Working Across the Continuum
The Continuum of Care model reminds us to think, more explicitly, about the relationships between promotion, prevention, and treatment. All too often these relationships are overlooked, opportunities for collaboration are missed, and outcomes are compromised. Consider this example:
To address increasing rates of underage drinking, the anti-drug task force of a small New England town decided to strengthen enforcement of its underage drinking laws. Police began arresting youth they found attending underage drinking parties. The arrested youth were required to receive an assessment of their substance use and attend a 6-week education program provided by the local substance abuse and mental health agency.
The intervention was effective on the prevention end: knowing that the threat of arrest was real, fewer youth attended underage drinking parties and underage drinking decreased.
But what about its effects on related treatment services? The increased enforcement efforts produced an increase in the number of referrals to the local substance abuse and mental health agency, as well as a change in the type of referrals. Prior to the increased enforcement, most of the youth referred to the agency were at high risk for substance use. These youth received selective interventions tailored to their needs. Now most of the referrals were youth who were at much lower risk; their needs were significantly different.
Recognizing the potential impact of its new enforcement policy, the task force worked closely with administrators of the treatment agency to prepare. Knowing what was coming down the pike, the agency was able to more appropriately allocate resources and address the diverse needs of all its referrals. Thus, collaboration and a more comprehensive approach to the problem of underage drinking produced a better outcome overall.