for-profit alcoholism and drug abuse treatment agency that runs an array Of programs for adults in Cambridge and Somerville, Massachusetts. For almost two decades, CASPAR has also sponsored an alcohol and drug education program that develops curricula and conducts programs for children and adolescents in schools and community sites and in after-school peer-led groups (DiCicco et al., 1983, 1984).
In 1984, the Education Program was approached by a probation officer in Cambridge who wanted us to assess and recommend services for some of his adolescent clients. Soon thereafter, Somerville High School developed a policy that required an assessment when a student violated the school's alcohol or drug rules. These requests put us into contact with older youth (median age of 16.7 years), some of whom had serious substance use problems. This paper examines some of the choices we have made and some of the things we have learned in trying to respond to the needs of this group of clients.
Overview of Programming
CASPAR offers a range of prevention and intervention services. In schools, classroom teachers and our own staff conduct lessons on alcohol and drugs from the early primary grades to the 12th grade. This type of programming works with general populations of youth and tries to prevent the development of substance use and associated problems.
CASPAR also works with youth who are at high risk for developing alcohol and drug problems. These services are structured differently at different grade levels. In both the elementary grades and in senior high schools, we conduct groups during school hours led by adult staff; we have offered similar groups in community locations such as housing developments and recreation centers. For junior high school students, CASPAR conducts after-school groups led by trained peer leaders.
In the younger grades, children are often selected to participate in groups by teachers because they are having problems. Parents, particularly those with alcoholic spouses, will often ask that their children be included in elementary school groups. Starting in junior high school, CASPAR (DiCicco, et al., 1983); (Roosa, Sandler, Beals, & Short, 1988) found that an effective way to recruit youth who are at high risk is to create groups that can attract students, since those who volunteer are likely to have real problems that are motivating their interest. In addition, we make special efforts to recruit students in special education classes, alternative high schools, in-school suspension programs, and other locations where those who are having trouble in school are likely to be contacted. Finally, CASPAR staff working in schools often suggest to particular students that they join an appropriate group.
When working with children or teenagers who are at high risk, we prefer group work to individual counseling. This is because we want group members to see that they are not alone in having problems and to see that other youth with similar problems are still important and worthwhile people. We also want them to learn that it is safe to share thoughts and feelings with others and to have the experience of bonding with and getting support from both group leaders and group members. It is this connectedness to others that appears to be a key protective factor in allowing adolescents to remain resilient in the face of difficult life circumstances (Berlin & Davis, 1989; Hauser, Jacobson, & Wertlieb, 19895).
In sum, the community response to high-risk youth must involve a variety of program elements at different age levels that complement and support one another. When we teach about alcohol and drugs in classrooms, this opens up the topic so that children who are having problems can identify themselves and be put in groups; we believe that children who receive help at one age level will be more likely to seek out further help when they encounter problems in later years. …