Intervention Methods in Human Services
Abstract
Drug use and engaging in antisocial and violent behaviors is a primary presenting problem among the youths and adolescents. Various preventive programs need to be put into place to address these issues. The two major preventative programs in this paper include the Multisystemic Therapy program and the Midwestern Prevention programs. The two programs target in preventing drug use among the youths and in return there will be a reduction in the violent and antisocial behaviors. Although the two programs have a common focus, there are major differences between them. Each program is best suitable for a particular population so as to yield high positive outcomes. Gender and culture are components which have both negative and positive impacts on the provision of drug use prevention services.
Keywords: Multisystemic Therapy, Midwestern Prevention program, Therapist, juvenile, treatment, culture, gender
Intervention Methods in Human Services
Introduction
According to the National Organization for Human Services (2015), the problem of juvenile involvement in drug and substance use and engaging in delinquent and antisocial behaviors has been in existence over the years. Different researchers have identified various programs which work towards preventing those problems. A prevention program should have specific modifications which address the risks that are unique to its target population. This paper focuses on explaining the major components of the Multisystemic Therapy and Midwestern Prevention Programs, the differences between the two programs, the particular population that is best suitable for each program and how culture and gender impact the delivery of the program’s services.
The Multisystemic Therapy addresses numerous limitations for the juvenile offenders. It is an intensive community and family- based treatment for severe juvenile delinquents who may be having substance abuse issue. It also provides services to the parents and caregivers of the youths. The program works in collaboration with the family members making it family driven and not therapist driven. The primary goal of this program is to decrease the adolescent and youth violent behavior and the out-of-home placements. Multisystemic therapy’s critical features include: promoting behavioral changes in the teens while they are in their natural environment, integrating treatment approaches which are empirically based so as to address wide-ranging risk factors across peers, family, and community contexts and in the schools. Another feature is the provision of arduous quality assurance mechanisms which have a goal of achieving outcomes by maintaining the treatment fidelity and also developing strategies so as to overcome various barriers to behavior change (Greenwood et al., 2007).
The program encompasses different essential components to yield positive outcomes. The programs include its target population, the services that they offer, the staffs providing various services and the recommended duration of offering the services. The target population of the program is the antisocial or delinquent youths who are between twelve to seventeen years old. They have to meet other specific criteria that are; they must present physical aggression at school, at home or in the community. The youth should be at an imminent risk of the out-of-home placement because of the criminal offenses. He or she portrays verbal aggression and uttering verbal threats of harming others. Lastly, there is involvement of substance abuse in any context (Henggeler, Sheidow, & Lee, 2009).
The intervention context of Multisystemic therapy includes the provision of services in the juvenile’s home or any other place that is convenient to them and in particular circumstances a place convenient for the family. The services are highly intensive with the application of the intervention sessions on a daily basis or once per week. A seven day twenty-four-hour on-call schedule is put into place to provide the availability of clinical services to the Juvenile’s family anytime they are in need (Hanser, 2010). The program ensures that only the staffs with appropriate training deliver the services. In addition, the program includes a homework component which the therapist can assign about different interventions which include: family communication training; parent management training; treatment for youth or caregiver substance abuse and treatment for anger management (Henggeler et al., 2009).
The Multisystemic therapy includes various staffs each having a particular role to carry out so as to ensure there is a change in the youth’s behavior once they exit the program. The staff members usually work on a clinical team of a supervisor and two to four therapists. The therapist should be of a master’s level, or they should have a clinical degree (Greenwood et al., 2007). The clinical supervisors must supervise one to two teams, and they should be at least 50% part-time. The clinical supervisors at a minimum should be Master prepared clinicians with a high level of skills. They should have training in the pragmatic family therapies (strategic and structural family therapy), behavioral and cognitive behavioral therapies (Hanser, 2010).
The Multisystemic Therapy develops its interventions using an analytical model. The models serve as a guidance to the therapist in assessing factors which are driving the significant clinical problems and designing suitable interventions to these driving forces. All the program’s intervention techniques are evidence –informed or evidence-based. Each therapist handles a maximum caseload of six young families, and the length of the case has a range of three to five months. The program’s intervention include the school interventions, peer interventions, family interventions, individually oriented interventions, psychiatric interventions and interventions to increase family social support (Henggeler, Sheidow, & Lee, 2009). The clinical supervisor conducts an on-site weekly clinical supervision, is available in times of crisis for the individual clinical supervision and he/she the program’s weekly telephone consultation.
The program’s service intensity varies depending on the needs of the family and the youth. During the early treatment period, the therapist can meet with the family for many days in a week, but the intensity tapers as the treatment progress. Close to the termination of the treatment, the therapist may contact the family to assure them about the maintenance of treatment gains. Throughout the period of therapy, communications can range from the brief check-ins either face –to-face or by telephone, about two-hour sessions which address the specific treatment issues. The duration of therapy is averagely four months to promote self-sufficiency, efficiency and cost effectiveness (Henggeler et al., 2009). The period includes sixty hours that the family is in contact with the therapist.
Components of the Midwestern Prevention Project
The Midwestern Prevention program is a school-based comprehensive project meant to prevent substance use and to promote antidrug messages throughout the communities. The substance use that it intends to prevent among the middle school students includes marijuana, tobacco, and alcohol. The program has been rated to be useful even in the prevention of violence among the youths. It includes the school normative environment change as one among many components of a comprehensive community –based prevention program. The duration of treatment is approximately three to five years (Botvin & Griffin, 2006).
The program targets youths who are in their transitory period from the early adolescence to the middle adolescence. It targets this age because it is the age where there is a high risk of engaging in the gateway drug use. The program is applicable in the school-based setting for the middle school students who are in the sixth and seventh grade. The program elicits the participation from the school, the family, and the community so that it can develop a comprehensive approach to preventing drug use among the adolescents (Botvin & Griffin, 2006). For proper implementation of this program, the staff members who should be present include the student leaders, teachers, principals, and parents. There should be effective communication and collaboration between them to prevent the behavior of using drugs.
The program involves numerous groups of people to pass its message. It uses the parents, the schools, and the mass media in communicating messages about the dangers of the gateway drug use and also the community organizations (Inman et al., 2011).The program seeks changes in the community practices and the health policies in reducing the youths’ access to the target substances. The program focuses each domain, i.e., the community organization, school, health system and parents in a given timeline by beginning with the school intervention and ending with the changes in the health policy.
Botvin & Griffin (2006) explain that the central component of the Midwestern Prevention component is the school-based intervention. The program commences in the sixth or seventh grade as this depends on the school’s district and the grade representing the transition to junior or middle high school. Teachers who have the curriculum training delivers ten to thirteen classroom setup sessions. The focus of the lesson is to increase the drug resistance skills and to attempt to change the school’s social climate by encouraging nondrug use norms (National Organization for Human Services, 2015). There are five booster sessions in the second year of delivering the interventions which have a goal of reinforcing previous concepts. Follow up support and peer counseling is present in the high school years.
The parent intervention component comes after the school activities, and it endeavors to develop family norms that discourage drug use. It is achievable through the parent skills training sessions which target prevention support expertise and the parent-child communication. The component is available throughout the junior or middle, high school years (Henggeler et al., 2009). Concurrently group consisting of the peer leaders, parents, teachers, and the school principal work towards changing the school climate. They do this by monitoring drug use in the community and the school grounds, institutionalizing the school-based curriculum and planning and implementing the training program for parents (Inman et al., 2011).
The community intervention program is present during the final stages of the prevention effort. It involves community leaders who have a role in creating and implementing drug abuse prevention services in the neighborhood, planning community activities which complement the family and school programs and lastly develop strategies which will change the health policies. The goal is achievable by the community leaders and the local government holding subcommittees which focus on reducing the demand and supply of the gateway substances. Throughout the project’s life, there is a mass media campaign by use of print outlets, radio, and television which has a goal of conveying parent and students skills (Botvin & Griffin, 2006).
Differences between Multisystemic Therapy and The Midwestern Prevention programs
Despite the fact that both programs target the youth, many differences exist between the two. First, the Multisystemic Therapy program usually runs for three to five months to yield high-quality outcomes but on the other hand, the Midwestern Prevention program’s treatment period lasts for about three to five years. Secondly, the therapists can conduct the Multisystemic Therapy in any setting for example at home or school where the youth is comfortable, but the Midwestern prevention program carries out its treatment in the school settings only.
According to Botvin & Griffin (2006), the Multisystemic Therapy Program targets children who are between twelve and seventeen years, and they do not need to be sixth and seventh grade. It also offers treatment to youths and adolescents with delinquent and antisocial behaviors. Parents and caregivers of this teens also receive treatment so that they can achieve the goal of community cohesion. On the other hand, the Midwestern Prevention program targets youths who are in their early and middle adolescent stage (Botvin & Griffin, 2006). Unlike the Multisystemic Therapy approach which addresses numerous issue, the Midwestern Prevention program addresses the problem of substance use specifically tobacco, marijuana and alcohol on the adolescents.
The Multisystemic Therapy program involves the work of the therapist who work with the teenagers and their families towards achieving the set goals. It includes a minimum of sixty contact sessions between the parents and the therapist (Henggeler et al., 2009). They work towards reducing the youth’s antisocial and delinquent behaviors. They also work towards helping the parents and caregivers acquire appropriate parenting skills. The Midwestern Prevention program does not involve the assistance of a therapist with relevant training and instead this program uses the information from teachers and other community members to prevent drug use (Botvin & Griffin, 2006).
Specific population highly suitable for each program
The Midwestern Prevention program targets adolescents who are transitioning from their early to the middle adolescent stage because this is the period when there is a high chance of using the gateway drugs. The Multisystemic Therapy program targets the youths between twelve and seventeen years because it is at this stage that most of the adolescents try to be repellant against the set social norms (Inman et al., 2011). By opposing those standards, they develop deviant and antisocial behaviors which can affect them and also affect many people in the society. The program is best suitable for this population because it pools together the support of many people including the parents and the community so as to help them learn socially acceptable behaviors.
The Multisystemic program can also be best suitable in addressing the problems that other groups can present not necessarily the adolescents because it can locate those people in their location (Botvin & Griffin, 2006). A therapist can offer their services in a place where the target population is comfortable. For example, it can address the issues of the people working unlike the Midwestern program which takes many years; they can complete their program in approximately four months. The Midwestern Prevention programs can only apply to students because the intervention is set to address the target population in the school setting (Inman et al., 2011).
Impact of gender and culture on service provision
Culture and gender have a considerable impact on the delivery of services that have a goal of reducing drug use and preventing antisocial behaviors among the youth. If members of the community have a culture of togetherness, they will motivate each other in achieving the program’s goals (Wolkow, & Ferguson, 2001). The parents will get an empowerment from the community on how to enhance a child’s behavior. The community members can encourage the culture of identifying drug use as an illegal act thus nobody should practice it. On the other hand, if the society’s culture lacks togetherness, it can be difficult to deliver the services as they require a combination of various persons to perform them efficiently. If the community also has a culture of each drug acquisition, it can be difficult to deliver the services of ending drug use because the competing force is high.
Gender has a significant impact on the delivery of drug use prevention services and prevention of delinquent behaviors. Both sexes need to be present for the efficient provision of the services. The youths may prefer to share their problems with a person of a given gender (Wolkow, & Ferguson, 2001). Availability of both sexes will ease the process because it can be easy to identify major issues that adolescents of a given gender encounter as they transit to adulthood. Lack of the opposite sex in the delivery of this services can negatively impact the program because the needs of some youths will be unmet.
Conclusion
In the recent years, the number of teens indulging in drug use and practicing antisocial behavior is on the rise. The Multisystemic Therapy program and the Midwestern Prevention Program have been put into place to curb those practices. The Multisystemic Program targets youths and their caregivers/parents in a place that is comfortable with them while the Midwestern Program targets teens in their school setup. The Multisystemic program takes three to five months while the Midwestern program lasts for three to five years. Gender and culture have both positive and negative impacts on the provision of those services that reduce drug use and antisocial behaviors among the youths.
References
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