Our seven residential homes are located in Northern, Central, and Southern Utah. Additionally, we provide multiple “step-down” facilities for our residents when they graduate to lower levels of care and are in need of proctor placement and independent-living services.
YHA’s comprehensive Continuum of Care places a tremendous value on the support of the family. As such, we actively encourage family therapy, visits, and reunification.
This exclusive feature of our clinical services has led to dramatic differences in the duration of treatment. In fact, YHA has demonstrated empirical evidence of treatment durations well below the national average of 18 months.
The Therapeutic Relationship and Alliance
YHA believes that all forms of therapy occur within the context of the therapeutic relationship and that the importance of the therapeutic relationship cannot be overstated.
The therapeutic assignments provided by all YHA therapists are most likely to be effective, and most effectively used, when embedded within a larger treatment model and within a supportive therapeutic relationship. As such, our clinical professionals recognize the important and essential elements for the development of a solid therapeutic alliance. They also recognize that implementing these elements into treatment is likely to enhance, support, and make all treatment more effective.
From within this alliance, client motivation is most likely to peak and client participation is likely to be the greatest.
To help our clients understand and in engage in the treatment process, YHA’s Clinical Level 1 begins by addressing the basic concepts driving this process, concentrating on each youth’s primary reason for treatment (their engagement in some form of sexually abusive or sexually inappropriate behavior) and their treatment goals.
During this accountability stage, we strive for an early level of engagement in and responsiveness to the treatment process. We discuss labeling issues related to juvenile sexual offending (such as “juvenile sexual offender”) and provide a brief overview of the legal process and sexual offender registries.
The treatment team also approaches the idea of partnership in treatment, with an emphasis on honesty, responsibility, and denial. During tis stage, we help each client understand such concepts as personal participation, the nature and role of the treatment team, and confidentially (and its limitations). This helps the youth focus directly on treatment and how to engage more effectively in that treatment.
The youth is also introduced to definitions of terms and ideas related to sexually abusive behavior and its treatment (and forms of treatment). Each youth learns how they may effectively participate in different treatment modes, what these treatment modes can offer, and what the youth may gain. The youth also learns a number of rules and guidelines that must to be present in their therapeutic environment in order for them to learn and absorb.
Finally, Clinical Level 1 helps the youth by outlining the dynamics of sexually abusive behavior. In particular, sexually abusive behavior is discussed in terms of three classic elements of such behavior:
During this initial stage of treatment, therapists work diligently to develop a case conceptualization, a solid treatment plan, and the beginnings of a therapeutic alliance with the youth.
Once the youth are able to establish a level of safety in their treatment, they begin accepting responsibility for all of their choices and their behavior, without minimizing, justifying, or blaming someone else for those behaviors. The safety of the therapeutic environment created for our youth assists them in being honest about their sexually abusive and inappropriate behavior.
Introduction to Treatment
Participating in Treatment
Understanding Sexually Abusive Behavior
YHA’s Clinical Level 2 is aimed squarely at introducing the youth to themselves and to the world of interrelated thoughts, emotions, and behaviors. In doing this, therapists are able to teach the youth the value of building relationships, establishing social connections, and taking responsibility through making social reparation.
This level addresses relationships from the perspective of the connections allowed by empathic and caring relationships. Empathy is taught to youth as:
This maxim sets the tone for both this level of treatment and the remainder of the youth’s time with YHA. We believe it to be an important element in any empathy, relationship, and community building work.
While victims and victimization is addressed throughout treatment, this level concentrates on sharpening the youth’s understanding of victimization and the damage their sexually abusive or sexually inappropriate behavior has caused. Taking an emotional tone, Level 2 goes beyond cognitive perspective-taking and applies an approach that attempts to have the youth “feel” the effects of their behavior on others.
The goal here is not to induce shame or highlight irreparable damage, but instead to allow the youth to move forward in developing remorse for their behaviors while recognizing that they are able to engage in a restorative and healing process that can help both them and their victims to move forward.
Preparations for victim clarification are discussed and worked on through written exercises. The focus is on increasing victim awareness and helping the youth become more attuned and sensitive to the victim’s experience through the use of victim empathy essays, victim letters, and apology letters.
Many young people who engage in sexually abusive behavior have experienced adverse or traumatic childhood experiences and/or have themselves been victims of sexual or physical abuse. Depending on the needs of the youth, this level addresses the possibility of the youth’s own experience of being victimized at some earlier point, with the intention of addressing the youth’s own experiences of abuse, neglect, or other forms of maltreatment.
If these issues are present and at work in the youth’s life, YHA’s Empathy Level encourages the youth to recognize them and understand how their own victimization may have contributed to the victimization of others.
Introduction to Treatment
Participating in Treatment
Understanding Sexually Abusive Behavior
YHA’s Clinical Level 3 explains and explore feelings, emotions and moods, and rational and irrational thinking processes. While thinking errors are discussed from beginning to end in treatment, they are addressed in more detail here.
In Level 3, behaviors are the key focus. Particular emphasis is put on behaviors that are self-defeating, self-destructive, and/or harmful to others. Building upon the ideas and work accomplished in Clinical Levels 1 and 2, the goal is to help youth recognize, identify, tolerate and cope with difficult emotions and then to recognize the value and positive use of their feelings.
This level also focuses on thought processes, attitudes, belief systems, and value clarification. Emphasis is placed on how the youth thinks, experiences, and expresses attitudes about self and others, their systems of belief and specific beliefs, what they value, and whether their behaviors honor or damage those values and beliefs.
This lays the foundation for assisting youth in learning about, identifying, understanding, and disrupting their own dysfunctional behavior cycles. Patterns of behaviors are explained in the form of five basic and interrelated elements, each one of which leads to the next:
Youth are also taught how this cycle of five elements leads the next event, contributing to or potentially beginning another behavioral cycle.
Once the youth have a grasp of generic dysfunctional behavior cycles, therapists teach the phases of the dysfunctional behavior cycle, helping youth to understand how triggering events can tie to dangerous situations, as well as high-risk situations and factors. These elements are related to repetitive patterns of dysfunctional youth in treatment so that youth can learn and explore these ideas if they are exposed to them in other treatment programs and venues.
Elements of risk, thinking errors, attitudes, and beliefs that support antisocial behavior are flagged as high-risk factors in the perpetration of sexually abusive and sexually inappropriate behavior. Likewise, urges and cravings that cannot be tolerated and managed are shown to play a role in risk factors, aggravated by immediate gratification.
This level thus addresses internal risk factors, such as antisocial attitudes and beliefs, as well as external risk factors, such as entering (or remaining in) situations or being with people that engender or encourage (even unintentionally) either self-destructive behavior or behavior that is harmful to others. This level also identifies the major concept of seemingly unimportant decisions (SUDs), as links in a chain that can lead to general antisocial behavior and sexual recidivism.
Dysfunctional Behavior Cycles
Phases of the Dysfunctional Behavior Cycle
High-Risk Situations and Behaviors
As experienced treatment professionals know, some variant of safety or relapse-prevention planning is basic to the treatment of juvenile sexually abusive behavior. And yet, many relapse-prevention plans, for any number of reasons, are poorly developed or simply unused.
YHA’s Clinical Level 4 helps youth to understand and develop the means and plans for preventing future behavioral problems. Emphasis is placed on behaviors that are destructive to themselves and others, with specific emphasis on any relapse of sexually abusive behavior. This level helps youth understand the similarities and differences between behavior-management plans and relapse-prevention plans: the behavior plan is more general while the relapse prevention plan aims at preventing a recurrence of dangerous behaviors.
Therapists guide the youth through:
The Relapse Prevention level also revisits and builds upon the ideas of previous levels, while testing for retention and comprehension of ideas explored in those levels and encouraging self-evaluation. Treatment assignments urge the youth to honestly appraise their prior sexually abusive or sexually inappropriate behavior.
Finally, this level helps the youth advance through treatment by discussing and distinguishing between types of relationships, ranging from close to more distant.
Many youths who experience difficulties in building relationships feel lonely and disconnected from others, including same-age peers. These young people want relationships but don’t know how to build or keep them and often feel awkward and unsure of themselves. This issue is central for many of the youth in our care. Understanding relationships and the quality and meaning of these relationships is often the key in helping youth to understand the driving forces behind juvenile sexually abusive behavior. Relapse Prevention helps youth to understand the characteristics of healthy non-sexual and sexual relationships, types of sexual relationships, and links between relationship difficulties and sexually troubled behaviors.
Tell me, I forget. Show me, I remember. Involve me, I understand.
Ancient Chinese Proverb
YHA’s integrated, holistic approach to treatment seeks to bring a variety of theories and models into the treatment process with the goal of enhancing our youths’ potential and providing them with the tools and skills necessary to lead healthy, productive lives and to prevent re-offenses.
Our use of experiential exercises helps facilitate treatment, adds new and different insights to client learning, and enriches the overall treatment experience. This is especially true when taking into account developmental delays, learning disorders, and the simple fact that individual youth have different styles of learning.
This use of experiential therapies has opened avenues for our youth to utilize all types of learning styles and has thus provided them with better opportunities to learn and grow while in treatment.
Learning styles include:
YHA provides care and treatment for youth dealing with Autistic Spectrum Disorders (ASD), Asperger’s Syndrome, and Pervasive Developmental Disorders related to their antisocial behavior problems.
Autism Spectrum Disorders (also referred to as Pervasive Development Disorders) are pervasive and have the potential to impact a youth’s development in many ways. We recognize that the young people we serve that are affected by one of these Autism Spectrum Disorders are just that… people affected by a disorder. These young people are NOT the disorder.
Our goals in treating children and adolescents with Autism Spectrum Disorder conditions and problematic sexual behaviors are:
To achieve these goals, YHA therapists will help parents, siblings, and other caregivers come to terms with—and even facilitate—the ASD-affected child’s or adolescent’s appropriate sexual development, knowledge, and interactions.
YOUNG PEOPLE WITH
YHA is proud to provide treatment to young people dealing with developmental delays and/or mental disorders.
As part of our holistic approach, we place strong emphasis on tailoring the intervention response to the particular needs of the young person, as well as their parents or caregivers. This includes clients with impaired intelligence (an IQ of 70 or below) and youth who have a significantly reduced ability to understand new or complex information or to learn new skills.
In many cases, these young people have a reduced ability to cope independently (also known as impaired social functioning). We appreciate that this reduced ability often begins before adolescence and has a lasting effect on development.
Our approach to these special youth is active and participative. We make use of multi-sensory techniques (such as games or other entraining approaches) in order to maximize the young person’s interest and engagement and to link emotion to learning. YHA therapists ensure that treatment messages are explicit and regularly reinforced. Our programs value participation of the client and celebrate small gains in all areas of functioning and behavior - not just those related to sexual misconduct.
We recognize and respond to the children, adolescents, and young people with whom we work as whole people. We understand that antisocial and sexually troubled behavior represent only one element of their makeup and experience. We believe that these behaviors can and must be understood and treated in this context. We work to impart this belief to the youth in our care, their families, others who provide treatment and care, and the community at large.
The potential to face and manage Crisis Behavior is a reality for any employee when working with youth-at-risk. YHA is committed to the healthy resolution of any behaviors that are inappropriate or potentially dangerous – both to one’s self or others.
As such, YHA has developed Crisis Behavior Management (CBM), a behavior management system that’s designed to provide employees with the knowledge and skills they need to effectively prevent, respond to, and report a crisis.
The CBM manual utilizes elements of multiple crisis response trainings, with a focus on demonstrating respect and maintaining the dignity of all involved. The ultimate goal for YHA training is to build healthy relationships between staff and clients in the workplace and maintain interactions that safely meet needs and achieve goals.
All meetings and trainings are run by a licensed clinician.
CBH Training includes: