Program Profile: AMIkids Community-Based Day Treatment Services

AMIkids is a program encompassing community-based, experiential treatment interventions for at-risk and delinquent youth, which is designed to reduce recidivism and be cost effective. The program is rated Promising. The treatment group showed a statistically significant lower likelihood of being rearrested, adjudicated, convicted, or experiencing a subsequent commitment for any offense within 12 months of release, compared with the comparison group.

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals

AMIkids offers a variety of community-based, experiential treatment interventions for at-risk and delinquent youths that are designed to reduce recidivism and be cost effective. The AMIkids programs are run by the nonprofit organization AMIkids, Inc. (formerly Associated Marine Institutes) in Florida and offer services through several different program settings, including day treatment centers, wilderness camps, home-based family counseling, residential programs for male adolescents, gender-specific programming for female adolescents, and alternative schools.

Program Theory

AMIkids’ service delivery is targeted at eight integrated components: education, challenge experiences, cognitive–behavioral therapy, strengths-based case management, behavior modification, family partnership, problem-solving and social skills development, and community service. This approach is based on theoretical perspectives and treatment interventions found in empirical research literature to effectively reduce juvenile delinquency (Winokur Early et al. 2010).

The foundation of service delivery adheres to the AMIkids Personal Growth Model (PGM), which is a unified approach to treatment, education, and behavior modification designed to help youths achieve personal growth and success. The PGM uses an experiential learning environment to deliver cognitive–behavioral interventions designed to reduce youths’ risks for mental, behavioral, and emotional problems while encouraging the youths to make positive changes in their lives to avoid future involvement in the juvenile justice system. The goals of the PGM are:

• Integration of evidence-based interventions and strategies into the services provided by AMIkids
• Reduction in recidivism and improvement in prosocial outcomes by addressing youths’ risks, needs, and responsivity
• Establishing a holistic approach to serving youth, encompassing the individual, the family, and the community

The conceptual framework of the PGM is based on research and theory of delinquency and treatment interventions for juveniles (AMIkids 2009a). The PGM also embodies the integration of program components centered on the AMIkids Culture, which consists of six core principles: bonding, family atmosphere, nonprison environment, positive learning environment, gender responsiveness, and cultural relevancy.

Program Components

Upon enrollment in AMIkids, each youth is administered a comprehensive assessment called the Positive Achievement Change Tool (PACT). The PACT assessment instrument identifies youths’ criminogenic risks and needs. Based on the PACT assessment, youths are assigned to mental health or substance use treatment services (or to both) that consist of:

• Cognitive–Behavioral Therapy, to address anger, mental health, behavior, and substance use treatment needs
• Motivational Enhancement Therapy, to address substance use treatment needs
• Aggression Replacement Training, which concentrates on anger and skills deficits as well as moral reasoning
• Skillstreaming, to deal with social skills deficits
• Motivational Interviewing for rapport building and moving youths toward positive change

The assessment also determines the necessary intensity and duration of treatment interventions based on individual risk and protective factors, responsivity to treatment, readiness to change, and criminogenic needs.

The AMIkids day treatment programs provide community-based interventions that allow youths to reside at home while they attend daily services. During the day, youths receive intervention services and attend school at the day treatment center in an academic setting. At night, youths return home, which fosters family involvement in the treatment process. Day treatment programs are designed to serve delinquent youths in a nonresidential setting and to improve youths’ academic achievement, vocational achievement, and school attendance and reduce their problem behaviors such as substance use, violence, delinquency, and conduct disorders. Youths participating in day treatment programs have been adjudicated delinquent by the court for misdemeanors and lesser felonies and often have co-occurring substance misuse and mental health issues.

The day treatment programs are usually small, usually located near the youth’s home, and generally operate from 8 a.m. to 5 p.m. on Mondays through Fridays. The average length of stay in the program is typically 4 to 6 months. Services provided by program staff address issues in both the home and neighborhood by working with each youth and his or her family together. Services include staff home visits, a small staff-to-student ratio, comprehensive counseling, individualized cognitive–behavioral treatment services, and family integration.

Study

The evaluation by Winokur Early and colleagues (2010) used a quasi-experimental design to compare recidivism outcomes for male and female juveniles who completed AMIkids’ community-based day treatment program during fiscal year 2007–08 to a matched sample of youths who completed secure residential programming during the same time period.

Youths completing AMIkids day treatment programs were compared with a matched sample of youths completing low-, moderate-, and high-restrictiveness-level residential programs. A completion of secure residential programming is defined as any youth designated in Florida’s Juvenile Justice Information System (JJIS) having successfully completed the program, having been assigned to probation following release, having been directly discharged without subsequent supervision, and/or having reached the maximum juvenile jurisdictional age or term served and then being released back to the community. Restrictiveness level refers to the physical and staff security level of the facility, and not to the risk of reoffending. However, youths were matched by risk level, as measured by the PACT that is used by the Florida Department of Juvenile Justice (FDJJ) to assess criminogenic risks and needs. A propensity score matching protocol was used to statistically control for inherent differences between the groups. The propensity score was calculated as the probability of a given youth completing AMIkids day treatment services versus residential commitment using the probabilities produced by a logistic regression model. Youths with the same propensity score were matched and divided into two groups: those who did and did not receive AMIkids community-based interventions.

Youths who received AMIkids day treatment services (n = 1,083) were 80 percent male, 51 percent African American, and 14 percent Hispanic, with an average age of 16.2 years at admission. Youths who completed residential programming (n = 1,083) were 81 percent male, 53 percent African American, and 15 percent Hispanic, with an average age of 15.8 years at admission. There were no statistically significant differences between the groups except on two factors: youths who received residential programming were younger at release and had a longer average length of stay, compared with youths who received AMIkids day treatment services.

Measures of recidivism and standard follow-up periods are based on those used by FDJJ in their annual outcome evaluations of juvenile justice programming in the state. Recidivism, defined by FDJJ, is any subsequent offense that results in adjudication, adjudication withheld, or adult conviction within 1 year of release. The analysis in the study also examined alternate youth outcome measures including felony adjudication or conviction, arrest and felony arrest, and subsequent placements into commitment, adult probation, or prison within 1 year of program completion. Data was compiled from the JJIS, the Florida Criminal Information Center, the Florida Department of Corrections, the FDJJ Office of Management and Budget, and the FDJJ Bureau of Quality Assurance. Independent sample t–tests were used to test for significant differences in the outcomes between the groups for each analysis. The study authors did not conduct subgroup analyses.

The relative expenses of AMIkids day treatment and residential services were estimated using the standard FDJJ method for calculating program costs. According to the 2009 FDJJ Comprehensive Accountability Report, it costs on average $40,235 for every juvenile who completes low-, moderate-, and high-risk residential programming. In comparison, AMIkids day treatment services cost approximately $9,356 for each youth who successfully completes the program. The difference in expense between the day treatment and residential programming is $30,879 for each youth receiving services. The cost comparison shows that the State of Florida saves more than $3 million for every 100 youths who complete AMIkids day treatment services (versus residential programming) each year (Winokur Early et al. 2010).

Additional information on AMIkids community-based day treatment services can be found on the program’s website.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

AMIkids. 2009a. AMIkids Personal Growth Model: Service Philosophy Manual. Tampa, Fla.: AMIkids, Inc.

AMIkids. 2009b. AMIkids Personal Growth Model: A Unified Approach to Behavior Modification, Education, and Treatment. Tampa, Fla.: AMIkids, Inc.

AMIkids. 2010. Behavior Modification Operations Manual. Tampa, Fla.: AMIkids, Inc.

Justice Research Center. 2011. AMIkids Outputs and Outcomes Reports 2010. Tallahassee, Fla.: Justice Research Center.

Following are CrimeSolutions-rated programs that are related to this practice:

Formal System Processing for Juveniles

The practice of using traditional juvenile justice system processing in lieu of alternative sanctions to deal with juvenile criminal cases. The practice is rated Ineffective for reducing recidivism compared to the youth that were diverted from the system. Test

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Juvenile Diversion Programs

An intervention strategy that redirects youths away from formal processing in the juvenile justice system, while still holding them accountable for their actions. The practice is rated Promising for reducing recidivism rates of juveniles who participated in diversion programming compared with juveniles who were formally processed in the justice system.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?