DSYTC Treatment Philosophy 

Addiction (dependency) is not a character flaw or a moral failing as a result of a personal choice, but rather a chronic health condition which is a function of many variables (i.e., biological, emotional, psychological and environmental). As such, individuals suffering from drug/alcohol dependency require support, understanding and evidence-based intervention, as opposed to scorn, ridicule and punishment which only enhance the detrimental stigma that already exists.

Although addiction treatment is as (or more) effective than most other treatments for chronic ailments, the complexity of the condition and its common co-occurring issues (e.g., mental health) necessitates a perspective where relapse is expected. As well, it is important to recognize that adolescent substance abuse and dependency is as severe but somewhat unique from the adult form, thus requires a specialized treatment approach.

The holistic biopsychosocial perspective of addiction guides clinical practices and overall program delivery at the DSYTC. Within this context, the broad spectrum of client needs and issues are identified and incorporated into an individualized treatment plan. Individual therapy is emphasized and the responsibility to engage and retain youth in treatment is assumed by the treatment provider.  

9 Key Program Elements  

Programming content was compiled with the aid of exhaustive research and expert consultation. The chosen clinical approaches reflect up-to-date evidence-based practices, which are consistent with the positioning of this facility as a future Centre of Excellence. 

There are 9 key program elements:

1.        Assessment and treatment matching
2.        Comprehensive and integrated treatment approach
3.        Family involvement
4.        Developmentally appropriate programming
5.        Teen engagement and retention in treatment
6.        Qualified staff
7.        Gender and cultural competence
8.        Continuing care
9.        Treatment outcomes

Evidence-based clinical approaches utilized by DSYTC include: 

·           Assertive Community Reinforcement Approach (ACRA)
·           Assertive Continuing Care (ACC)
·           Family Support Network - Modified (FSN)
·           Cognitive Behavioural Therapy (CBT)
·           Contingency Management (CM)
·           Motivational Interviewing (MI) / Motivational Enhancement Therapy (MET)
·           Seeking Safety (Trauma)

Clinical approaches NOT utilized by DSYTC include:

·         Aggressive confrontation
·         Disease model elements (e.g., powerlessness)
·         Mandatory 12-step support group
·         Personal self-disclosure by clinical staff
·         Psychoanalysis
·         Approaches which are not substantiated via empirical study

Harm Reduction 

“Given a choice between changing and proving that it is not necessary, most people get busy with the proof.”
                                                                                John Galbraith

Harm reduction is both a controversial and difficult to define concept which has different implications depending on the context in which it is applied (e.g., drug policy, sexual health, broader health initiatives, etc.). Regarding drug and alcohol use specifically, the term has negative connotations for some as it is deemed to infer the enabling and/or ignoring of substance use. For others, harm reduction is one of the key pillars in helping address substance use (along with enforcement, prevention, and treatment), and is considered an invaluable and necessary approach when working with those suffering from drug abuse and dependency.

For the DSYTC specifically, a harm reduction philosophy permeates its overriding treatment objective and mandate, and is deemed to more meaningfully capture the concept of relapse than rigid abstinence-only perspectives (i.e., relapse as an opportunity to learn as opposed to a sign of failure). With client safety as our top priority, our residential treatment facilities operate as 100% substance-free environments (including tobacco products), and those who threaten such safety by attempting to sell or provide drugs or alcohol to our clients are subject to harsh consequences (including discharge for those clients who may participate in such activities). However, we recognize that substance dependency is a chronic condition and that relapse may occur for clients during scheduled off-site visits as part of their residential stay and/or upon completion of their residential experience (e.g., during the aftercare phase). As such, an understanding and non-judgmental clinical approach is paramount. More specifically, we believe harm reduction application facilitates client engagement and honest discussion by eliminating the sense of shame and risk of punishment that so often deters the disclosure of substance use, thus fostering a trusting therapeutic relationship which is essential for the attainment of the most positive treatment outcomes.

As youth treatment providers, a harm reduction approach is realistic, pragmatic and necessary, and reinforces our desire to help youth not only reduce or eliminate their substance use, but facilitate healthier living via the reduction of harms that can accompany substance use and other risky behaviours (e.g., sharing of needles, unprotected sex, self-harm, operating a vehicle while under the influence, etc.). This philosophy also aligns well with our evidence-based and client-centred approach.

DSYTC Definition of Harm Reduction

Harm reduction is a pragmatic philosophy and set of evidence-based strategies aimed at reducing substance use and/or related harms. Along this continuum of intervention and depending on the context in which it is applied, abstinence may be considered the most effective form of harm reduction. Ultimately, strategies that foster tangible and healthy change, whether or not such change results in complete abstinence or cessation of other risky behaviours, are deemed meaningful and appropriate means of service provision.