Treatment worth trying

Editorial Notebook

March 03, 2007|By Ann LoLordo

The way Sharon Bellamy tells it, her teenage daughter was "out of control" - mouthy, too full of herself for her own good, staying out late, running away. But when 15-year-old Lenisha was caught stealing a cell phone, her mother had had enough: "I was at my wits' end."

A court-ordered, months-long, intensive therapy program got mother and daughter on the right track. With a counselor visiting twice weekly, Mom learned how not to take out her frustration on her teenager and Lenisha came to recognize that her mother's rules were the rules of the house. While piecing together elaborate jigsaw puzzles - a suggestion of the therapist - the two learned how to listen and be heard. "It worked for me," says the single mother from Prince George's County.

Gail Venzke couldn't control her 15-year-old son. He would come and go as he pleased, smoke dope with neighborhood kids, and turn on his mother in a flash.

"Nothing I did worked," she said.

After Andrew was locked up for stealing mopeds, a Baltimore County judge ordered him into a drug treatment program and enrolled him in the same in-home, intensive counseling. They've been at it for several months now, and so far, Andrew is drug-free, working and not getting into trouble,

"It's a wonderful thing," says his mom.

Multisystemic Therapy (MST) is a treatment for kids in trouble with the law who are at risk of being placed in residential treatment at great expense to the taxpayers, and, say advocates, at great cost to families. Specially trained therapists, available round the clock and with intense supervision, work with delinquent kids and their families at home several times a week to find ways to cope with their behavior and solve problems.

For parents, it's about setting limits and sticking to them. Kids learn the consequences of their actions. That sweatshirt left in the living room for three days? It will be in the trash on the fourth day.

Ms. Venzke learned what not to do: Don't yell back, don't argue, don't get physical.

Experience has shown that youths involved in this therapy are less likely to reoffend. Baltimore County, which has been using the treatment since 2002, says 86 percent of its clients in the last fiscal year had no new arrests.

"If we are able to keep these [young] people engaged and show them some hope for themselves, they can become engaged in their own futures," says Dr. Pierre Vigilance, the county health commissioner. "If you don't see hope, why not act out?"

But the therapy is not widely available to Maryland families who need it but can't afford it, and that should change. Teenagers placed out of their homes by the state Department of Juvenile Services, many of whom have mental illnesses, have dismal recidivism rates - 76 percent will be rearrested within three years.

That should be reason enough to shift toward MST, which the U.S. Department of Justice rated among the top youth violence prevention programs. A 60-hour treatment regimen over three to five months costs about $5,000 to $8,000, a fraction of the $60,000 to $88,000 that Maryland pays for a residential treatment placement. It's not a panacea, but for those delinquent youths who meet the criteria, it has shown results.

"It teaches the kids how to be responsible, to know there are consequences for their action, and it helps gives the parent the moral support that they need, and it gives the parents other ideas on how to correct their kids without it being a negative on the kid," says Ms. Venzke.

The Maryland Disability Law Center and the public health officers in Baltimore and Baltimore County say the state has a legal obligation to provide this treatment as a Medicaid-eligible expense. It's not a radical idea - 16 states and Washington include MST as a Medicaid-eligible therapy.

Including this home-based therapy for Medicaid reimbursement would have initial costs for the state, but eventual savings too -Washington state found that every dollar spent on this therapy produced $28.33 savings in criminal justice costs, according to a recent report by the Maryland Disability Law Center.

That would be a much better return on the state's investment. The limited experience in Maryland shows that most of the kids getting this treatment in Baltimore and Prince George's counties remained at home, in school and out of trouble.

Isn't that what we want from our juvenile justice system?

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