Therapeutic Programs

• Adolescent Sex Offender (ASO)

• ASO Cognitive Low Functioning

• Children's PTSD

• Adolescent's PTSD

• Transition/Aftercare 

• Social Skills

• Independent Living Skills

• Oppositional-Defiant Behavior

• Conduct Disorder Group

• ADHD Social Skills

Openings available in most groups Call 703-549-4000 for details.

We have started to prepare for the millennium. The government and private industries are spending billions of dollars so computers do not crash to bring our lives to a stand still on January 1, 2000. People have started to plan how they are going to celebrate the start of the next century. As we make these preparations, we have to stop for a moment and ask ourselves: are we prepared to deal with the problems and concerns of what has become known as the "millennium generation"? Dale Russakoff wrote in his article, Millennium Generation is Shaping Trends, in The Washington Post, that there are more children today than there were at the peak of the baby boom.

Unfortunately, more children have led to more problems concerning children. Schools are overcrowded (Russakoff, 1998), the number of children living in foster care has risen, (Census Bureau, 1998) and the number of juveniles committing violent crimes has risen (Jenson and Howard, 1998). Also, it seems that every day there is a news story about a child committing a violent crime in a school.

The good news for the "millennium generation" is that children's issues are big news (Russakoff, 1998).

Almost every day, there is a story about how to extend health coverage to all children. People are talking about ways to reduce the number of children living in foster care. Recently, there have been discussions on how to reduce the number of juveniles committing violent crimes. At the same time, some states are discussing plans to lower the age to try juveniles as adults.

Now, we have to put our words and thirty second sound bites into action. We have to move from a reactive country to a pro-active one. In other words, we have to provide services to children before they become another child living in foster care, attending an over crowded school, and committing a violent crime.

How do we this? We need to provide services to the children and their families before things go wrong. Social service programs have a long history of reacting to the demands of the society. So many social service programs try to help the child after the fact. To help the "millennium generation" succeed, we have to develop programs that prevent problems from happening. When that happens, we will be fully prepared for the next century.

Poor Social Skills Predict Teen Problems

A recent study of 288 carefully screened adolescents by researchers at The John Hopkins School of Public Health found that a teen's social functioning (how they intteract with peers, family and how well they control their behaviors and participate in school ) is a better indicator of the presence of a psychiatric or emotional disorder rather than acting-out behavior that occurs later when the problems are more entrenched and harder to treat.

Social role problems can also forecast whether a teen is more likely to act-out externally on others or in the community, or internally causing emotional difficulties.

The teens studied were divided into four groups: those with emotional (internalizing) behaviors, disruptive (externalizing) behaviors, those with both and those with none. The findings reported in the June 1998 issue of the Journal Of the American Academy of Child and Adolescent Psychology found that those with disruptive behaviors had the most significant school, family, and peer problems. These teens also had the most difficulty with " self management" behaviors like taking responsibility for their actions, impulsivity, and controlling anger.

Lead author Anne W. Riley, PhD said "Currently, less than half the teens with major psychiatric problems are identified and given help for emotional problems." She stated that many problems such as depression and anxiety are not identified until they are adults.

Riley also pointed out that treatment currently aimed at problem teens focuses more on stopping problem behavior rather than getting youth on track socially and emotionally.

Outcome Measures Should Determine Treatment Goals

By Kristi Messer, MSW, MPH F.T.S. Program Evaluator

Outcome data proving the efficacy of therapeutic Intervention is the cutting edge of medicine as we progress toward the millennium. Cost-effective, efficient and efficacious treatment outcomes have become "buzz words" around the pro-vision of services. It is no secret that the effectiveness of psychotherapy has been one of the most difficult interventions to measure and to predict outcomes. As mental health clinicians we often ask questions like, "How do we actually know whether what we're doing is working?", or "How can we increase the chances that this family gets better?" Outcome measures allow clinicians to view the progress of treatment over time, whereas in the past, we measured the efficacy of treatment with anecdotal evidence. With the birth of managed care, it is increasingly important that as clinical professionals, we find a method to answer these questions and to measure interventions in a manner which allows us to know how effective our services are at any given point in the course of treatment.

The development of such a treatment outcome system will ultimately lead to a new standard of effective and appropriate treatment for all clients. That is, if the data is utilized in a manner that informs the provision of treatment services. With the move toward collecting information regarding treatment outcomes, agencies have been pushed to develop outcome protocols and collect volumes of data with no plan of how to use this information. Much of the time, the data is stored in client files with high hopes that it will in some way affect treatment. The development of a treatment outcome system must involve a plan regarding how to utilize the information. Otherwise, it is simply a way to satisfy those enforcing outcome measures. As long as we're collating the data, we might as well use it to the clients' benefit.

Although overwhelm' at first, it is possible to develop simple, cost-effective, and helpful outcome measures to answer questions regarding the cost-effectiveness, efficiency, and efficacy of treatment. Family Trauma Services recently developed and implemented a treatment outcome protocol which has proven to be clinically useful in the treatment of our families, as well as efficacious in modifying existing programs. Family Trauma Services currently completes outcome data for all of our clients at three month intervals, including the Child and Adolescent Functioning Scale (CAFAS), Global Assessment of Functioning Score (GAFS), and scales individualized to target the unique issues of youth and families. In addition, the Child Satisfaction Scale (CSQ-8) developed by Clifford Attkisson and the Vanderbilt Satisfaction Scales are administered to the parent(s) following the termination of treatment. FTS is available to provide consultation and training regarding the development and use of treatment outcome measures.

Working with Conduct Disorders Is a Challenge

"Conduct disorders" are a complicated group of behavioral and emotional problems in youngsters. Children and adolescents with these disorders have great difficulty following rules and behaving in a socially acceptable way. They are often viewed by other children, adults and social agencies as "bad" or delinquent, rather than mentally ill. Their expression of anger is the major problem. They are often aggressive, both physically and verbally, with other children and to adults. They may lie, steal, destroy property and misbehave sexually.

Research shows that the future of these youngsters is likely to be very unhappy if they and their families do not receive early, ongoing and comprehensive treatment. Without treatment, many youngsters with conduct disorders are unable to adapt to the demands of adulthood and continue to have problems with relationships and holding a job. They often break laws or behave antisocially. Many children with a conduct disorder may be diagnosed as also having a coexisting depression or an attention deficit disorder.

Many factors may lead to a child developing conduct disorders, including brain damage, child abuse, defects in growth, school failure and negative family and social experiences. The child's "bad" behavior causes a negative reaction from others, which makes the child behave even worse.

Treatment of children with conduct disorders is because the causes of the illness are complex and each youngster is unique. Adding to the challenge of treatment are the child's uncooperative attitude, fear and distrust of adults. 

A child and adolescent psychiatrist uses information from other medical specialists, and from the child, family and teachers to understand the causes of the disorder and then organize a comprehensive treatment plan.

Behavior therapy and psychotherapy are usually necessary to help the child appropriately express and control anger. Remedial education may be needed for youngsters with learning disabilities. parents often need expert assistance in devising and carrying out special management and educational programs in the home and at school. Treatment may also include medication in some youngsters, such as those with difficulty paying attention and controlling movement or those having an associated depression.

Treatment is rarely brief since establishing new attitudes and behavior patterns takes time. However, treatment offers a good chance for considerable improvement in the present and hope for a more successful future.

Facts for families: the American Academy of Child and Adolescent Psychiatry Online Psych ,1997. All Rights Reserved.

The Family Trauma Services Foster Care Program

Clinical consultation with professionals related to the attainment of the family's stated goals is also available, including schools, special education instructors, parole/probation, and court.