Adolescent Day Programs
The Child and Family Institute at St. Luke’s and Roosevelt Hospitals features a
unique adolescent day program: the Comprehensive Adolescent Rehabilitation and Education
Service (CARES). CARES is composed of two tracks, the Adolescent Alternative Day
Program (AADP) and the Comprehensive Addiction Program for Adolescents (CAPA). Both
programs offer a fully integrated academic experience, which is taught by New York
City Department of Education teachers. This can lead to either a New York State
Regents Diploma, or a Generalized Equivalency Diploma (GED), depending on the student’s
academic progress. The programs provide an intensive five-day a week therapeutic
milieu from 9 AM to 3:15 PM.
CARES Program Description
The purpose of the Comprehensive Adolescent Rehabilitation and Education Service
(CARES) at St. Luke's and Roosevelt Hospitals is to provide a safe and therapeutic school
environment for New York City public high school students whose previous school
performance has been limited by emotional and behavior difficulties. Our program
provides both educational and therapeutic components, including substance abuse
treatment for students who use drugs or alcohol.
The CARES educational component is provided directly by the New York City Department
of Education. All CARES treatment components are designed to address the specific
problems that have interfered with each individual student's academic and social
success in the past. Your CARES teachers and clinical staff will work hard to provide
you with the education, life-skills training, and individually focused therapies
that you will need in order to reach your goals.
CARES is a friendly place, and all rules and policies of the program are intended
to maintain the safe and respectful community that helps our students to succeed.
As members of the CARES community, all students and families must be familiar with
the program rules and expectations, and all must agree to abide by them in order
to participate in the program. These rules and expectations are described in our
CARES Handbook
We help teenagers become motivated, examine and change their destructive behaviors, learn to cope effectively
with life stresses, and become abstinent from mood-altering substances. Based upon the needs of the teenager
and her or his family, we provide an intensive day-treatment program in combination with on-site New York City
Department of Education educational services.
CARES Program Tracks: AADP and CAPA
Though they share the same educational and treatment resources, each of the two
tracks offered by the CARES program has a distinct focus: The Adolescent Alternative
Day Program (AADP) track is designed to help students whose school performance has
been affected most by problems with social skills, anxiety, and/or mood changes.
The word "Alternative" in the AADP title refers to the more focused, individualized,
safe, and respectful school environment that students are seeking when they apply
here from regular high school settings. AADP is a therapeutic day school for emotionally disturbed and truant
adolescents (ages 14-18). The program is designed along a milieu treatment model. The integration of
the therapeutic and educational components provides a unique opportunity to treat adolescents with
severe emotional problems. Integrated into the program is a full academic experience which is taught
by Department of Education teachers.
The Comprehensive Addiction Program for Adolescents (CAPA) track serves adolescents (ages 14-19)
who are struggling with substance abuse, either as active users interested in stopping, or as
persons in recovery. This program is designed for those teens who require a significant level
of structure to turn their lives around, but who can continue to live in the community. An
integrated substance abuse/mental health model is used to allow for identification and treatment
of all relevant issues. The program uses a harm-reduction model to help students reduce and ultimately abstain from substance use.
CAPA is run in collaboration with The Addiction Institute of New York (http://www.addictioninstituteny.org)
and provides an alternative for New York City teenagers who have just started abusing substances or
who have already been in significant substance-related trouble. These problems may include: depression
and other mood-related disorders, mild to moderate behavior problems
(angry outbursts, disrespect, breaking family rules, lying, truancy, early run-ins with the police),
school problems and/or legal problems.
CARES Education Component
CARES provides a full-time, diploma-granting high school education curriculum through
the New Your City Department of Education. In addition, certain students will be
able to opt for a GED curriculum based upon their needs and preferences. Following
New York State Education Department mandates, the diploma program enables students
to earn and accumulate credits as well as prepare for Regents exams.
A focus on literacy and numeracy will help students reinforce skills in these areas.
The diploma and GED educational programs are run through the Restart Division of the New York City Department of Education.
CARES Treatment Model
CARES provides multidisciplinary therapeutic services to students whose emotional and/or
behavioral difficulties have interfered with their success at school. CARES
clinical staff work together as a team to make an individualized treatment plan
for each student. The different parts of your treatment plan are described below.
1. Individual and Family Therapy
You will be assigned an individual therapist and a psychiatrist, who will keep track of how you are doing on a weekly basis and will meet regularly with you and your family. It is CARES policy that the assigned individual therapist and psychiatrist cannot be changed upon student or guardian request. Therapists will help students focus on treatment in order to target personal emotional, behavioral, academic, family and substance abuse goals. Additionally, pregnancy prevention and smoking cessation will be included in the treatment as needed. Once you have set your treatment goals, you and your therapist will monitor your progress weekly. Students selected for the DBT track will be expected to complete weekly diary cards. All students will be required to write out behavioral analyses as needed.
2. Group Therapy
Like school classes, group therapy sessions form an essential part of the daily learning curriculum at CARES. Every student is assigned to a particular group schedule. We offer several kinds of groups, such as skills groups (including individual art therapies), verbal therapy groups, wellness groups, DBT groups (see below), and others. Students for whom drug or alcohol use is an issue will also be assigned to a weekly substance abuse recovery or relapse prevention group.
A major component of the CARES group program is modeled according to the principles of Dialectical Behavior Therapy (DBT), a highly effective treatment method for teenagers who wish to change from dangerous or self-defeating behavior patterns to more successful responses to stress. Five sets of skills will be taught in rotating periods throughout the year, in coordination with the treatment goals monitored in each student's individual therapy. These five skill sets are:
Mindfulness Skills (to increase awareness of feelings and thoughts experienced through the day)
Distress Tolerance Skills (to teach how stress and bad news can be handled)
Emotion Regulation Skills (to teach how to recognize and manage difficult thoughts and feelings)
Interpersonal Effectiveness Skills (to teach how to make and keep positive relationships)
Walking the Middle Path (to teach that there is always more than one way to see a situation and
solve a problem)
Students enrolled in DBT groups will be required to complete weekly diary cards. After the completion of a 6 month intensive DBT group, students, in conjunction with their individual therapist, will be able to tailor their participation in DBT groups.
3. Psychopharmacology/Medication Management
All CARES students who take medication must meet with their assigned psychiatrist at least once per month. Each new student must provide a written record of a recent physical exam, which will need to be updated at least once per year. Students who are taking medications must not change their dosages or stop their medications without discussing this beforehand with their psychiatrist. For students under the age of 18 years old, starting new medications requires the written consent of a parent or legal guardian.
4. Academic/Education
Students attend daily academic classes taught by Department of Education teachers. Clinical staff work closely with the teachers each day to ensure that students are attending their classes, working well with teachers and peers and participating to the best of their ability. On occasion field trips are part of the academic coursework.
5. Milieu Therapy
Each day, two staff members monitor the community space. These milieu staff are available throughout the day for brief-counseling, to answer any questions you have about the program, and to help you follow program rules and practice interpersonal effectiveness skills. The milieu staff schedule is posted throughout the floor so you can easily determine who you can go to each day for assistance. Milieu staff may require that students complete a modified version of a behavioral analysis prior to returning to their class. Students are expected to follow directions given by milieu staff. By not following directions, students are communicating that they may need to be sent home.
6. Your Community
Each student is expected to bring all of his or her individual strengths to the community in order to support fellow students. We expect each community member to take this role of peer support seriously. This is demonstrated in small and big ways, and can include everything from cleaning up after oneself to being a good listener when appropriate. The completion of chores is part of this community involvement and responsibility. Chores are assigned to four students each day. Chore assignments are posted on the kitchen bulletin board. It is the students’ responsibility to check the chore schedule and follow through with the completion of his/her chore. To be successful we need everyone’s full cooperation.
Additionally, community meetings are held on most school days. The Community Meeting provides each student the opportunity to learn how to negotiate community issues effectively. Both students and staff share the responsibility for working out any differences of opinion in a safe and respectful manner. Participation in the Community Meeting will keep you informed about program events, allow you to contribute to program decisions, and increase your ability to assert yourself in a group situation.
7. Complementary Services
Students often have additional needs that CARES cannot provide for, which may require involvement of other services. Such services may include AA or NA meetings, case management, waiver program, and community organizations including religious groups or after school programs. Participation in such services will be determined by each student and his or her family with the help of the individual therapist. It may be decided that complementary services are required for you to continue in CARES. Case management services are often deemed necessary for students attending CARES. If a student does not have case management services, it is likely that the student’s individual therapist will refer the student and his or her family for services through C-SPOA (Child Single Point of Access).
Comprehensive Adolescent Rehabilitation and Education Service (CARES)
Child and Family Institute
St. Luke's-Roosevelt Hospital Center
411 West 114th Street, 3rd floor
New York, NY 10025
(212) 523-7233
To make a referral, please call our Intake Coordinator at 212-523-3083.
For Information, contact:
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