Mental Health Treatment

I. Program Description

Male and female youth accepted at MVJRC will be provided with mental health treatment as determined by the results of a mental health therapist driven assessment.

II. Assessment

Part of the assessment process includes an initial review by a multi-disciplinary Treatment Team and the development of a Personal Program Plan, which is initiated when the youth is being considered for placement. This includes a listing of identified issues and strengths, determination of risk level per the Ohio Youth Assessment System (OYAS), and both education and medication needs. The Millon Adolescent Clinical Inventory (MACI) is then administered by the mental health therapist to the youth. The MACI is an assessment tool which provides an explanation of the personality patterns of an individual, interpretive considerations, clinical syndromes, and both prognostic and therapeutic implications of treatment. A treatment plan is then developed to approach particular mental health needs, such as, mental health therapy for depression, grief and loss, sexual abuse, etc., as well as a possible referral to the program psychiatrist for a medication evaluation.

III. Treatment Planning

Individual treatment plans are developed with the youth and the mental health therapist. Goals and objectives are established based upon issues and concerns identified during the assessment process. In particular, helping the youth to correct cognitive distortions (thinking errors) and supporting the youth to practice view behaviors that help to change negative behavior patterns is essential.

IV. Program Milieu

A Daily Character Development Program is provided to all youth placed at MVJRC. Acceptance of personal responsibility, recognizing common positive traits needed to live a healthy life, demonstration of pro-social skills through role playing, and other aspects of character development are central to the treatment of each youth. This perspective utilizes a Cognitive Behavioral Therapy approach where errors in thinking are identified and then corrected. This approach particularly reinforces the principles that underlie mental health treatment.

Because of the importance of safety and security concerns, youth are also constantly being visually supervised. This includes all interactions with other youth as well as when they are with parents or community resource providers.

V. Treatment

Every youth in the program is provided individual mental health therapy once a week and family therapy once a month.

Some of the materials used in treatment, such as manuals and workbooks, are those available through the Hazelden Foundation. These materials are specifically designed to treat emotional issues such as anger, depression, anxiety and worry, and self-esteem. Youth who are dealing with grief issues are provided The Mourning Handbook (A Complete Guide for the Bereaved) by Helen Fitzgerald. Those youth who have experienced sexual abuse may be provided with treatment materials as well. The Courage to Heal Workbook (for Women and Men Survivors of Sexual Abuse) may be made available to male youth. Female youth may also or otherwise be provided with In Their Own Words (A Sexual Abuse Workbook for Teenage Girls). Any workbooks and treatment materials provided to the youth are reviewed with the mental health therapist during individual mental health therapy in order to assist the youth through the mental health therapy process. A primary treatment tool that is utilized involves use of personal journaling. The journal is considered part of the confidential relationship of the youth with their mental health therapist and is reviewed privately. This process emphasizes helping the youth to express their thoughts and feelings in order to recognize patterns of both healthy and destructive behavior and to understand how their thinking affects their behavior.

Once youth reach the third stage of the four stage program, they have the opportunity to start the Transition Release process. This involves youth visiting their home every other weekend starting with an 8-hour release, then successively for 2 days, 3 days, and 5 days. Before a youth may begin visiting home for overnight visits, the youth's readiness to be in the community is determined during a Progress Review with the Program Manager and his/her mental health therapist. In the review, the youth's progress on his/her treatment goals and in the program is reviewed along with the thinking errors the youth is working to correct as well as any special plans that have been developed by the youth, such as, an Anger Management Plan. The Transition Release process then provides an opportunity for the youth to meet the challenge of spending time with family in the community and to demonstrate the personal skills to be successful once permanently released from the program. Although the targeted length of stay to complete the program is five months, cooperative and well behaved youth may require less time to successfully meet program requirements.

VI. Anger Management Group

Those youth identified with anger management issues either by the placement assessment tools of the OYAS (Ohio Youth Assessment System) Residential Tool, the HIT (How I Think), or the MAYSI-2 (Massachusetts Youths Screening Instrument); on the Personal Program Plan or as determined through the therapeutic assessment process may be placed in a weekly Anger Management Group. Activities in group sessions focus on irrational thinking and the damaging effects of anger when expressed in aggressive and negative ways. Triggers, understanding how anger may cover up one’s true emotions, breaking the anger-aggression connection, and understanding the differences between passive, aggressive, and assertive communication are key elements of group sessions. Also, elements of ART (Aggression Replacement Training) are incorporated into the sessions utilizing Social Skills Training, Anger Control Training, and Moral Reasoning Training where scenarios are processed by role playing to discern one’s thinking from one’s actions in the practice of healthy management of anger skills.

Youth with identified anger management issues will also be assisted with developing a Relapse Prevention Plan-Anger Management.

VII. Transition and Aftercare

Before a youth is discharged from the program, a wraparound meeting is held to review transition and aftercare planning. For this meeting to occur, the mental health therapist and a parent or guardian is required. Preferably a probation officer is also in attendance. Also invited would be other program staff, school officials, social service workers, and community resource providers.

During the meeting, the youth’s progress on his/her treatment goals are reviewed as well as progress in the overall program. The youth will also share any special plans he/she developed. Otherwise, the principle goal of this meeting is to develop a clearly written and documented Transition and Aftercare plan which should contain the following:

Identified positive family and /or adult support
Arrangement for a risk-free community living situation
A required, specific level of community supervision

Also to be addressed on the plan:

Identified out-patient treatment and/or support group involvement
Identified educational and vocational plans
Required restitution or community service
Medical needs, including prescription medications and follow up medical support
Recreation resources

In the end, transition and aftercare planning requires the agreement of all parties and should support the goal of the youth expressing his/her emotions in healthy ways and demonstrating pro-social behaviors. The overall expectation is that the resources being put into place will help the youth to demonstrate that he/she has corrected identified thinking errors and has been provided the tools needed to become a successful member of the community.