Two different evidence-based programs each have unique pros

SHIELDS for Families has been using both Multisystemic Therapy (MST) and Functional Family Therapy (FFT) off and on since 2004. Some might ask why not one or the other? They both are evidence-based models and work with the whole family and the offender—with good results.

Before going further, it should be said that at my agency, SHIELDS, they are used quite differently. MST deals with youths who are repeat violent offenders having committed several serious crimes. Many can be characterized as hard core and will very likely end up incarcerated. FFT works with high-risk juveniles who might have committed lesser crimes.

On Thanksgiving, people count their good fortune for many things—small and big. You snagged the last package of fresh sage for your stuffing. The lump proved benign. Your family will make it through the blizzard and be together feasting on turkey and all the scrumptious side dishes.

Kathy has a different reason to be thankful. But let her tell it.

This story doesn’t start out with the warm and fuzzies. It starts with pain, tears, anger, worry, and frustration. It starts with a mom and a daughter on opposite sides of a deep chasm. I was convinced we’d never reach each other, and frankly, I was already giving up. I was in a place of pain. And whenever pain takes up residence in your heart, you carry it like a curse. I couldn’t figure out how we got so far apart, so fast. I felt as if I were screaming into a void.

The MST program was first suggested to me by my daughter’s middle-school counselor, but I was sure it was a lot of hype and would be of very little help. There was nothing they could tell me to do that I hadn’t already tried. How were these people going to make anything happen? And if they thought they were going criticize me, if they thought they were going to judge me, they had another thing coming. No one was going to tell me I was a bad parent. And that was that.

Meanwhile, that chasm was growing wider and wider. My daughter seemed so unreachable. It was as if I had never known her. It was heartbreaking, devastating, and hopeless. I was losing myself in the absolute sadness of it all. I cannot describe the ache that was centered in my chest. Sleepless nights. The nights I did sleep, I had nightmares. My daughter was lost in the darkness and cried for me. Me searching for her, trying to find her, waking up with tears on my cheeks. I felt like a failure as a mother. That is a gut-wrenching battle that never gets easier.

The numbers are frightening. Right now, 2.3 million Americans are behind bars. That’s 1 in 137 people, and the majority are African-American and Latino. 

It’s mind-boggling that the U.S. has the highest incarceration rate of any country on earth. Is the country overrun with evildoers, or are we are doing something different than, say, Canada, which only has 40,500 people behind bars. Even Iran, considered an oppressive nation, has a prison population of 218,000.

The consensus at yesterday’s American Justice Summit at John Jay College of Criminal Justice in New York City was we are doing something exceedingly counterproductive—and it’s not sustainable.

As John Wetzel, secretary of the Pennsylvania Department of Corrections, said about incarceration and its aftermath, “Higher-risk offenders leave lower-risk. Lower-risk offenders leave higher-risk.”  And what does that mean? Simply that we may be locking up too many non-violent wrongdoers and turning them into hardened criminals behind prison walls.

Fewer than 15 years ago, Connecticut’s network of contracted programs to rehabilitate juvenile offenders was in jeopardy. The programs were not producing good enough results to justify their cost. And yet, in the past five years, there has been a 40-percent decrease in arrests. So, how did Connecticut turn the tide?

Crystal had reached the “What more can I do?” stage. Her 17-year-old daughter, Danielle, had been getting in trouble for years. It reached crisis overload when the girl disappeared over a Memorial Day weekend. Crystal was sure she had run away but hesitated involving the police.

As time passed, the mother felt she had no choice and had a PINS (People In Need of Supervision) warrant issued on her daughter. This meant that if found, Danielle would be returned to New York City, where they lived, and brought before a judge. 

Getting a warrant wasn’t a decision Crystal took lightly. She knew she ran the risk of losing her child to the juvenile justice system. Danielle was found safe in Washington, D.C. And then things changed dramatically for mother and daughter. The New York City’s Administration for Children’s Services (ACS) had a mandate to keep kids out of the system and with their families whenever possible.

So instead of Danielle being carted away, the court recommended Multisystemic Therapy (MST) as her treatment plan. Crystal was “skeptical,” as she later put it. After all, she and Danielle had been seeing individual therapists for two years at the great out-of-pocket expense with little evidence her daughter was improving. MST was different, Crystal was told. A therapist would be assigned to the case, she would work with them in their home—and it wouldn’t cost the family anything.

What we already know from years of research is effective interventions for young people in the juvenile justice system must address risk factors across all aspects of the adolescent’s life. To succeed, the intervention has to take into account what puts the youth at risk for current and future anti-social behaviors, whether it has to do with the individual, family, peer, school, or community. Not to be overlooked are such considerations as to whether there are warm, supportive relationships with caring adults and positive peer associations, which help steer juveniles away from behaviors that put them at risk for criminal activity.

Recently, New York City newspapers published articles raising awareness regarding violent incidents at Rikers Island.   

For those not familiar with New York, Rikers Island is the city’s main jail complex, a 413.17-acre island located in the East River between Queens and the Bronx. If you fly into LaGuardia Airport, you will see the razor wire-surrounded island located only a short swim from the runway. Adult and youth offenders reside on this island dedicated exclusively to incarceration. 

While the news articles bring up significant concerns, the incidents of violence are not new. As one might expect, the occupants are not there because they are model citizens. A wide range of law infractions and violations can earn a trip to Rikers. The constitutionality of sending youth offenders there has been questioned, especially considering that "most of whom have not yet been convicted of a crime, and about half of whom have been diagnosed with a mental illness," according to Manhattan U.S. Attorney Preet Bharara.  

Once there, safety is not assured. There are rival gangs looking to start a fight. Forty percent of the population has been diagnosed with mental problems. The staff response to violent inmates has resulted in frequent injuries and sometimes death.

Mental Health Services Conference awards MST a Gold Achievement 

Police in Western Australia described 2013’s 53-percent drop in serious juvenile crime as “extraordinary.” One explanation given for the decline is the expanded use of behavior-management programs. One hundred and sixty of the 297 offenders being handled by youth crime intervention officers were assigned to a program. These 160 youths accounted for 1,098 offenses costing taxpayers $2.5 million. Since being placed in interventions, the number of crimes committed by them dropped to 471.

"Besides the cost-benefit, addressing the underlying issues of these young people has now been shown to reduce reoffending,” said Western Australia acting police inspector Mark Fleskens said.

In 2011, it was reported that Kentucky had one of the highest rates in the country for sending juveniles to jail for noncriminal offenses such as running away and truancy. The year before that meant 1,500 adolescents were incarcerated at the staggering cost of $2 million. “There has to be a better alternative than locking a child behind a door to get their attention,” said Kentucky’s Deputy Director of Juvenile Justice Hasan Davis.

The state government decided there are—evidence-based treatment programs. 

Identifying an individual solution for each family

"I don't know what to do with her anymore." Ms. Martinez and I sat knee to knee on her black vinyl couch. "Maybe she would be better off living somewhere else. A place where she has lots of rules."

Ms. Martinez's words may have seemed callous but sending her daughter away appeared to be the only viable option to keep her safe. I placed my clipboard on the seat next to me and looked at her face. "I know how overwhelming this all seems right now. We know Gabriela is using drugs, not going to school, and maybe involved in a gang. Sending her away might make some problems go away temporarily but what will happen when she comes home to the same environment? I think we have a better chance of helping Gabriela by looking at all the pieces of the puzzle."