Educational and Therapeutic Residential Program for Adolescents with Behavioral and/or Substance Abuse Concerns
by Dianova International
Description (Methodology, Techniques and Strategies Used)
This program is designed for adolescents aged 14 to 18 having difficult behavioral problems and/or engaging in drug or alcohol abuse. The program can accommodate 100 individuals at a time, and during 2007 a total of 164 adolescents participated in the program. Prior to entering the Dianova program, 90% of the youth were being cared for by the various agencies of the Spanish youth protection system, which eventually referred them to more specialized care due to the system’s inability to deal with the increasing behavioral concerns. The Dianova program also addresses the needs of underage migrants whose parents are unknown or absent.
The Dianova program offers a dual, educational and therapeutic, dimension, the elements of which reinforce one another and encourage the positive development of the adolescent. The intervention aims first at halting the further escalation of destructive behaviors and at motivating the adolescent to become aware of his problem. The latter is an important step toward being able to take appropriate decisions about the present and future.
The program's general objectives are to promote the adolescents' protection factors concerning the use of drugs; to develop cognitive, emotional and behavioral abilities likely to enhance personal and social development, and to lead them to successful re-integration into normal society, with active participation in the outside community.
The approach is biopsychosocial, which means treating all of the different elements related to the adolescent's difficulties with physical and mental health, personal development, social and relational issues, the use of drugs, family ties, the use of free time, etc. The treatment program is holistic in that it promotes a balanced intervention between all of these different pieces of the puzzle. The program's methodology aims at creating a trust-based relationship between staff and residents and promotes the active participation of the latter in the center's schedule and activities.
Implementation MethodologiesThe Dianova program for adolescents was initiated with close cooperation from, and networking with, the youth protection system and other institutions concerned with positive youth development. The result is a unique program which effectively addresses specific needs. An experienced staff consisting of youth counselors and psychologists is dedicated to designing, with and for each individual, a personalized program that ensures flexibility and an adequate balance between educational and therapeutic dimensions. Positive relationships are used to foster recovery and personal growth; other therapeutic and educational tools are also utilized, including occupational activities, regular academic education, group meetings, cultural outings, sports, family visits, etc.
One of the most important concepts is that of optimum proximity as opposed to optimum “distance", the latter which is based on staff not engaging in close relationships with their patients. On the contrary, adolescents need a strong tie, i.e. a mentoring relationship, with their counselors. The counselor assumes much the same role as an athletic coach – a teacher and a guide, but very much part of the team. At the same time, however, as they move through the project, it is important that they increase their autonomy in order to achieve positive re-integration. Upon reintegrating, nevertheless, the youth are encouraged to maintain appropriate resources for support when needed.
What Is Innovative About This Approach
What is most innovative, and critical as well, is the ongoing participation of the adolescent in his own rehabilitation, supervised, of course, by experienced staff. The primary distinction is the shift away from methodology of the juvenile correctional facility where adolescents are separated from supervisory personnel physically and socially and are subject to strict control and supervision. In the Dianova program, the residents become closely engaged in their own development process, in the decision making and the assessment of the decisions taken. They are also counseled regarding the effects of their actions, good or bad, on their peers, on the community and on themselves.
Their engagement is multi-facetted; it is, first, the engagement in the functioning of the center itself. Initially, the adolescent becomes responsible for taking care of his room and for other center facilities. As he moves through the program, and once having gained the desired level of stability, he is expected to broaden the scope of his responsibilities for his own rehabilitation process to that of his peers as well. He cares for himself, and he cares for others. For example, the adolescent is asked to begin taking care of a newcomer, to whom he transmits basic information about the center's daily life and helps him with his adjustment to the center. This commitment leads the new “junior mentor” to understand better the objectives of his own program. Then, guided by his own mentors and his more acute understanding, he is able to participate further in the achievement of his own objectives with greater determination.
This process of engagement, with appropriate supervision, leads to a greater sense of balance and security. The adolescent understands better what's going on with himself, and what is going to happen. He gains greater self-trust and self-esteem. In the end, this approach is far more successful in a true rehabilitative sense than the stricter alternative.
Evidence of Results and Impact
The success of the program was evaluated by Comillas University of Madrid, which process resulted in the university recommending it for an award for Best Practices by the Spanish Red Cross. Dianova was so honored by this award from the Red Cross in November of 2007. The study by the university was under the direction of Dr. José Antonio López Ruiz, Chairman of the Department of Sociology. At this time, we are still waiting for detailed results of the Comillas study to be published. However, we can say that a key-element of rehabilitation programs which has been referred to in a number of previous studies, and upon which success depends, is the duration of the resident’s exposure to a program. In the case of the Dianova program, the result based on this factor is an exceptionally positive 65% of adolescents remaining in the program for more than 6 months, which duration enables them to, 1) to break with the high risks related to their life styles; 2) to regain optimum physical and mental health; 3) to increase awareness of the risks to health and social well-being; 4) to establish positive life habits and enhance self-esteem; 5) to understand individual risk factors and protection factors (i.e. the use of drugs and other risk situations for health, emotion, family and social relations) and to apply them in their daily lives; 6) to use the personal abilities gained during program, as well as the maturity, that are necessary to pursue a successful reintegration process.
Completion, drop-out, and referral statistics are as follows
An encouraging 40% of residents completed the entire program and reached all the objectives defined in their personal educational and therapeutic plans, including the completion of the treatment program and reintegration into their home communities. 15% dropped out, and 45% were referred back to facilities of the youth protection system and other social service agencies.
The impact of the program is the achievement of social stability. The adolescents are ready for a process of social and vocational integration. They are able to lead self-reliant, productive and positive lives back in their communities. They are no longer financial burdens to the community.