Addiction Treatment for Teens: Introducing Adolescent IOT with Madelin Biddle and Katherine Richards

May 14, 2020

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Despite the efforts of dedicated health care professionals and organizations, substance use continues to be a major behavioral health issue for millions of people across the U.S. According to the National Survey on Drug Use and Health, approximately 20.3 million Americans suffered from a substance use disorder (or SUD) in 2018. In Indiana, the estimated number of afflicted Hoosiers totaled 389,000.

Although not everyone who needs treatment for SUD ultimately receives it, there are today a wide variety of providers and services that can help adults who have substance use problems. However, one population that is sometimes overlooked is teenagers and adolescents. Although 916,000 American adolescents aged 12–17 suffered from a SUD in 2018 (18,000 in Indiana), only 159,000 received any treatment for substance use. In addition, statistics show that the percentage of adolescents with a SUD who receive treatment is consistently lower than among individuals above age 26.

Cummins Behavioral Health has long provided substance use services for individuals who need them, which includes our popular Intensive Outpatient Treatment (IOT) program, but they’ve sometimes been difficult to cater toward adolescent populations. However, we’ve recently launched a virtual IOT program specifically for youth and adolescents to meet the needs of this age group.

To learn more about the specifics of this new program, we spoke with two of its facilitators: Madelin Biddle, one of our school-based therapists, and Katherine Richards, a graduating intern in substance use counseling. They explained the origins of the adolescent IOT program, how it has been received by consumers, and what plans are in place for its future.

Addressing a Difficult-to-Meet Need for Teenage Youth

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Madelin Biddle, MSW, LSW, school-based therapist (left) and Katherine Richards, MSW, graduating intern in substance use counseling (right)

Although Cummins’ adolescent IOT program is brand new—it started in Putnam county on April 27th—the need for this type of program is not. “I’ve spoken about it extensively with [Director of Operations for Montgomery and Putnam counties] Rebecca Roy, and she’s been talking about doing this since I first started as an intern a little less than a year ago,” Katherine says.

Traditionally, adolescent consumers who need Intensive Outpatient Treatment for substance use have been integrated into our adult IOT groups. While this policy has allowed younger consumers to receive the treatment they need, they’ve often been unable to undergo treatment with other individuals of similar age. “We had a lot of people who were 17 or 18 in adult IOT, and it very much felt like they could’ve benefited better from a group consisting more of their peers. It was very evident that they would benefit from adolescent IOT, but we just didn’t have one,” Katherine says.

Ironically, the COVID-19 pandemic played a role in finally making adolescent IOT a reality. As most schools remained closed and telehealth services quickly became normalized, some of the obstacles that had previously prevented the program’s implementation were cleared away. “As a school-based therapist, I think the barrier was getting around school schedules. It’s not really our job to pull kids out of school for three hours at a time,” Madelin explains.

“There were also barriers like transportation needs for a lot of adolescents,” Katherine adds. “Being able to do IOT through telehealth has opened doors that were previously closed.”

The Future of Adolescent IOT at Cummins BHS

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Although the virtual adolescent IOT program has only been running for a few weeks, early feedback from consumers has been encouraging. “Some of our feedback has been that consumers feel they’re not the only ones who made mistakes and that they feel they can find trust in the group,” Madelin explains.

For some teens, nine hours of group sessions every week seems like a big commitment at first, but Madelin and Katherine have found that many participants end up expressing gratitude for the opportunity to connect with their peers. “When I was first introducing the idea of Group to individuals, I found that the time component was really intimidating for them,” Madelin says. “But I think they’ve been really surprised by how well Group is going. And especially during COVID-19, I think it’s been really beneficial to have that time to meet as a group and that space to talk about substance use with peers where there isn’t such a stigma surrounding it.”

While the program is completely virtual for the time being, there’s a possibility that it will be expanded to include in-person sessions in the future. As with many of Cummins’ services, this depends on how the COVID-19 pandemic changes in the coming months. “We’re waiting to see what happens,” Katherine explains. “If it’s more convenient to continue it online even if restrictions are loosened, then we may do that. But I was hired into my role to do this kind of work, so I believe the intention is to continue the program whether it’s in-person or online.”

In case the program does begin offering in-person sessions, preparations are already being made to remove some of the associated barriers. For example, Area 30 Career Center in Greencastle has indicated that it could assist with providing transportation to and from sessions for students who need it. “I think the intention is to eventually work with Area 30 to reduce that barrier,” Katherine says.


Cummins’ virtual adolescent IOT program is primarily operating in Putnam County at this time, although it is open to individuals living in all counties that Cummins serves. If you or your teenage friend, child or relative is struggling with substance use, we encourage you to call us at (888) 714–1927 and inquire about substance use treatment. Our adolescent IOT program could be a good fit for you or your loved one!

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