A number of evidence-based interventions for youth and their families facing behavioral health challenges are being used by select providers and organizations in South Carolina.
The Attachment Biobehavioral Catch-Up (ABC) Program |
The Attachment Biobehavioral Catch-Up (ABC) Program is a parenting intervention designed to help caregivers increase their responsiveness to infants and toddlers who have experienced early adversity, whether it be maltreatment or disruptive care. The program aims to teach caregivers sensitivity through correctly identifying behavioral signals and actively responding with the goal of creating healthy attachments. Randomized clinical trials also suggest the program helps to stabilize biological processes and regulate behaviors of at-risk children.
The program has two sets of modules based on age, ABC-Infant is designed for children 6 to 24 months of age and ABC-Toddler for children 24 to 48 months old. Currently, because of COVID-19 the course consists of ten weeks of one-hour interactive sessions concluding with a celebratory video.Becoming an ABC Coach require on year of training including a prescreening, two day training at the University of Delaware, (which can be conducted onsite for larger groups), as well as a weekly commitment of four hours of supervision through Zoom. For additional information on the ABC Program, please visit: http://www.abcintervention.org https://www.nctsn.org/sites/default/files/interventions/abc_fact_sheet.pdf More Useful Resources: Coaching Parents of Vulnerable Infants: The Attachment and Biobehavioral Catch-Up Approach 1st Edition by Mary Dozier and Kristin Bernard (ISBN-13: 978-1462539499, ISBN-10: 1462539491) |
Dialectical Behavior Therapy (DBT) |
Dialectical Behavior Therapy (DBT) was developed in the 1980’s and was published as a manualized evidence based treatment in 1993 (Linehan, Cognitive behavioral treatment of borderline personality disorder). Since it was originally tested at the University of Washington, 36 randomized trials and numerous non-randomized trials have demonstrated DBT’s efficacy in treating out of control behaviors, including suicide, self-harm, other behaviors requiring medical and/or psychiatric hospitalization, treatment drop-out, substance abuse, binge eating, binging and purging and significant isolation.
Often, those behaviors (suicide, self-harm, substance abuse, etc.) are both a consequence of extreme emotion dysregulation and an attempt to avoid emotions. Although DBT was originally developed for adult populations, it is currently being used extensively in adolescent outpatient and residential treatment programs. To date, there have been numerous non-randomized trials, one randomized trial for DBT with suicidal adolescents and a multi-site randomized trial for DBT with adolescent clients with multiple, out of control behaviors including suicide and self-harm. Standard, comprehensive DBT includes a weekly multi-family (at least one caretaker is required to attend), 2 hour skills training group, individual therapy with a DBT psychotherapist for one hour per week, coaching via telephone, text or other technology as needed 24-hours-per day and participation by the DBT Skills Trainers and Psychotherapists in a once weekly DBT consultation team for providers. Currently DBT individual psychotherapists and DBT programs can be certified through the DBT-Linehan Board of Certification. Although there are other certifying bodies, the DBT-LBC is the only certification that has been vetted by the DBT treatment developer, Marsha Linehan and a group of DBT researchers and experts. For information on DBT training, two of the organizations that provide training accepted by the certifying board are: |
Ending the Silence (ETS) |
Ending the Silence (ETS), developed by the National Alliance on Mental Illness (NAMI) and actively supported by NAMI South Carolina, is a school-based health promotion and stigma-reduction intervention. Stigma regarding mental health concerns can prevent individuals and families from getting the help that they need, and education regarding mental health concerns is a first step.
ETS is designed to teach middle and high school students, school staff, and families about the warning signs, facts, and statistics of mental health conditions and provide resources on how to get help for themselves or others. The two-part intervention consists of a leader presenting the educational information and the other leader, who is a young adult with a mental health condition, shares their journey of recovery. This framework promotes open discussions about mental health with the goal of reducing stigma about mental health concerns. |
Functional Family Therapy (FFT) |
Functional Family Therapy (FFT) is a short-term, family-based prevention and intervention program for high-risk youth ages 11-18 that is returning to South Carolina. These youths have been referred by the juvenile justice, mental health, school, or child welfare systems for behavioral or emotional problems. These youths’ problems range from acting out to conduct disorder to alcohol and substance abuse. FFT focuses on assessment and intervention to address risk and protective factors within and outside of the family that impact the adolescent and his or her adaptive development. Treatment consists of 12-14 sessions delivered over a period of 3-5 months in either a clinical setting or the family home. Based on a foundation of acceptance and respect, its core is to focus on assessment and intervention to address risk and protective factors within and outside the family that impact the adolescent. FFT consists of five phases: engagement, motivation, relational assessment, behavior change, and generalization. The aim of FFT is to strengthen family relationships and reduce substance use and delinquent behavior.
There are three training phases in FFT. Phase 1 consists of clinical training and takes 12-18 months to complete. The goal for this phase is for clinicians to demonstrate strong adherence and high competence in the FFT model. Phase 2 consists of supervision training and takes 12 months to complete. The goal for this phase is to support sites in being more self-sufficient while maintaining and enhancing site adherence and competence in the FFT model. Phase 3 is a maintenance phase, and its goal is to assure ongoing model fidelity and staff development. To learn more about FFT training, please visit https://www.fftllc.com/about-fft-training/implementing-fft.html for more information. |
High Fidelity Wraparound |
High Fidelity Wraparound is a care planning process that is integrated, multi-agency, and community-based. This care planning process is grounded in a philosophy of unconditional commitment to support families to safely and competently care for their children. The single most important outcome of the Wraparound approach is a child thriving in their home with their family and maintained by normal community services and supports.Wraparound is a planning process that follows a series of steps to help children and families who have complicated needs. The Wraparound process also helps make sure children and youth grow up in their homes and communities and works to bring people together from different parts of the whole family’s life. With help from one or more facilitators, people from the family’s life work together, coordinate their activities, and blend their perspectives of the family’s situation.
The South Carolina Continuum of Care uses this approach to support the youth that they serve. For more information, please visit the SC Continuum of Care website at: http://coc.sc.gov/ For additional information on the High Fidelity Wraparound process, please visit: https://msp.scdhhs.gov/pcsc/site-page/high-fidelity-wraparound |
Homebuilders |
HOMEBUILDERS is an in-home, Intensive Family Preservation Service (IFPS) and reunification program for families with children from birth to 17 years old who are at imminent risk of placement in state-funded care, including the child welfare, juvenile justice, and/or mental health systems.
HOMEBUILDERS is used across many counties in South Carolina, and their goal is to prevent unnecessary out-of-home placement of children through intensive, on-site intervention, and teach new problem-solving skills to prevent future crises. This program aims to improve parental skills, parental capabilities, family interactions, children’s behavior, and family safety. The key elements of HOMEBUILDERS are intervention at the crisis point, treatment in the natural setting, accessibility and responsiveness, intensity, low caseloads, research-based interventions, and flexibility. Therapists are available 24/7 for families and provide 40-50 hours of direct service. To become a therapist or supervisor for HOMEBUILDERS, the five-day Core Curriculum Training needs to be completed, along with approximately 13 additional 1–2-day optional trainings to support therapists and supervisors in mastering a range of intervention techniques and topics. Additional mandatory training is required for supervisors to promote building internal organizational capacity, which takes an additional 4-8 days. For information about how to become a therapist or supervisor for HOMEBUILDERS, please visit http://www.institutefamily.org/Training_homebuilders.asp. |
Incredible Years Series (IY) |
The IY Series is designed to increase social and emotional competence and prevent, reduce, and treat behavioral and emotional problems in children up to twelve years of age. IY interventions are group-based interventions and include a parent training program, a child program, and a teacher training program. The child program consists of 45 minute sessions delivered twice weekly for consecutive years. Small group treatment is also provided in 2 hour sessions for 18-22 weeks. The parent training program consists of 2-3 hour sessions over the period of 12 to 20 weeks. The teacher training program includes 42 hours of monthly training delivered over the course of 6 days. Please visit the website for additional details: http://incredibleyears.com. |
Modular Approach to Therapy for Children with Anxiety, Depression, Traumatic Stress, and Conduct Problems (MATCH-ADTC) |
MATCH-ADTC is an evidence-based approach to treatment for youth ages 8-13 experiencing anxiety, depression, traumatic stress, and/or conduct problems. This modular form of treatment is designed to be flexibly applied in a manner best suited to client and family needs. Each module contains elements of common practices that have been demonstrated in research to be effective; the order in which modules are used is determined by the presenting concerns of the client and family. MATCH-ADTC includes guidelines for intervention delivery as well as resources that can be used directly with families in treatment delivery; a web-based system is available for tracking client outcomes. The MATCH-ADTC protocol are directly available (see http://www.practicewise.com/portals/0/MATCH_public/index.html).
Becoming a MATCH Therapist requires participation in a MATCH Direct Service Workshop and completion of post-training requirements. Additional training to become a MATCH Supervisor is also available from Practicewise. |
Multisystemic Therapy (MST) |
Multisystemic Therapy (MST) is a scientifically proven, intensive home and community-based intervention for at-risk youth that is returning to South Carolina. MST is designed to help youth with psychiatric needs, emerging adults, incarcerated juvenile offenders, substance-abusing youth, and juvenile sex offenders. MST for Juvenile Offenders is an evidence-based juvenile delinquency prevention program designed to empower children ages 12-17 and their families to function responsibly. Treatment lasts between three and five months, and therapists are available 24/7 to provide services in the home at times convenient to the family.
The goal of this program is to reduce youth criminal activity and antisocial behaviors and decrease rates of incarceration and out-of-home placement for youths involved in the juvenile justice system for serious offenses with a significant history of arrests. MST can only be implemented by licensed MST teams. Each team consists of 2-4 full-time therapists, a half-time supervisor, and organizational support for service delivery. To learn more about MST training, please visit https://www.mstservices.com/resources-training for more information. |
Parents as Teachers |
Parents As Teachers (PAT) is an international, non-profit organization that promotes optimal early development, learning, and health of young children by supporting and engaging their parents and caregivers. PAT is an evidence-based home visiting model used across many counties in South Carolina that consists of year-round home visits from a trained affiliate, group meetings with other families in the program, periodic developmental screenings for children, and referrals to community services to address family needs beyond the scope of PAT.
The foundation of PAT is the “strengths model” which emphasizes the family’s strengths and relies on the parent to be the child’s best teacher, rather than a professional. Services are available for all families from pregnancy through kindergarten. South Carolina First Steps serves as the South Carolina state office for PAT. |
Parent-Child Interaction Therapy (PCIT) |
PCIT is a clinic-based therapy program for children 2-7 years old with conduct disorder. Parents are taught skill building and positive relationship strategies. The aim of the program is to increase the pro-social behaviors and strengthen family functioning. Therapy involves 2 phases of intense direct coaching which usually requires about 15 sessions. The first phase, Child-Directed Interaction, is focused on improving the parent–child relationship and attending to positive child behavior. The second phase, Parent-Directed Interaction focuses on providing parents with skills for managing misbehavior.PCIT is currently being provided by select South Carolina Community Mental Health Centers in South Carolina: http://www.state.sc.us/dmh/center_inpatient.htm as well as by several additional organizations and providers. Please see the PCIT website for further details on the intervention: http://www.pcit.org/. |
Strengthening Families Program 6-11 |
Strengthening Families is a 14-week multiple group program designed to improve parenting skills, children’s social skills, and family life skills. The program targets high risk families and children in the 6-11 year old age range and is being implemented in South Carolina through the Children’s Trust (https://scchildren.org/).The program is also available for families of children ages 3-17; visit the Strengthening Families Program website for additional details: http://www.strengtheningfamiliesprogram.org/. |
Trauma Focused CBT (TF-CBT) |
TF-CBT is designed to treat children and youth who are victims of sexual abuse or who have been exposed to trauma. This method is used to treat PTSD and related emotional and behavioral problems for youth ages 3-18. Both individual and parent-child sessions are central to this therapy. Parallel child and parent therapy sessions are given each week with psycho education, parenting skills, regulation strategies, and cognitive coping and processing being discussed. The program typically runs for 12-16 sessions, with one one-hour session each week. For additional information on TF-CBT in South Carolina, please visit the website of Project Best at the Medical University of South Carolina (MUSC): http://academicdepartments.musc.edu/projectbest. |
Triple P Positive Parenting Program (Triple P) |
Triple P is a suite of parent-only interventions designed to improve parenting confidence and competence on a broad scale. Interventions of varying levels of intensity can be delivered in home or community settings and range from single session individual or group meetings to 8-14 week interventions. Using a self-regulatory framework, parents are taught a wide range of strategies for promoting desirable behavior and for managing misbehavior. The Triple P System is ideally designed to be delivered as a population-level approach, in which all families of children ages 0-17 can access the level and type of support that best suits their needs. See the website for further details: www.triplep.net. Please also visit the website of the Children’s Trust for details on Triple P in South Carolina: https://scchildren.org/. |