Adolescents in need - study of the origin and demands of adolescents and youngsters arriving at West Lisbon CRI indicated prevention locals

Background
In view of the evolution of risk behaviours and juvenile addictive behaviours evidenced in epidemiological surveys, and the increase in requests for intervention related to adolescents and young people, the West Lisbon CRI of DICAD has organized responses within the scope of Indicated Prevention, specially prepared to receive young people. The Indicated Prevention Group of the West Lisbon CRI is multidisciplinary and consists of a staff group who are interested and trained to work with adolescents and young people.
Method
In this communication we will present an evaluation of the activity of Indicated Prevention with adolescents and young people, in the year 2018, using the following indicators:
- Referral

- Referral motive

- Previous interventions

- Identified needs when received by indicated prevention staff

- Intervention proposals

- Intervention effectively carried out

- Resources involved

The aim is to obtain a picture of the identified needs, the interventions proposed or considered relevant by the staff and of the initial and continued adherence to these interventions. This framework also contributes to adjusting our responses, within the limits of existing resources, and to improve the articulation with referral and partner institutions, with a perspective of integrated and complementary intervention.

Results
The adolescents and young people arriving at West Lisbon CRI teams, within the scope of indicated prevention, are mainly referred by other health services, namely child psychiatry teams; by schools; by child/young promotion and protection institutions; by foster care institutions, or by family request. The number of young people who come by their own initiative is small, perhaps because the existence of this service is little known.
In most cases there is associated use of psychoactive substances, or relatives with drug addiction problems.

The requests concern the stopping of consumption, emotional stabilization, changes in behaviour and self-control. Intervention with families, especially family therapy, is not a usual request of referral institutions, but is often recognized as a necessity and a determining factor by CRI staff.

The interventions proposed by the CRI technicians are quite conditioned by the existing resources. Psychological counseling or psychotherapy, social work counseling, appointments with parents, and child psychiatric consultations are the most frequently proposed interventions. The need for other types of responses, such as group interventions and family therapy, is acknowledged.

Conclusion
Working with adolescents and young people at risk for addictive behaviours confronts us with challenging questions. Many of these adolescents have a history of medical, psychological and institutional interventions to which they have no positive feelings and are wary of more interventions/referral. An important part of individual interventions fail if there isn't a good assessment and preparation phase with adolescents (and families when possible).

Evaluating the origin, situations and effectiveness of the intervention proposals, allows us to improve the articulation with the community institutions and to develop strategies to try to obtain better results of adherence and change.