ATP (Alternative to Placement)

PLL-ATP is a specialized version of PLL that is:

  • A community-based alternative to residential placement for moderate to high-risk youth ages 10-18 and involved with Juvenile Justice.
  • A community-based alternative to out-of-home placement into foster care for youth ages 10-18 who have come under Child Protective Services.
  • A community based alternative to keeping at-risk youth from further involvement in therapeutic services.

How it Works?

  • A Short-Term 3-4 month model that includes:
    • A 6 week parenting education group
    • A minimum of 6 family therapy sessions
    • Specialized Motivational Interview procedures to engage resistant youth and parents
  • PLL-ATP uses a unique delivery system that combines group and family therapy. Family therapy involves the caregiver, identified client, siblings, and extended family members, and focuses on behavior modification and family systems trauma work in one continuum of care (see PLL Clinical Applications)
  • PLL-ATP provides comprehensive relapse prevention by providing 30, 60, and 90-day callbacks with families after they complete the PLL program. Tune-up sessions occur as needed.

PLL-Clinical Applications employed

  • FT-FST (Family Systems Trauma)

    This application focuses on eliminating problem symptoms in adolescents ages 10 to 18 caused by unhealthy undercurrents (e.g. unresolved grief, abandonment, family secrets, high anxiety, unmet basic needs like food, clothing, and shelter, etc.) that either cause or maintain Unhealed Wounds.

    PLL Delivery Systems employing FT-FST:  Reentry, ATP

  • FT-BM (Family Therapy Behavior Modification)

    This application focuses on eliminating problem symptoms in adolescents ages 10-18 caused by unhealthy undercurrents (e.g., inconsistent discipline, unhealthy boundaries, lack of proper parental hierarchy, lack of nurturance, etc.) that either cause or maintain chronic Misuse of Power in the family system.

    PLL Delivery Systems employing FT-BM: Reentry, ATP, Prevention

  • MI (Motivational Interview)

    This application serves as a “soft startup” to increase family engagement by accelerating joining and rapport building and lowering resistance to treatment. The Motivational Interview involves two levels: level one is a Motivational Phone Call to begin the “soft startup” process of increasing family engagement, and level two is a face-to-face meeting to further accelerate joining and rapport building with the goal of engaging the family to come to the first treatment session.

    PLL Delivery Systems employing MI: Reentry, ATP, Prevention

  • GT (Group Therapy)

    This application utilizes a teaching psycho-educational format that brings clusters of families together to learn new skills to eliminate problem symptoms in adolescents ages 10 to 18. The group process is also designed to move families into Contemplation around the cause of the adolescent’s problem symptoms and prepare the family for the FT-BM and FT-FST applications to occur.

    PLL Delivery Systems employing GT: Reentry, ATP, Prevention

PLL-ATP Outcomes

Karam, E.A., Sterrett, E.M., & Kiaer, L (2016) The Integration of Family and Group Therapy as an Alternative to Juvenile Incarceration: A Quasi-Experimental Evaluation Using PLL. Family Process

Highlights from this PLL-ATP study include:

  • 72% Completion Rate - 111 out of 144 PLL families completed the program voluntarily (p. 9)
  • 70% of this sample consisted of African American juveniles (p. 12)
  • These positive outcomes were achieved with more violent offenders. Youth served by PLL entered the program with more charges related to violence than the comparison group of non-PLL youth (50% vs. 33%). (p.12)
  • Low Recidivism: PLL re-adjudications only 12.6% vs. 21.3% for the non-PLL comparison group (a 41% reduction). (p.11)
  • Similar results for felony adjudications, with only 9% for PLL youth vs. 16% for those not receiving PLL. (p.11)
  • New charges also dropped to only 19.8% vs. 32.9% for youth not receiving PLL. (p. 11)
  • The average PLL service duration was only 2.9 months vs. traditional community mental health at 7 months and probation at 20 months. (p.12)

TABLE 4 (p.11)
Treatment and Comparison Group Outcomes within 1 Year of Completion: Protocol Adherence (n = 111)

Recidivism: PLL Graduates
Protocol Adherence Model (n = 111)
Outcomes Within 1 Year of Completion Recidivism Rate Significance or p-value (1-tailed) Relative Risk
PLL Matched Control Group
Contacts 36.9% 51.0% 0.02 72.4%
Felony Contacts 18.9% 28.4% 0.051 66.5%
Charges 19.8% 32.9% 0.01 60.2%
Felony Charges 15.3% 21.3% 0.14 71.8%
Adjudications 12.6% 21.3% 0.046 59.2%
Felony Adjudications 9.0% 16.1% 0.06 55.9%
Incarcerations 2.7% 6.5% 0.13 41.5%

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