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Substance Use Care Substance Use Care for Young People with Co-Occurring Disorders

Effective and timely substance use care

CHDI is improving care for young people with co-occurring mental health and substance use needs through timely substance use screening and care that’s available in the same places they receive mental health support.

Improving substance use care for young people with co-occurring conditions

Youth substance use is a concern for many families, yet less than 40% of adolescents and only 16% of young adults who need substance use treatment receive it. CHDI is working to change this by helping behavioral health providers identify and address early substance use among patients with mental health disorders and if needed, connect them to high-quality treatment. 

With the support of federal and state funding, CHDI is leading three initiatives to expand the availability of four evidence-based practices for substance use screening, early intervention, and treatment in community-based mental health settings across Connecticut. The initiatives include SBIRT PATHS, CT-TREE, and the Substance Use Disorder Project.
 

CHDI is disseminating four evidence-based practices

SBIRT (including the adolescent adaptation A-SBIRT) is a comprehensive, evidence-based approach that trains direct service staff to detect substance use with validated screens, use a brief intervention with motivational interviewing (MI) to engage young people in behavior change, and refer them to treatment.

Once screened, a provider can use brief intervention or treatment with motivational interviewing (MI) to engage the youth in behavior change. This can be done briefly or integrated within outpatient treatment for youth with mild or moderate substance use disorders. Providers can refer youth with severe substance use concerns and families to more intensive care.

MDFT-TAY addresses substance use problems in 4-6 months with TAY (aged 16 through 25), caregivers, the family, and the community. Services are provided in a hybrid format, which includes telehealth, in-home, and clinic-based sessions by a behavioral health clinician, clinical supervisor, and a therapist assistant.

MET-CBT integrates two established evidence-based practices to address substance use and co-occurring mental health conditions. The intervention cultivates change in motivation, thoughts, and behaviors. It is flexible and can be delivered in brief or extended formats ranging from 5 to 12 outpatient sessions.

A Wraparound approach for service coordination helps families identify and meet their needs in a way that is family-centered, strengths-based, and builds informal and formal supports. Services are uniquely tailored for families and youth with substance use concerns.

SBIRT (including the adolescent adaptation A-SBIRT) is a comprehensive, evidence-based approach that trains direct service staff to detect substance use with validated screens, use a brief intervention with motivational interviewing (MI) to engage young people in behavior change, and refer them to treatment.

Once screened, a provider can use brief intervention or treatment with motivational interviewing (MI) to engage the youth in behavior change. This can be done briefly or integrated within outpatient treatment for youth with mild or moderate substance use disorders. Providers can refer youth with severe substance use concerns and families to more intensive care.

MDFT-TAY addresses substance use problems in 4-6 months with TAY (aged 16 through 25), caregivers, the family, and the community. Services are provided in a hybrid format, which includes telehealth, in-home, and clinic-based sessions by a behavioral health clinician, clinical supervisor, and a therapist assistant.

MET-CBT integrates two established evidence-based practices to address substance use and co-occurring mental health conditions. The intervention cultivates change in motivation, thoughts, and behaviors. It is flexible and can be delivered in brief or extended formats ranging from 5 to 12 outpatient sessions.

A Wraparound approach for service coordination helps families identify and meet their needs in a way that is family-centered, strengths-based, and builds informal and formal supports. Services are uniquely tailored for families and youth with substance use concerns.

 

SBIRT PATHS Initiative

Screening, Brief Intervention, and Referral to Treatment Prevention and Access to Treatment Hubs and Services (SBIRT PATHS)

What is SBIRT PATHS?

The Screening, Brief Intervention, and Referral to Treatment Prevention and Access to Treatment Hubs and Services (SBIRT PATHS) is a five-year initiative developed and led by CHDI to expand access to timely and effective substance use care for youth ages 12-21 with substance use and/or co-occurring disorders in five Connecticut counties.

It is funded by a $5 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded to CHDI in September 2024.

Read Press Release

What will it do?

The primary goal is to provide integrated substance use, mental health, and trauma-informed services for youth ages 12-21 with low and moderate risk substance use.

Activities include:

  • Expand three evidence-based practices (EBPs) for youth utilizing a learning community framework: SBIRT, Motivational Enhancement Therapy/Cognitive Behavioral Therapy (MET/CBT), and a Wraparound approach for coordinating services.
  • Establish hubs to provide substance use/co-occurring disorder (SU/COD) services to youth (ages 12-21) in five Connecticut counties (Fairfield, Hartford, New Haven, New London, Windham).
  • Build community-based, localized partnerships to ensure youth are identified for screening and stay connected to services and care planning throughout treatment.
  • Begin to develop a Connecticut community-based model of co-occurring care for youth

Who will it help?

The initiative will serve Connecticut youth (ages 12-21) in the five counties with the highest percentage of youth living below the poverty line and rank the highest for overall Social Vulnerability (socioeconomic status, household characteristics, racial and ethnic minority status, housing type, transportation). In these rural and urban communities, more than one of every five youth report active substance use upon behavioral health service initiation each year.

Who are the Partners?

CHDI developed and leads the SBIRT PATHS initiative with guidance from an Advisory Committee, support from national, state, and local organizations, and partnerships with four behavioral health providers to form regional SBIRT PATHS centers. The Advisory Committee is composed of diverse stakeholders of which at least 25% have personal or family SU/COD lived experience.

Organizational partners include: Connecticut Department of Children and Families (DCF), Connecticut Department of Mental Health and Addiction Services (DMHAS), UCONN School of Social Work, Center for Behavioral Health Integration, LLC (C4BHI), FAVOR, Connecticut Community for Addiction Recovery (CCAR)

Behavioral health partners include:The Child and Family Agency - serving New London county, Child and Family Guidance Clinic - serving Fairfield county, Clifford Beers Community Care Center - serving New Haven county, Community Health Resources - serving Hartford and Windham counties

SBIRTH PATHS Press Release



Read Press Release

Substance Use Disorder Project (A-SBIRT)

Connecticut Treatment Expansion and Enhancement (CT-TREE) Initiative

Connecticut Treatment Expansion and Enhancement (CT-TREE) is a five-year initiative to improve the treatment of substance use and co-occurring disorders for transition-aged youth (ages 16-25) in Connecticut. CHDI partnered with United Community and Family Services (UCFS) and Community Mental Health Affiliates (CMHA) to develop the CT-TREE initiative. 


It is funded by a $2.7 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded to CHDI in June 2023. 

 

Read Press Release
 

The CT-TREE initiative will expand and enhance two well-established, evidence-based substance use disorder treatment models at UCFS and CMHA. The models include Screening, Brief Intervention, and Referral to Treatment (SBIRT), Multidimensional Family Therapy for Transitional Aged Youth (MDFT-TAY), and a Wraparound approach for coordinating services. 


The initiative will provide SBIRT training to at least 100 UCFS and CMHA providers and partners, with the goal of screening at least 1000 youth ages 16-25 for substance use. CT-TREE also aims to provide at least 450 transition-aged youth with MDFT-TAY and a Wraparound approach for service coordination to achieve outcome benchmarks for youth functioning and stability.

CT-TREE is a joint initiative between CHDI,  United Community and Family Services (UCFS) and Community Mental Health Affiliates (CMHA). An Advisory Committee includes stakeholders from the Connecticut Department of Children and Families and Department of Mental Health and Addiction Services, Connecticut Community for Addiction Recovery (CCAR), Turning Point CT, community providers, and includes individuals with lived substance use and/or mental health disorders. 

The initiative will provide SBIRT training to at least 100 UCFS providers and partners, with the goal of screening at least 1000 youth ages 16-25 for substance use. CT-TREE also aims to provide at least 450 transitional-aged youth with MDFT-TAY and Care Coordination to achieve outcome benchmarks for youth functioning and stability.

Connecticut Treatment Expansion and Enhancement (CT-TREE) is a five-year initiative to improve the treatment of substance use and co-occurring disorders for transition-aged youth (ages 16-25) in Connecticut. CHDI partnered with United Community and Family Services (UCFS) and Community Mental Health Affiliates (CMHA) to develop the CT-TREE initiative. 


It is funded by a $2.7 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded to CHDI in June 2023. 

 

Read Press Release
 

The CT-TREE initiative will expand and enhance two well-established, evidence-based substance use disorder treatment models at UCFS and CMHA. The models include Screening, Brief Intervention, and Referral to Treatment (SBIRT), Multidimensional Family Therapy for Transitional Aged Youth (MDFT-TAY), and a Wraparound approach for coordinating services. 


The initiative will provide SBIRT training to at least 100 UCFS and CMHA providers and partners, with the goal of screening at least 1000 youth ages 16-25 for substance use. CT-TREE also aims to provide at least 450 transition-aged youth with MDFT-TAY and a Wraparound approach for service coordination to achieve outcome benchmarks for youth functioning and stability.

CT-TREE is a joint initiative between CHDI,  United Community and Family Services (UCFS) and Community Mental Health Affiliates (CMHA). An Advisory Committee includes stakeholders from the Connecticut Department of Children and Families and Department of Mental Health and Addiction Services, Connecticut Community for Addiction Recovery (CCAR), Turning Point CT, community providers, and includes individuals with lived substance use and/or mental health disorders. 

The initiative will provide SBIRT training to at least 100 UCFS providers and partners, with the goal of screening at least 1000 youth ages 16-25 for substance use. CT-TREE also aims to provide at least 450 transitional-aged youth with MDFT-TAY and Care Coordination to achieve outcome benchmarks for youth functioning and stability.