From the Perspectives Newsletter: Early Intervention

Youth and Family Services Build Strong Foundations for Children and Parents

From the Fall/Winter 2015 Perspectives Newsletter

Giving kids and youths the opportunity to just be kids is the focus of Places for People’s (PfP’s) Youth and Family Services.

Early intervention services, like the array of programs offered at PfP, are designed to promote healthy childhood development and successful transitions to adulthood. They are the response to some stark realities:

• While early onset behavior problems occur in 4-6 percent of the general pre-school population, among children in low-income, one-parent families, that percentage increases to 35 percent.
• Children with early onset behavioral problems are 2-3 times more likely to be chronic juvenile offenders.
• Without intervention, juvenile offenders are highly likely to offend again. A history of chronic juvenile problems predict violence, incarceration, and substance abuse during adulthood.

The philosophy of Places for People’s Youth and Family Services programming is simple. Though the children and youth involved might have histories of disruptive, violent, and sometimes criminal behavior, “These kids are not villains. They’re not victims. They’re kids with the same basic developmental needs as any other kid … safety, stability, meaningful relationships, and opportunities outside of the family to learn, grow, and take on roles that are valued by the community,” said Mike Lamping, Youth and Family Services Program Manager.

The various programs, Lamping explained, build stronger foundations for the children/youths and their families. PfP offers an array of programs serving children of various ages and with various needs.

Incredible Years

PfP’s Incredible Years program helps kids – both directly and through the adults closest to them – get off to a positive start.

The Incredible Years is a skills-building, evidence-based program for parents, children, and educators. For parents, for example, PfP offers 14-week sessions of parenting education and support. The curriculum-based instruction provides a structured learning environment for parents who are experiencing significant stress – often related to poverty, unemployment, lack of personal support, and/or a personal history of growing up in an environment of harsh, ineffective
discipline.

Participating parents want to be better for their children, but they may not know where to start or what sort of techniques could be successful.

The goal of the Incredible Years program is to help parents discover and build the skills necessary to provide appropriate and effective boundaries for their children and to access any resources necessary for their personal success.

Through role play, guided discussion, video clips, and sharing of experiences, participants develop their confidence and skills as parents. They learn how to set expectations, enforce consequences, utilize praise, and problem solve in positive, productive ways.
The children benefit from a more stable environment with a clear understanding of behavioral expectations.

“Perhaps the most important years in anybody’s life are the first five to eight years,” said Lamping.

The Incredible Years groups are conducted using two group co-facilitators. Each session includes childcare, snacks/meals, and instructional materials, all at no cost to the parents or children who attend.

Additionally, the groups are usually held at a neighborhood school, church, or community center, reducing the barriers to attendance often experienced by busy parents.

Multisystemic Therapy (MST)

The Multisystemic Therapy (MST) program was the first of its type in the state, and it looks beyond a youth’s behavioral problems that may have resulted in juvenile court interventions.
“What’s happened in the past is that these kids have gone to court, and all of the focus is on the youth and what they have to change,” Lamping explained. “Fair enough – there’s stuff each of these kids can do differently. But there are a lot of factors they can’t control and they need significant help with.”

The MST program, also an evidence-based practice, evaluates all of the factors that have contributed to the youth demonstrating a behavioral problem or getting into legal trouble. Through intensive interactions, MST therapists look at the family unit, the school system and services received, the youth’s social connections and activities, and at any mental health issues the youth may be experiencing.

The youth’s success is the ultimate goal, and the family is the most important resource.

“MST is a very intensive service. There’s a lot of time, energy and commitment from parents, because parents are really leading the charge here,” said Lamping. “We really feed off their energy, their strengths as a family, what they already do and do really well. And they really have to be present, available and partner with us, because the MST focus is that families are the solution.”

MST helps to prevent out-of-home placements of court-referred youth and to mitigate family issues that might be causing stress and conflict. It seeks the root causes for behavioral disorders, and through therapeutic interventions, helps to identify better, more positive behavioral alternatives.

Family Outreach and Community Services

MST builds on a family unit that is seeking assistance to help the youth in their lives. But what about those families that do not have the capacity, for a variety of reasons, to commit to the time and intensity required by MST therapy?

“What we found is that we were getting loads and loads of referrals for kids in need, and they fit the MST criteria in terms of the youth’s needs, but the parents were simply not in a place where they were going to be able to provide the resources that were going to be needed to get this kid back on track,” Lamping said.

Through a pilot program, PfP’s Youth and Family Services program designed a new approach to address the needs of the entire family, with the goal of building support around the youth. This intergenerational service, Family Outreach and Community Services, steps in when MST is not feasible because of sometimes intensive needs of the adult family members themselves. The barriers the adult members of the family face may include their own mental health symptoms or substance abuse, a lack of stable housing, being disconnected from the community (especially if they’ve recently moved to St. Louis), or working multiple jobs to try to make ends meet. Whatever the reason, they would be unable to get involved in the intensive MST sessions.

Instead, Lamping explained, Family Outreach and Community Services staff gets to know the family and essentially develops parallel treatment plans to benefit both the youth and the adult family members. That might include assisting parents with housing or employment issues, mental health counseling or trauma-recovery therapy, or connecting with community resources or other service providers.

Similar to MST, the youth works with a therapist to evaluate the influences in his or her life, to discuss possible alternatives to negative behavior, and to explore more positive activities.
Through this new program and the traditional MST model, PfP can provide a wealth of options to youths and families in crisis – and a way to avoid getting trapped in a system.

“We want to help them build or uncover things that will help them be successful in the face of challenges,” said Lamping.

Youth Psychiatry Services

Therapy is an essential part of helping youths and their families, but additional support may be needed, as well.

Through grant funding from the Greater St. Louis Health Foundation, PfP has started providing youth psychiatric services.
The program targets youths who are not currently engaged in psychiatric services and who are undiagnosed, but clearly demonstrate symptoms of a mental illness, were diagnosed several years ago and may be taking medications but have not been reassessed recently, or who have received crisis mental health interventions but without long-term follow-up.

Youths who are currently receiving psychiatry services outside of PfP successfully are encouraged to continue to do so.
The psychiatrist will evaluate the youth and his/her medication needs or ways to help that don’t involve medication, including talk therapy.

Then, working closely with Youth and Family Services staff, the psychiatrist helps to design a plan to get the youth engaged in community-based services. That can involve helping the family to identify an easily-accessible psychiatrist near their home and seeing the youth and family through to the first appointment with that provider. This new short-term intervention is available to youths in any of PfP’s Youth and Family Services and it helps to build a successful transition to long-term services.

Future Plans

PfP’s assistance for children, youths, and their families has expanded significantly since the inception of MST services in 2001. These early-intervention programs help give kids their best opportunity to grow up healthy and with a support system that addresses their needs.

On the wish list for the future, said Lamping, are an expansion of services in St. Louis County, a dedicated program to help adult family members of youths and children who have serious mental illness or substance abuse, and dedicated staff to assist working-age youths find jobs.

Growth from the current model predicts future success, Lamping said. He recalled one youth participant who had committed a crime at age 15, and who spent the next few years believing that his life was over. Through therapy and introduction of new possibilities, the youth gradually changed his outlook.

“We tell youths, ‘You are not this label. You are not your diagnosis,’” Lamping said.