Utilizing Technology for Enhancement of Services
and Engagement of Youth
Bridget Ruiz, M.Ed.
Alison Greene, MA
Southwest Institute for Research on Women
The University of Arizona
181 S. Tucson Blvd Suite 101
Tucson, AZ 85716
Presented at the Strategic Planning for Providers to Improve Business Practices
October 21-23, 2009
• Review of media definitions and history
• Media utilization in health care
• Web 2.0
• Description of Assertive Adolescent and Family
• Enhancing AAFT with media
• What’s next?
• Emerging issues, recommendations
A people without history is like the wind
on buffalo grass”
• Tools used to store and deliver information
or data(Wikipedia, 2009)
• The means of communication, as radio
and television, newspapers, and
magazines, that reach or influence people
Brief History of Media
Grunts and Gestures
Internet Convergent Technologies
Media Utilization in Behavioral Health Care:
• Electronic health records (Knowles, 2009)
• Web-based data collection tools
– SAIS (Mulvey, Atkinson, Avula, & Lucky, 2005)
– GAIN (Dennis, M.L., Titus, J.C., White, M.K., Unsicker, J., & Hodgkins, D. 2003)
• Mail and Telephone Continuing Care
Systems (Godley, Coleman-Cowger, Titus, Funk, & Orndorff, in press; Kaminer, Burleson, &
Assertive Adolescent and
Family Treatment (AAFT)
I have found the best way to give advice to your children is to find out
what they want and then advise them to do it.
-Harry S Truman
SAMHSA-CSAT Adolescent Initiatives
• For more than a decade SAMHSA’s Center
for Substance Abuse Treatment (CSAT) has
funded a series of initiatives to replicate
evidence-based practices and collect
information on their effectiveness in the
– CSAT required use of:
• Evidence based treatment
• Evidence based assessment (Global Appraisal of
Individual Needs [GAIN])
Muck et. al., 2009
CSAT Adolescent Initiatives
• Since September 2006, the Center for
Substance Abuse Treatment (CSAT) has
awarded 32 Assertive Adolescent Family
Therapy (AAFT) grants
• Purpose of AAFT grants: To provide support
for the initial training and implementation of
evidenced based approaches to assessment
and treatment for adolescents and their
Details of AAFT
• Provide evidence based assessment for
clinical planning and outcome monitoring
– Global Appraisal of Individual Needs
• Provide evidence based treatment
– Adolescent Community Reinforcement
Approach (ACRA) and Assertive Continuing
• Social Learning Theory
• Operant model with social systems approach
Dennis et. al., 2003; Godley, SH et. al., 2001
• Training and Certification
• Coaching and Supervision
• Peer to Peer Discussions
CSAT Full GAIN Data
Source: CSAT 2008 SA Dataset Adolescent Subset (n=16,006) 13
Change in 6 Month Abstinence Relative to Other
CSAT Adolescent Treatment Grant Programs
Source: SAIS System (GPRA) 2008 data
Butler et. al., 2009
If I could tell you what it meant,
there would be no point in dancing it
Enhancing A-CRA for Youth Engagement
– iTunes U
– MP3 player
Ruiz et. al., 2009
TAKE A LISTEN!
You guys must really trust me to lend me this
iPod—it is a nice one.
I am sharing these podcasts with my friends.
This is pretty cool.
I had a hard time downloading them to the iPod.
Maybe I can help you [the youth] download
This is a good way to share information with
With one of my clients who has ADHD I was able
to play the podcast in a session, pause the
podcast to discuss the procedures and then
return to listening. For example, with the
podcast on problem solving I was able to pause
the recording after each step was reviewed to,
then, discuss with the client how it applies to his
real life example. He seemed to focus better
and understand the material.
I was able to help a client access the site using the
A-CRA problem solving steps.
SIROW ―My Space‖ HOMEPAGE
"The past is a source of knowledge, and the future is a source of hope.”
Recovery Oriented Systems of Care for Youth
• Looks very different that adult ROSC.
• Must incorporate representatives from
various disciplines (e.g., education; juvenile
justice; child welfare; youth recovery
• Examine our own treatment systems to
make sure they are healthy.
• Examine issues and implement strategies
to reduce stigma.
• Implementing Sanctuary Model (Bloom, 2009)
• Implementing ROSC-Consortium
• Examining community perceptions
– Perceptions of:
• awareness, availability, access of recovery
supports for youth
• Typical adult attitudes/feelings towards youth in
– 100 electronic surveys distributed to
Las Rosas: Services and Supports Model
Adapted from: Clark, W (2008). The benefits of ROSC for Adolescents and Transitional Aged Youth. Presented at the SAMHSA Consultative
Session to Develop ROSC for Youth. 11/14/2008 Rockville MD
Community Survey Results
• 37 participants: 70% female with an age
range of 26-76 years old
• Professions represented:
– Professional, other unspecified (24%)
– Administrative/management (22%)
– Consultant/self-employed (14%)
– Health care (11%)
– Real estate (8%)
– Public service, Education, Arts, &
Retired/Volunteer (5% each)
Korchmaros, Lopez, & Ruiz (2009)
• Number of recovery supports available in
– 36% report 5+ in Tucson
– 24% report 3 or 4
– 24% report 1 or 2
– 16% report 0
How easily adolescents find and receive recovery supports that
How easily can can adolescents findand receive recovery supports that are are
available in our community
available in our community?
Degree of ease
Perceived degrees of sympathy toward and support of adolescents by
Perceived degrees of sympathy toward and support of
typical members of the community
adolescents by typical members of the community
Percent of respondents
Very Moderately Somewhat Not at all
Perceived extent that the typical member of our community feels that
Perceived extent that the will be productive in the community
adolescents in recovery typical member of our community feels or
successful in life
that adolescents in recovery will be productive in the community
or successful in life
Very Moderately Somewhat Not at all
Recovery Supports for Adolescents and Families
• CSAT funded and led by Chestnut Health
• Four Sites:
– Tucson, Arizona
– Bloomington, Illinois
– Seattle, Washington
– Fitchburg, Massachusetts
Recovery Support Services
• Recovery support telephone support by trained
• Recovery oriented social networking site
• Family Support using the Community
Reinforcement and Family Training (CRAFT)
The world is moved along, not only by the mighty shoves of its heroes,
but also by the aggregate of the tiny pushes of each honest worker.
How Media Can Support
Treatment Business Practices
• Data and communication infrastructures
• Shift from informing to creating value
• Design virtual spaces to connect recovery
• Transactional and relational
Changes in Health Care
• Evidence based practice
– Production of positive changes
• Cost effectiveness
– Best outcomes that are least expensive
• Internet and mobile technology media is
here to stay! Given this, we need to
continue to find innovative ways it can be
useful to and complimentary of services.
• There is little documented in the literature
about the effectiveness of technology uses
in the addiction field.
• It is thought that utilization of technology is
cost efficient yet we need more studies that
examine these costs.
Acknowledgements & Disclaimer
The authors wishes to thank Jutta Butler, Monica Davis, Stuart Glogoff, Mark
Godley, Susan H. Godley, Kristin Hedges, Sasha Keyes, Jo Korchmaros,
Vicki Lilligard, Randy Muck, Raquel Ramirez, Andrea Verdin, project staff
who have helped in the development of this presentation. Moreover the
author wishes to acknowledge all the youth/families who have participated
in treatment and engaged in the recovery process.
The development of this presentation was funded, in part, by a grant from the
Substance Abuse and Mental Health Services Administration Center for
Substance Abuse Treatment – TI-17604 & TI-020138. The views expressed
here are the authors and do not necessarily represent the official policies of
the Department of Health and Human Services; nor does mention of trade
names, commercial practices, or organizations imply endorsement by the
Bloom, S. (2009) The Sanctuary Model: Implementation Training. Yonkers, NY January 26-30, 2009
Butler, J., Muck, R., Dennis, M.L., Godley, S.H., & Godley, M.D. (2009) Assertive Adolescent Family Treatment (AAFT) Cross-Site Progress
Report. Webinar Presentation for AAFT grantees on February 25, 2009.
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Korchmaros, J., Lopez, E. & Ruiz, B. (2009). Perceptions of Community Feelings and Attitudes about Adolescents in Recovery: Summary
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Ruiz, B., Greene, A., Lopez, E. & Bernal, D. (2009). Enhancing the Adolescent Community Reinforcement Approach (A-CRA) with Podcasts:
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