Sean Roberts, PhD LPC Clinical Director, Cascade Crest Transitions
I have been honored to serve as guest editor over the past year for the Journal for Therapeutic Schools and Programs (JTSP). This issue highlights work with young adult populations in our industry and would not have come to fruition without the behind the scenes support of Abigail Nash and the leadership of Dr. Ellen Behrens. In addition, NATSAP’s commitment to the dissemination of peer- reviewed articles through its support of JTSP reflects a dedication to promoting healthy conversations that leads to better care for our clients and families.
Young adulthood is a tumultuous time of life rich in risk and opportunity. It is a window of time that puts our clients at a higher risk for problematic substance use and mental illness than any other subsection of the population in the United States (Substance Abuse and Mental Health Services Administration, 2013). Young adults burdened with psychiatric disorders also experience more struggle than their peers when faced with the developmental challenges of completing school and transitioning into adult occupational and social roles (Pottick, Bilder, Vander Stoep, Warner, & Alvarez, 2008). Even with these known risks, the majority of young adults with substance use or mental health disorders do not receive treatment (Substance Abuse and Mental Health Services Administration, 2012). There is a void in mental health care for young adults with persistent mental health challenges and each year we see more NATSAP programs responding to this need by extending more and more tailored young adult programming.
The majority of the articles found in this journal are focused on the challenges, constructs, nuances, outcomes, and opportunities in working with the young adult population. Each author attempted to provide concrete suggestions and ideas that can inform our work with clients. The process of selecting articles for publication and working with the authors to bring their ideas to a polished product has been rewarding and informative. The articles vary from research articles to position papers introducing new ideas. My hope is that the reader is able to extract meaningful, practical information from the articles that directly inform their work.
The first article in this edition of the JTSP, “Young Adults in Transition: Factors That Support And Hinder Growth And Change”, shares the findings from a comprehensive research project examining the experience of 17 young adults who completed a young adult transitional living program. It highlights the importance of high quality connection and relationships for young adults and disseminates important feedback for NATSAP programs working with adults on topics such as dating, medication management, group therapy, and family work. The second article presented in this edition of JTSP, entitled “Young Adults in Residential and Outdoor Behavioral Health Programs: Preliminary Outcomes from the Practice Research Network of the National Association of Therapeutic Schools and Programs”, is a first look at the data that have been gathered through the collective efforts of many OBH and residential programs. This article looks at outcomes and also compares the demographic information of the clients who attend OBH and residential programs. This article is exciting as it is a product of the increased collaboration across programs to join e orts to produce more robust studies through shared data.
Longitudinal research is essential to the viability of our industry. The third article, “The Relationship Between Self-Reported Prior Drug Use and Treatment Effectiveness in Substance Use Disorder Residential Wilderness Treatment with Young Adult Males”, takes a closer look at the treatment needs and outcomes of young adults with substance abuse disorders in a specific Outdoor Behavioral Healthcare program. An important implication of this research is the need to alter the treatment and steer away from a ‘one size fits all’ depending on the level of substance abuse the client presents with. This article illustrates the value of research in helping us gather the information we need to tailor treatment to meet the specific, unique needs of each of our clients.
The next article, “A Novel Investigation of Substance Use Outcomes in Substance-Specific Outdoor Behavioral Healthcare Programs” continues looking at substance use outcomes with a novel research design that compares young adult outcomes in substance-specific Outdoor Behavioral Healthcare (OBH) programs with more traditional substance-specific treatment. This article is able to utilize a control group design that has rarely been seen in our field and provides useful data that supports the utilization of OBH for young adults. While we have greatly increased the amount of research occurring in our field, we have suffered from a lack of instrumental diversity. The article, “An Evaluation of Alaska Crossings: Comparison of the Client Status Review and the Youth Outcome Questionnaire”, not only contributes additional, meaningful outcome data but also explores the utilization of a new outcome monitoring system called the Client Status Review.
Moving away from quantitative research the next article, “The Confounding Variable: Working with Shame in Young Adults in a Holistic Treatment Model”, dives into a thorough exploration of shame and the nuances of working with shame in the young adult population. It is one of two articles in this edition that explores a concept in working with young adults in an attempt to provide a model that informs our work with clients. It gives pragmatic ideas in how to identify and work with shame relying on emerging neuroscience and the power of the therapeutic relationship.
The article “Coming of Age in Foreign Lands” is the next theoretical article and speaks to the power of cross cultural immersion experiences to serve as a rite of passage for young adults. It proposes a theory of Supportive Immersion that outlines how these experiences can lead to unique client gains not found within the confines of traditional treatment programming. This article encourages programs to provide creative, dynamic, and non-traditional experiences that can serve our clients who often have failed to respond to traditional therapeutic approaches.
The last article is not specific to young adults. JTSP is committed to the timely publication of quality articles and so we chose to include the article “Better Relationships, Mental Wellness, and Self Development: What Parents Expect from Residential Treatment for Their Struggling Youth” in this issue. It uses qualitative research to extract common expectations parents have when their child is in residential treatment. Amongst other findings it provides a detailed and very accessible breakdown of what parents hope for within the categories of relationships, mental wellness, and self development.
It is my belief that you will find each of the articles rich with applicable findings that can inform our work with clients and families. I’m so appreciative of the work and dedication each author put into sharing their work in this format. Enjoy!
Sean Roberts, PhD LPC Clinical Director
Cascade Crest Transitions