Journal Issue: Juvenile Justice Volume 18 Number 2 Fall 2008
Aftercare and Substance Use in Juvenile Justice
Given the short-term effects of treatment and the concomitant importance placed on aftercare, it is striking that a recent national survey of program directors providing treatment for juvenile offenders found that only 26 percent of secure institutions and 25 per- cent of community-based programs included aftercare services.62 An analysis of the same data set found that only 51 percent of substance- abusing youth in residential facilities and 31 percent in jails were referred to a community-based treatment provider when they were discharged.63 These findings suggest that a substantial proportion of adolescent offenders is released into the community without appropriate aftercare to manage their substance use disorders.
The need to improve aftercare has led researchers to test innovative models of aftercare services. One study examined "assertive aftercare," in which a case manager linked multiple services.64 Among a sample of adolescents in residential drug treatment, most of whom were involved with the criminal justice system, assertive aftercare increased both linkages to treatment services and adherence to continuing care. But although assertive aftercare reduced marijuana use at nine-month follow-up, it had no effects on other substance use.
Because environmental risk, including family substance use and deviant peer networks, affects aftercare outcomes, aftercare services might benefit from using family-based interventions (or multisystemic interventions) to help target these risk factors and maintain positive treatment outcomes.65 At the time of this writing, researchers are testing a family-based intervention to help young offenders in juvenile detention rejoin the community.66 Another approach involves training probation officers to provide adolescent probationers with cognitive interventions (that is, strategies to change reasoning processes and beliefs about substance use and offending).67 One final promising strategy, recently implemented in general substance abuse treatment, is adaptive interventions, which adjust the type and intensity of the treatment over time to the changing needs of the individual.68 Given the difficulty of retaining adolescents in substance abuse treatment, aftercare treatments that likewise vary in their intensity may improve long-term adherence to treatment. Two important policy questions are how to implement (and fund) continuing aftercare when an adolescent leaves justice system supervision and which, if any, formal system of care would be responsible for providing such services.