Adolescent Portable Therapy

The Intervention: Short-term, in-home family therapy

Who is Served: Justice-involved young people age 12-24

The Challenge

Family relationships are both a key risk and protective factor for young people involved in the criminal justice system. According to a 2013 report by the National Research Council, the powerful influence of families has been found to produce positive outcomes for justice-involved youth in confinement and community-based settings.1 This applies even in cases where parents may have played a role in influencing the young person toward anti-social behaviors. Unfortunately, some parents/guardians of justice-involved youth lack the skills and personal experience to help their children address challenges, avoid delinquency, and achieve positive youth development thresholds. This lack of skills is often exacerbated by structural inequalities concerning race and neighborhood of residence that can increase challenges related to education, poverty, and justice involvement.

The APT Approach

Established by the Vera Institute of Justice in 2001 and adopted by CASES in 2014, Adolescent Portable Therapy (APT) is a flexible in-home family therapy model designed to identify, reinforce, and leverage a family’s existing strengths and assets to create buy-in and willingness to learn new relational skills and begin to address challenges including the participating young person’s problem behaviors (e.g., substance abuse, truancy, etc.). This short-term intervention lasts up to four months and includes cognitive-behavioral therapy (CBT) techniques.

Young people age 12-24 are referred to APT primarily from two CASES youth programs: the Court Employment Project, an alternative to incarceration for youth facing felony charges, and Family Court Mental Health Screening, an early intervention program for youth awaiting charges in Family Court. Referred youth have been identified as having a need for substance abuse and/or mental health services that puts them at risk of violating the requirements of their alternative sanction and/or becoming involved in further delinquency. Participation in the program requires the voluntary assent of both the young person and his or her family. Specific APT services include:   

  • Clinical assessment and individual treatment planning
  • Individual CBT sessions for the participating young person to address problem behaviors
  • Caregiver/family sessions
  • Weekly telephone contacts to the family to support goal achievement
  • Crisis intervention as needed
  • Guidance to youth and family/caregivers on navigating the justice, education, and behavioral health systems
  • Support for the young person’s ongoing engagement in developmentally-appropriate, positive activities in the community (including education) 

The Impact

A Vera Institute of Justice evaluation of APT from 2001-20042 compared youth in APT to a control group of non-APT youth with similar justice-involvement. Vera found the following among youth who had participated in APT:

  • Significantly lower levels of alcohol, marijuana, and overall substance use
  • Significantly lower levels of depression and traumatic stress symptoms
  • Significantly more likely to report positive family relationships
  • Marginally higher rates of school attendance and recent employment

In 2014, CASES assumed operation of APT from Vera. In our first year operating the model, APT served more than 40 youth and families. Of these participants, 70% either successfully completed the program or remained active at the end of that year. Among those youth exiting APT (including both successful and unsuccessful exits)

  • 70% achieved substance use avoidance
  • 70% had reduced symptoms of mental illness
  • 80% had improved family functioning
  • 50% had improved rates of engagement in education

While Vera’s 2001-2004 evaluation found no significant impact on recidivism, 93% of all CASES APT participants in FY 2015 avoided placement in a detention facility, jail, or prison.

References

1 Committee on Assessing Juvenile Justice Reform. (2013). Reforming juvenile justice: A developmental approach. Bonnie, R.J., Johnson, R.L., Chemers, B.M., & Schuck, J. (Eds.). Washington, D.C.: National Academies Press. ^

2 Parsons, J. & Ross, T. (2008). Evaluation of the Adolescent Portable Therapy (APT) program (New York City), 2001-2004. Ann Arbor, MI: Inter-university Consortium for Political and Social Research. ^