Models for Youth Aftercare: Finding Out What Works

Several years ago, I had the pleasure of conducting focus groups with youth who were in various stages of recovery following treatment. The consistency of responses among the groups of youth I spoke with was overwhelming and pushed me to think about what we need to do for youth following treatment that might be different than for adults.
 
A major theme that came out of each group was that they felt abandoned after they completed treatment. They were told things like:

•  “You need to find a new group of peers who do not use.”
•  “You need to find a self-help group that will meet your needs and get a sponsor.”
• “You need to attend aftercare” (although where they might find a good aftercare program -- or even what that meant -- was not clear for the youth).

 
I know adults who struggle with these concepts and life changes, so it was difficult to understand how these youth, who sincerely wanted to maintain their sobriety, were going to be able to do this on their own.
 
A group of adolescent girls was the only exception. They were in a recovery home after residential treatment, and were being assisted by each other and by professional staff to work on these tasks. They remained in the recovery home until they had a workable recovery plan in place, a new group of peers who could help them, someone to mentor or sponsor them, and a safe place in the community to live. as well as a job or reentry into a school or vocational training program. It seemed to be a great program, and a necessary adjunct following treatment for reentry into the community. The youth were clearly growing mentally and spiritually. But where are the resources to provide this level of assistance to all youth who go through treatment (whether they “graduate” from treatment or not)?
 
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) has recently launched an effort to better understand what youth need following treatment and how it might differ from what adults need. A consultative session was held with youth, family, education, labor, child welfare, treatment (substance abuse and substance abuse with co-occurring disorders), youth advocates and others to get the broadest perspective possible.
 
From this consultative session, one or more models to help youth will be developed and tested. This effort is related to what youth and families say they need, and what communities can bring to bear on the issues. It is our hope that over the next two years, we will find one or more models for assisting youth and their families that will result in better long term outcomes, and will engage communities in supporting recovery for youth.
 
We may not have the money to pay for all of the necessary supports and services from the federal government, but we can develop and test the most efficacious means to enlist communities to support youth who have been through treatment to continue on their journey to recovery.
 
Treatment providers don’t solve the problems of youth; they merely help point them in the right direction toward hope and healing. Other youth, families and communities are necessary and integral to their healing, support and growth. Hopefully, by engaging them, along with service providers, we can find a model – maybe even more than one – that can be replicated across many communities, in which they can all work together toward physical and mental health for our youth. 
 
It’ll be interesting to see what we learn.  Any thoughts or suggestions?   
UPDATE Jan. 28, 2011: The Pathways to Desistance study found that aftercare is a key to youth coming out of the justice system. Check out this post for more information about the study.