It has been estimated that nearly 70% of children currently involved in the Juvenile Justice System experience psychological issues or distress. Research shows that youth who do not get those mental health needs addressed, will go on to recidivate and become more entrenched in the justice system, potentially leading to adult incarceration. In order to minimize this evidence, Applewood has partnered with the Juvenile Courts in both Cuyahoga and Lorain County to offer mental health services to youth involved in the Justice System.
At every level of the court process and placement, Applewood offers programming to assist youth and guardians in order to diminish court involvement as well as address the mental health needs that may have contributed to court charges in the first place. Applewood has created a Youth Justice Division of services that offers evidence-based treatment in a variety of settings to best meet the needs of the youth and the community.
The Coordinated Approach to Low-risk Misdemeanors Project or CALM is a combined effort by Cuyahoga County Juvenile Court and Applewood Centers and is funded by CCJC through the use of ODYS funds to provide alternatives and true diversion from the juvenile justice system for youth being served in Cuyahoga County. Staff is available through an on call system 24 hours per day, 365 days per year.
As the name implies, CALM seeks to intervene with youth who are engaged with law enforcement for low-risk domestic violence offences. Applewood Centers provides assessment, respite and coordinated linkage for children who are brought to the program by the police. Rather than have the child go through the intake process through the Detention Center and Courts for low level offenses, youth involved in the CALM Project will be assessed, have a safety plan completed, placed in respite for 3 days (kinship or respite), and connected with ongoing services to provide youth/family support around the issues that lead to the police being called to the home.
Applewood's Intervention Center is a collaborative program with the Cuyahoga Courts and funded by CCJC through the use of ODYS funds. The Intervention Center staff work with first time offenders or someone who is charged with a misdemeanor. The goal of the program is to prevent continued involvement in the court system and to recommend appropriate services to help the youth. Upon referral, the youth receives an assessment/screen by a licensed agency clinician to determine what treatment services (individual, group, family therapy etc.) and/or programs (mentoring, vocational, literacy, recreational etc.) would best meet their need. The agency clinician determines the level of need and appropriate services based on the assessment/screen and input from the family and court staff. The clinician then places calls to intake departments at appropriate agencies to facilitate services. Hours of service are Monday through Friday from 8:00am to 8:00pm
The Community Based Intervention Center (CBIC) is a program of juvenile court designed to serve moderate to high risk youth ages 11 to 18 who have been referred by probation or the courts. The youth referred to the program have not been successful in completing less intensive programming. It is the goal of the program to serve youth in the community without the need for out of home placement or confinement in the Detention Center.
The court contracts with the agency to provide a master level Clinical Case Manager. The agency Clinical Case Manager assesses and responds to youth with behavioral health issues. Upon referral to CBIC an assessment is completed by the clinician to determine level of risk, the youth’s needs and the services to be provided. Services provided to all youth in the CBIC program include case management i.e. supporting the youth and family in gaining access to needed medical, social, educational or other services essential to meeting their needs and facilitating communication between service providers involved in the youth’s life; Cognitive Behavioral Interventions-Comprehensive Curriculum (CBI-CC) is an intervention that addresses behavioral health and criminogenic needs (CBI-CC is a 56 session curriculum); and prevention groups to assist with skill development, i.e. anger management, coping skills, communication skills to better manage behavioral health symptomology.
The youth attend the CBIC program Monday through Saturday from 8am to 7pm. Treatment services, educational services through the Cleveland School district and recreational time are provided each day. The average length of the program is 90 days; however it may take some youth longer to complete the program.
The Lorain County Crossroads Program was created by the Lorain County Juvenile Court in order to address the complex needs of some of the youth that it serves. In collaboration with Applewood Centers, Crossroads is a 12 week intensive therapeutic program that runs Monday-Friday 4pm-8pm. The therapist screens, assesses, and provides treatment to adolescents who are referred to the Crossroads Program at the Lorain County Detention Center campus. The clinician provides therapy to the youth and their family; this may include groups with both the youth and their guardian. Services are provided at the center, in the home and in the community. After completion of the 12 week program, the therapist develops an after care plan which may include recommendations for continued services and/or treatment. Upon successful completion of the 12 week program and the after care plan, the youth is removed from probation and terminated from court involvement.
Multisystemic Therapy (MST) is an intensive family based treatment approach that has demonstrated unusually high success in treating delinquent youth who are in danger of out of home placement. MST uses family preservation as a model of service delivery, which emphasizes the provision of treatment in natural contexts, such as the home and community. Services are available 24 hours a day, 7 days a week. Therapists carry small caseloads of 4-6 families each in order to provide the intensive level of service necessary to meet the needs of these families. Services typically are 4-6 months in duration.
Multisystemic Therapy was developed at the Family Service Research Center, Medical University of South Carolina. It is the only intervention program whose effectiveness has been validated through experimentally designed research studies. In randomized clinical trials, MST has demonstrated effectiveness in decreasing re-arrest rate for up to 4 years following treatment, has decreased the need for out of home placements, and has proven to be a cost effective alternative to out of home placement.
Multisystemic Therapy provides a unique combination of therapeutic and case management services. Services provided range from individual, family, and marital therapy to substance use interventions, victim treatment, and behavior modification. Case management services include school and peer interventions, and serving as a liaison with the courts, school, and other involved systems. Through the full range of services offered, MST seeks to identify and neutralize the primary predictors of delinquent behavior, strengthen family involvement, improve family-school interactions, help build community supports, and interrupt negative interactions with delinquent peers.
Implementation of MST services begins with a complete psychiatric diagnostic evaluation without medical and a functional assessment in order to understand the “fit” between the identified problems and their larger systemic context. The culmination of the initial assessment process leads to the development of three or four overarching goals, and the design of therapeutic interventions to achieve these goals. The assessment process continues during the course of treatment in order to understand the “fit” of certain behaviors and the barriers in the system that is contributing to these behaviors. Progress in treatment is measured by the achievement of the overarching goals, as well as maintaining the youth in their home and community.
Multisystemic Therapy was developed to treat youth (under age 18) who primarily present with delinquent or anti-social behaviors, especially for youth who are at imminent risk of out of home placement due to their behavior.
These youth typically display:
The MST model strongly emphasizes provider accountability and adherence to the treatment model. As part of the MST model each team has weekly supervision meetings with their team supervisor, and weekly consultation team meetings with a trained MST consultant. These activities are designed to continue the development of intervention skills, monitor adherence to the MST treatment model, provide objective monitoring of family outcomes, and provide a forum to review and discuss clinical interventions, progress, and barriers to providing services. In addition, families who participate in the program are surveyed monthly during the course of treatment to measure the therapist’s adherence to the model using research-validated instruments (Therapist Adherence Measure). We are obtaining this data on an ongoing basis to use for therapist development and to obtain Independent Licensure from MST Services, Inc. as a validated MST treatment provider.
The MST program is available to youth in Cuyahoga County and Lorain County by staff located at the CAS Campus.
Applewood Centers also operates Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST-PSB) in Cuyahoga and Lorain Counties. This clinical adaptation of Multisystemic Therapy (MST) has been specifically designed and developed to treat youth (and their families) for problematic sexual behavior. Building upon the research and dissemination foundation of standard MST, the MST-PSB model represents a state-of-the-art, evidence-based practice uniquely developed to address the multiple determinants underlying problematic juvenile sexual behavior.
MST-PSB is delivered in the community (clients' homes, schools, neighborhoods) to ensure ecological validity and treatment generalization, occurs with a high level of intensity and frequency (often three or more sessions per week), incorporates treatment interventions that are strongly supported and informed by research, and places a high premium on approaching each client/family as unique.
Ensuring client, victim, and community safety is a paramount mission of the model. Extensive assessment and planning underlie the individualized safety plan of each youth and family. Treatment commonly incorporates intensive family therapy, parent training, cognitive-behavioral therapy, skills building, school and other community system interventions, and clarification work.
MST-PSB was developed to specifically treat youth under age 18 who are displaying problematic sexual behavior. Although the primary reason for a referral to MST-PSB is a sex offense these youth may also display other delinquent or problematic behaviors. Therapists carry small caseloads of 4-5 families each in order to provide the intensive level of services necessary to meet the needs of the families. Services typically are 5-7 months in duration.
In addition to services offered in the juvenile detention centers, Applewood Centers is able to support those youth living in the community who have had involvement with the juvenile justice system or are experiencing a crisis. Applewood provides residential treatment for youth ages 11 to 18 who have a variety of severe mental health needs or have demonstrated self-injurious, risk-taking, and aggressive behaviors. Through a multidisciplinary approach, we work with clients to address each of their individual complex needs — building upon their strengths toward recovery. ACI’s services and interventions target criminogenic needs and behaviors.
Applewood has two programs, Apple Blossom and Orchard, including short-term crisis beds. These beds offer high-quality, short-term solutions for children and youth experiencing a psycho-social crisis, including those with specialized co-occurring mental health/development disabilities and mental health/juvenile justice needs. Diverting youth from psychiatric hospitalization, this short-term, intensive placement provides crisis stabilization, comprehensive assessment and evidence-based therapies while using High Fidelity Wraparound care coordination to seamlessly refer and link youth and their caregiver(s) to formal and informal services in their community.
Our team employs a number of evidence-based Cognitive Behavioral Therapy (CBT) modalities, including Dialectical Behavior Therapy (DBT) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Vital to the target population is ACI’s use of the evidence-informed group curricula developed by the University of Cincinnati Corrections Institute (UCCI) for youth involved with the juvenile justice system who are at moderate to high risk for reoffending:
Applewood Centers therapists provide a complete functional assessment of the youth in the context of their family, school and community. The therapist seeks to understand the youth's problems and the factors that contribute to those problems. Treatment focuses on helping parents build supportive social networks and empowers parents to address the needs of their child more effectively. The program is most effective in helping youth with chronic, violent, delinquent behavior and those with serious emotional problems, including:
The therapy's interventions are developed with full collaboration of family members and key figures in the youth's life and can include any combination of the following services:
Therapy is provided in the home, as well as in neighborhood and community settings. Treatment can be intensive, often including multiple contacts with family and other participants every week. Therapists are available 24 hours a day, seven days a week.
To make a referral or obtain additional information about how our services might be beneficial for a young child you know, please call us at the number below. Our professionals will talk with you confidentially about your concerns and determine if this program would be a good fit.