Adolescent Substance Abuse Program (ASAP)
(Revised 4/15)
The Adolescent Substance Abuse Program (ASAP), offered by the Denver Family Therapy Center provides treatment and support for adolescents struggling with alcohol and/or substance abuse and chemical dependency. Treatment for adolescents with dual diagnosis (those struggling with substance abuse and mental health issues is also provided. This program is licensed by the Office of Behavioral Health (OBH) and is considered an intensive outpatient (IOP) treatment facility by insurance companies.
ASAP has a family systems-based approach to treatment. While adolescents learn about drug abuse and ways to maintain abstinence, the entire family is included in setting treatment goals, to address the problems related to substance use. Our goal is to help move adolescents and their families down the continuum of care to the least intrusive and least restrictive services available. Adolescents are held accountable for sobriety through regular urine drug testing. Parents get help and support in building their parenting and communication skills, and by setting clear limits, expectations and personal boundaries. Because the program treats the family as a whole, it is very important for parents to participate in the treatment process.
How ASAP Works
Licensed and masters level therapists, who are also Certified Addictions Counselors and who specialize in family systems therapy conduct an initial assessment to determine the appropriate level of care and design an individualized treatment plan. The assessment will lead to one of several different levels of intervention.
Assessment Phase
The first level of intervention is referred to as the Assessment phase of treatment. This level is for clients who have experienced some problems, but may appear to be at low risk for further or increased problems related to substance abuse. This level of treatment is also the first level of treatment for clients who will continue on to more intensive treatment. This Assessment phase lasts a minimum of 4 weeks to a maximum of 6 weeks and includes:
-Initial evaluation session- which involves the client along with at least one parent
-One (1) individual therapy session with the client
-Three (3) multi-family groups (group therapy session where clients and parents attend together)
-One (1) follow-up family therapy session
-2-3 Urine screens for monitoring.
Ongoing Outpatient Treatment
Clients who are exhibiting a moderate level of risk as well as moderate level of life disruption as a result of their substance use, will be referred to ongoing treatment. This treatment does not have a maximum length of time, and will be completed when the client and family have me their treatment goals. This level of treatment will include:
1-2x/week therapy sessions that may be individual therapy, family therapy, or group therapy (see schedule below)
Regular urine screens to monitor substance use
Intensive Outpatient Treatment
For many families, the most effective treatment is the intensive outpatient treatment, which includes family and individual therapy, and up to four hours of group therapy per week for a total of up to 9 hours per week. The length of stay in the intensive outpatient treatment is determined based on the needs of the family. The average length of stay at this level of care is six to ten weeks, before reducing frequency. It is common that a client will “step down” from the intensive outpatient level of care to the ongoing outpatient level of treatment.
Schedule
-Tuesday- Multi-Family Therapy Group 6:00-8:00pm
-Thursday- Peer Support Group 6:00-8:00pm
Individual and Family therapy scheduled 1-4 times weekly by appointment.
Service Rates
Assessments $250
Family/Individual Therapy $110 per hour
Group therapy $40 per group
Urine Drug Screens $20
Guiding Philosophy
The ASAP program utilizes a Brief Family Therapy/ Systemic approach to treating adolescent substance abuse. “Brief Family Therapy is a planned and co-creative process, utilizing both family strengths and the least restrictive and intrusive treatment interventions to help the family identify and develop solutions” (Blair, Kelsall, 2001).
People change when they are either experiencing pain or discomfort. Change is an attempt to avoid or eliminate this pain/discomfort. Our job is to facilitate enough pressure to elicit change in the adolescent drug/alcohol abuser. Pressure can be facilitated in numerous ways:
Intrapersonally
Educate-
Providing new information that causes the person to feel uncomfortable enough to change behaviors. This is known as Cognitive Dissonance.
Consequent-
Making it harder to use than not to use (drugs and/or alcohol)
Substitution-
Creating alternatives to use which solves the same problem that they were trying to solve with the drug/alcohol use (i.e., social interaction problems, need for stimulation, developmental need for individuation, etc.)
Interpersonally
Environmental interventions-
Getting parents, probation officers, school personnel, and other people with more hierarchical power, to change their interaction with the drug/alcohol using adolescent. This change results in increasing the discomfort the adolescent experiences for his drug/alcohol use.
Consequencing-
Repercussions for drug/alcohol use.
Rewarding-
Positive reinforcement for positive situations.
Changing-
Modifying responses to drug/alcohol use (i.e., new pattern or new role).
The problem is behavior, which disrupts the adolescent’s or family’s life. Sometimes a person can change these behaviors without abstinence from drug or alcohol (controlled use). Sometimes a person cannot change these behaviors without total abstinence (addiction). Our job is to help the person decide for themselves which of these types of use he/she is. This is often done by trial and error.
Our goal is to help the adolescent change the behavior that is disrupting his/her own livelihood or the livelihood of his/her family, peers, and/or community. We will utilize Individual, Family and/or Group interventions, as well as urine analysis (UA) screens and medication when appropriate.
ASAP Treatment goals include:
Improving overall family functioning (according to the family’s definition of what is functional for them)
Increasing/improving community involvement for the adolescent in school, occupation, extra-curricula’s, or community service.
Reduce drug and/or alcohol use.
Reduce the level of involvement in the court system.
Specific objectives for ASAP’s treatment program include:
Developing a common language among family members and treatment providers (i.e. therapists, probation officers, psychiatrists, etc,).
Identifying patterns around destructive behaviors and helping to develop alternative responses. This will include looking at roles, communication patterns, solution patterns, etc.
Allowing for mutual peer support during the process of change and its predictable pain and relapse process.
Establishing a trial and error process to help the adolescent and family determine needs for future treatment (e.g., sobriety, controlled use, AA, etc.).
Helping the adolescent and family discover alternatives to use that enhance intrapersonal and interpersonal developments.
Facilitating a pro-social process of separations/individuation.
Assessment/Evaluation
All patients admitted to the Adolescent Substance Abuse Program will receive a comprehensive initial intake assessment. This is designed to aid the clinical staff in making a determination of appropriateness for treatment, level of care, and need for further medical and/or psychiatric evaluation. This assessment will include a thorough Chemical Dependency History, Mini-mental Status Exam, Family Assessment, Suicidal/Homicidal/Self Harm assessment, and a Medical History questionnaire. This will be completed, in most cases, by the Intake Therapist.
Intake Therapist will provide phone screen for Patient, Patient Family, Other referring parties including Managed Care, Law Enforcement, Physician, Outpatient Providers, etc. If appropriate, an Intake Assessment will be scheduled within 24 hours. If not appropriate, recommendations for further care will be provided.
Intake Therapist will complete the Intake Assessment on prospective clients that are considered clinical viable.
Assessment tool will include:
Substance Use Survey (SUS)
Adolescent Substance Abuse Questionnaire (ASAQ)
Assessment for Need of Psychiatric Consultation
Medical information and Emergency Medical Release
Clinical Interview with youth and family
BioPsychoSocial Assessment
DSM-IV-TR Five Axis Diagnosis
Assessment for motivation, Patient and Family
Recommendations for Treatment
Recommendation for Relapse/Prevention Plan
1. Intake Therapist or representative will assess funding source, if appropriate Release of Information forms are completed, and provide consultation to the responsible parties regarding cost of programming.
2. Verbal summary of Assessment will be provided to referring party, if appropriate Release of Information forms are completed. This includes patient, patient family, managed care representative, law enforcement, physician, outpatient provider etc.
3. If Services to be provided by Denver Family Therapy Center, Assessment phase, Out-patient or IOP, then primary clinical will be assigned immediately. If In-patient services are recommended, then immediate coordination with responsible parties will occur. If other outpatient services are recommended, then appropriate referral will be made immediately.
4. Assessment material will be reviewed at weekly team meeting. Primary Clinician is responsible for organizing and presenting material and completing the “Diagnosis and Master Treatment Plan”. This will be completed within seven days of admissions to ASAP.
Group Curriculum
The Peer support group held on Thursday evenings at the Adolescent Substance Abuse Program, incorporates curriculum-based topics in a process oriented group. At ASAP we strive to meet the needs of our clients, which means that the curriculum is flexible and changes as the needs our clients are continually changing. There are some things that do not change as well, including some important themes that we makes sure to cover each with each cycle of the group. These important topics are as follows;
HIV/AIDS Education and Prevention
STD Education and Prevention
Physical impacts of Substance Abuse
Relapse Prevention planning
Dealing with cravings and triggers to use
Drug/alcohol Education
Problem solving
Effective communication
Addition in families
Anger awareness and management
Pro-social activity planning
In addition to the above-mentioned discussing topics, many other topics are discussed and presented upon. For these groups, we draw from three main sources: The Adolescent Community Reinforcement Approach (A-CRA) from Chestnut Health Systems, The Cannabis Youth Treatment Series, Volumes 1-5 from the U.S. Department of Health and Human Services, and Pathways to Self-Discovery and Change by Harvey Milkman and Kenneth Wanberg. Discussion topics and activities are chosen based on the needs of the clients enrolled in the program. The groups are chosen and directed by the therapist in charge of the group.
Contacts (303) 456-0600
David Blair, LCSW, CACIII x122
Jamie Blair Echevarria, LCSW, LMFT, CACIII x148
Janna Phillips, LCSW, LAC x110
Becky Price, MSW, x 131
Location: 4891 Independence #165
Wheat Ridge, CO 80033
Fax: (303) 456-0607
Referrals: (303) 456-0600 x120
Spanish Speaking services: (303) 456-0600 x128