ACS FY17 Year-End Report

Adolescent Consultation Services supports and empowers court-involved children and families by providing mental health prevention and intervention services to help them envision and work toward a better future Mission Statement Adolescent Consultation Services supports and empowers court-involved children and families by providing mental health prevention and intervention services to help them envision and work toward a better future.

FRAN MILLER BOARD PRESIDENT I am continually shocked by the problems young people in our community face each and every day. I am equally amazed by the dedicated staff at ACS, who work tirelessly to guide and support these young people through these challenges. ACS provides the children and families they serve with the opportunity to envision a better future. For many, this is the first time they’ve had that opportunity. But what I am most impressed with is YOU. You, our generous supporters and donors, show us that we are not alone in this fight to support court-involved kids and families. Because of you, each child and family we work with has hope. Hope for a better future. Thank you. Frances H. Miller LEAH M. KELLY EXECUTIVE DIRECTOR This year in the media, renewed awareness has been raised about some of the complex mental health issues that so many of our young people experience. At ACS, we specialize in identifying those needs and linking struggling kids with critical resources so that they can begin to heal, grow, and thrive. We support and advocate for families in crisis, for whom the court system is the last resort. And we know that success so often follows a series of failures, so we never give up. We could not do this difficult work without the steadfast support of our allies, partners, and donors, not to mention our incredible staff and Board of Directors. Thank you for caring about these vulnerable kids and families. Leah M. Kelly, Psy.D. 1

Who You Help 438 kids received help from ACS in FY17 ACS serves the children and families of Middlesex County. The Massachusetts Trial Court provides ACS with in-kind office space in Cambridge, Lowell, Framingham, and Waltham. 69% 74% Mood Disorder 66% Anxiety Disorder (including PTSD) were struggling with at least 63% ADHD 37% Suicidality one psychiatric condition 28% Substance Use Disorder 22% Self-injurious behavior 2

438 RACE AFRICAN 30% AMERICAN 12% of the children we served have parents who HISPANIC immigrated to the U.S. 29% CAUCASIAN 46% ASIAN 5% 77% OTHER/ UNKNOWN of the families we served 8% received insurance coverage under Mass Health 15% UNDER 7 1% 51% 7-12 15% AGE 13-15 31% 51% 16-17 31% 18+ 2% GENDER 63% 36% 1% BOYS GIRLS TRANSGENDER/ GENDER NON-CONFORMING Moving in a positive direction 3

Diagnostic Evaluations ACS clinicians conduct same-day emergency mental health and substance use evaluations and comprehensive diagnostic evaluations of court-involved youth. Our clinicians conduct in-depth interviews with the child and family, gather school and health records, and prepare a detailed report of their findings for the Juvenile Court. The report tells the story of the child and family in a new way, taking into account the many facets of the child’s life and their unique circumstances. A careful and detailed formulation is developed, incorporating family history, the child’s developmental background, their school performance over time, and a full review of their medical and mental health history. This formulation informs a list of thoughtful and individualized recommendations intended to target the specific needs of the child and their family. 115 Same-day emergency evaluations completed 531 Comprehensive diagnostic evaluations completed FUNDED BY: • Massachusetts Trial Court • Department of Mental Health • You (our private donors) 4 *To protect confidentiality, ACS does not use the names, photos, or identifying features of our clients

In many ways, Jacob* is your typical 11-year-old boy. He is artistic, tech savvy, and enjoys school. His teachers describe him as engaging and cooperative, but that’s only when he can stay awake in class. Despite his interest in school, he would often fall asleep in class and was increasingly absent altogether. Due to his chronic absences, Jacob’s school filed a Child Requiring Assistance (CRA) application with the Juvenile Court. The presiding Judge referred Jacob to ACS for a comprehensive diagnostic evaluation. A clinician then met with Jacob, interviewed his family members and teachers, and carefully reviewed his medical and school records. It soon became clear that Jacob was dealing with some challenges at home. Jacob lived with his grandparents because his parents both struggled with addiction. There was also a family history of mental illness and domestic violence. Jacob’s presenting symptoms, the painful events leading up to his separation from his parents, and his family history of mental illness led the clinician to suspect that Jacob was suffering from depression. Knowing that depression tends to impact energy levels, internal motivation, and having a sense of purpose in life, this insight was a critical factor in understanding Jacob’s school attendance problems. Jacob’s clinician recommended that he be referred Jacob for further medical follow-up to recieve a * proper diagnosis and treatment. She also recommended enhanced support services to assist the whole family. She asked the Judge to provide Jacob’s teachers and service providers with a copy of her report so they could be made aware of the With a better understanding family’s needs. of his needs and with the proper treatment, there is reason to hope that Jacob will be feeling better soon. 5

Treatment ACS offers individual, family, and group treatment at no cost to the child or family. Treatment sessions are focused on self-identified issues and helping the child or adolescent find positive ways to manage life stressors. Psychoeducational treatment groups help kids learn the skills needed to understand and cope with the challenges they face. 239 “ ‘Grow Strong Without Notice’ is a phrase that sticks 182 with me because 239 a lot of people 52 underestimate me, and I do not believe in myself. But now I am starting to stand up for myself. Before I Group treatment Individual and family Hours of no-cost did not know I actually sessions held therapy sessions treatment provided conducted could.” – participant in the Motherhood Enrichment Program FUNDED BY: • You (our private donors) 6 *To protect confidentiality, ACS does not use the names, photos, or identifying features of our clients

Chloe* was 15 years old when she was referred to ACS through the Juvenile Diversion program. She had been charged with Assault and Battery after an argument with a peer escalated to a physical fight. Engaging in mental health treatment at ACS would mean the charge would be cleared from her permanent record. Chloe began individual therapy sessions with an ACS clinician right away. It soon became clear that Chloe’s behavior was a result of challenges she faced at home. Chloe lived with her mother, Jessica*, and her older siblings. Her father was incarcerated due to gang violence, which Chloe and her siblings witnessed while growing up. In treatment sessions, Chloe began to realize that her aggressive impulses were connected to her exposure to violence as a child and also linked to a strained relationship with her mother. Her clinician suggested that it could be beneficial for Jessica to join Chloe in therapy, but Chloe was adamantly against this. Her clinician patiently helped Chloe to understand that improving communication with her mom could ease tensions. In time, Chloe came to trust her clinician’s guidance, and she allowed her mom to join her in session. This shift empowered Chloe to verbalize her need for her mom’s support and to express how much she needed Jessica to really listen to her feelings. The clinician also provided support and guidance to Jessica to help her better understand and respond to her daughter’s emotional needs. Chloe * A few months after ending treatment, Chloe’s clinician followed up with the family. Chloe had engaged in no further altercations with her peers and shared that her relationship with her mother was slowly improving. It will continue to take time, but Chloe is clearly on a positive path forward. 7

Education and Advocacy Education & Advocacy for Children and Families - ACS developed the E&A Program to help children access direct mental health care and assist families in navigating the juvenile justice and child welfare systems. The program provides the following services: education of children and families about issues identified during the evaluation process, such as special learning needs or mental illness; advocacy for clients and assistance linking them with appropriate community services, such as medical care, mental health treatment, and in-home support for the family; and follow-up, with clients and providers, to help ensure that the recommended services are in place. 213 Education & Advocacy for the Court and Community - ACS has close ties with court personnel, schools, and community providers, who often turn to us with questions to help them better understand a variety of topics ranging from basic court procedures to kids and how to access mental health services. We educate providers about the needs of high- risk, court-involved children and advocate for enhanced services and support for families. families received OUTCOME Education & Advocacy 86% of children increased their compliance with treatment and recommendations services 85% of children improved their attendance at school or an alternative educational setting 87% of families became more engaged in treatment FUNDED BY: • You (our private donors) 8 *To protect confidentiality, ACS does not use the names, photos, or identifying features of our clients

Dylan’s* mother, Sarah*, turned to the juvenile justice system as a last resort when her son’s behaviors became dangerous and she feared she could no longer keep him safe. When Dylan arrived in court, the Judge ordered an Emergency Mental Health Evaluation in order to determine his immediate needs. An ACS clinician promptly met with Dylan and his mother to evaluate the situation and to determine the best plan for his safety. The ACS clinician realized the severity of Dylan’s mental health needs and explained the range of clinical options to Sarah. The clinician recommended that Dylan be placed in a Partial Hospitalization Program (PHP). This intensive treatment setting would provide a safe environment in which Dylan’s symptoms could stabilize while still allowing him to spend nights at home. While explaining this recommendation to Dylan and his mom, the clinician became aware of several obstacles to accessing this level of care for Dylan. Dylan’s Mass Health coverage had lapsed, rendering him ineligible for the PHP. Sarah spoke limited English and did not own a car. Arranging transportation to the hospital would be costly and scheduling appointments with her son’s treatment team meant arranging for an interpreter. The of children increased their compliance with treatment and recommendations clinician tackled each of these hurdles. Together, they called Mass Health and the Department of Children and Families to reinstate Dylan’s health insurance. The clinician provided Sarah with an MBTA pass and explained of children improved their attendance at school or an alternative how to get to the hospital via public transportation. She also called educational setting the hospital to schedule the intake interview and arranged for an interpreter to be presentfor Sarah when they arrived. Dylan * Sarah and Dylan, like many of the children and families we of families became more engaged in treatment serve, face multiple challenges when accessing care and resources. The Education and Advocacy services at ACS enable our clinicians to devote additional time to families to ensure they have the information they need to access A few weeks after their initial meeting, appropriate services for the ACS clinician followed-up with Sarah and Dylan their child. and learned that Dylan had been admitted to the PHP and was making meaningful strides in treatment. 9

ACS Staff SUSAN FLOOD Ph.D., CJCC I, CJCC II, CJCC I Mentor Fourteen years with ACS, at Framingham and Cambridge sites. What is most important to you in your work with court-involved kids? Helping a child learn the tools they need to find success. Our diverse, What makes this work challenging? interdisciplinary Some people are quick to negatively judge a child or family team of licensed that they simply don’t understand or who is different than social workers, them. mental health What is a talent or skill that you bring to the work you do? My willingness and openness to connect with children and counselors, and adults who are struggling and in pain. And, of course, my psychologists sense of humor. is one of our greatest Fun Facts: strengths. • Born, bred, and still resides in Cambridge, MA • Went to Smith College • Loves Reggae music 10

AMY SANTANA FELICITY TURGEON LMHC LICSW, CJCC I One year with ACS, Seventeen years with ACS, at Cambridge site. at Lowell site. What is most important to you in your work with court- What is most important to you in your work with court- involved kids? involved kids? I want the adolescents I work with to understand that they Giving children a voice. We provide them with a safe and have some agency in their lives. They ultimately have control supportive space where they can share their perspectives, over their future and are at a crucial point where making a thoughts, feelings, and opinions. positive choice today can change the direction of their lives. What keeps you motivated? What keeps you motivated? The little things, like seeing a child smile and relax when When a child or adolescent chooses to participate in they feel heard and understood. There are these wonderful treatment, they begin to see what’s possible for their future. moments when you can tell that a child just caught a glimpse Just knowing they have options can make a difference in their of hope in what they thought was a hopeless situation. actions, even when they are facing incredible challenges. What is a talent or skill that you bring to the work you do? Why did you choose to work in the field of child and Compassion. I believe every child and family deserves the adolescent counseling? opportunity to live a happy and fulfilling life. While in college, I volunteered with a theater group called “Reality Check”. We traveled to middle and high schools performing educational skits on substance use, safe sex, Fun Facts: bullying, etc. Each skit was followed by a question and answer session. Facilitating these tough and necessary conversations • First job after graduate school was at ACS sparked my desire to pursue youth counseling. • Wanted to be a vet when she grew up....until Fun Facts: she encountered an injured animal and panicked • Loves to read historical fiction • Wanted to be a singer, actress, fashion designer, AND a journalist while growing up • Born in Santo Domingo, Dominican Republic and moved to Boston as an infant so that her father could attend Berklee College of Music 11

ACEs: Adverse Childhood Experiences The Centers for Disease Control and Prevention (CDC) examines the connection between childhood exposure to ten types of trauma and stress that can lead to significant and potentially deadly health risks. 50% Number of ACEs in youth nation-wide vs population PERCENTAGE OF YOUTH 25% served by ACS National Average * ACS population ** *Based on ACEs Study conducted by the CDC 0% **159 total ACEs questionaires from ACS clients 0 1 2 3 4+ NUMBER OF ACEs PREVALENCE OF ADVERSE CHILDHOOD EXPERIENCES Emotional Abuse Physical Abuse Sexual Abuse Emotional Neglect Physical Neglect Mother treated violently Household substance abuse Household mental illness Parental separation/divorce Incarcerated household member 0% 50% 100% 12

MAJCC: sustaining essential services ACS is proud to be a founding member of the Massachusetts Alliance of Juvenile Court Clinics (MAJCC). Below are some of the many highlights from the past year: SUSTAINED FUNDING IN FY18 STATE BUDGET MAJCC lobbied for an increase in funding for the Juvenile Court Clinics. The Senate Committee on Ways and Means provided an increase specifically for the Juvenile Court Clinics, which unfortunately, did not prevail. However, the documented record of increased support represents greater leverage when seeking increased funding during the FY19 State Budget process. CRIMINAL JUSTICE REFORM LEGISLATION The Legislature engaged in an ongoing debate regarding changes in juvenile justice legislation. Changes in the age of juvenile jurisdiction were considered based on research advances in understanding adolescent brain development. MAJCC Co- Chair, Rebecca Pries, attended meetings with the Chair of the Senate Judiciary Committee and joined a panel of experts at a Legislative Hearing where she gave testimony on raising the lower age of Juvenile Court jurisdiction. MAJCC remains a strong and vocal advocate for changes to criminal justice legislation that will better support children and adolescents. PREPARATION FOR THE IMPACT OF CRIMINAL JUSTICE REFORM LEGISLATION MAJCC is at the forefront of meetings and dialogue across the state to ensure that the juvenile court clinics are equipped to respond to any legislative changes that are ultimately instituted. They are planning and preparing for how legislation to raise both the lower and upper ages of juvenile jurisdiction will affect the children and families involved with the Juvenile Court Clinics. 13

Fall Event ACS friends, donors, and supporters gathered to honor OCTOBER 19, 2017 Peter J. Koutoujian, Middlesex County Sheriff, and Barbara Leggat, ACS Advisory Council Member, for their commitment to helping some of the most disadvantaged kids and families in the Commonwealth. Barbara Leggat’s Family Barbara Leggat, Leah Kelly, and Sheriff Peter J. Koutoujian Bill Paine Jacquie Kay and Michael Lafleur commitment to helping Rebecca Pries and Terrie Graham 14

Financials FY2017 From the most recent audited fiscal year: July 1, 2016 – June 30, 2017 FY17 FUNDING SOURCES OPERATING REVENUE Public Sector $1,073,238 Corporate and Foundation Grants $245,452 Individual Contributions $85,401 Investment Income $153,740 In-kind $98,800 Other income $25,741 TOTAL $1,682,372 Barbara Leggat’s Family FY17 PROGRAM EFFICIENCY OPERATING EXPENSES Program Services $1,311,976 Management and General $190,842 Fundraising $60,596 TOTAL $1,563,414 Rebecca Pries and Terrie Graham 15

FY17 Donor List Thank you for empowering court-involved kids and their families. ACS is extremely grateful to all of our generous supporters. This list highlights donors whose financial contributions were received during FY17 (7/1/2016-6/30/2017). LEADERS Forest Foundation Edward H. Mank Foundation GIFTS OF $10,000+ Roy A. Hunt Foundation Martin Fund at the Boston Foundation Marion F. Boynton Trust Elizabeth Keating Fran and Hugh Miller Cogan Family Foundation Barbara Leggat Richard P. and Claire W. Morse Cummings Foundation John Petrowsky Foundation Nancy Donahue Beth K. Pfeiffer William and Margaret Paine Eastern Bank Charitable Foundation Wendy Shattuck and Sam Plimpton Deborah Porter The Janey Fund Gardiner Howland Shaw Foundation Carolyn and Frank Reynolds Klarman Family Foundation TJX Companies, Inc. Karen Richards Thomas E. Leggat Trust Mary and David Shahian ADVOCATES Ludcke Foundation GIFTS OF $1,000-$2,499 Vivian M. Shoolman Lia G. and William Poorvu Jane and Ben Siegel Judith Aronstein Family Foundation Stevenson Family Charitable Trust Rhoda Baruch Public Sector David Wilcox and Charlotte Pierce Molly Beard Department of Mental Health Ann W. and Donald A. Brown ALLIES Massachusetts Juvenile Court GIFTS OF $250-$999 Cambridge Trust Company CHAMPIONS Cosette Charitable Fund Richard and Bonnie Barnum GIFTS OF $2,500-$9,999 Anne Covert Pete and Sara Caron Anonymous Susan Culman Mary K. Eliot Trustees of the Ayer Home Thomas and Andrea Dupree Terrie Graham Cambridge Community Foundation East Cambridge Savings Bank Jonathan Hecht and Lora Sabin Bushrod H. Campbell and Charles and Sara Goldberg Julian Houston Adah F. Hall Charity Fund Charitable Trust Alison P. and Dan Jaffe James Champy Mr. and Mrs. Stephen P. Heney Rudolph Kass Ann Collier Daniel Jacobs and Susan Quinn Leah M. Kelly Mary W.B. Curtis Trust Amalie Kass T. Ross Kelly Robert W. and Evelyn H. Doran Margo Kelly Ann Macomber Fish Family Foundation Barbara Lee John and Kristin Macomber 16

Susan and Pieter Mimno Robyn Eastwood Sandrine Medeiros Linda Myers Ron and Debbie Eastwood Ellen G. Moot Martha Ondras and Martin Pearlman Margaret Fearey Katherine Page and Alan Hein Tim and Joanne Oyer Fiduciary Trust Company Shirley Partoll David and Shirley Parish Susan Flood Joan H. Perera Mathilde Pelaprat and Peter and Kathleen Forbes Ellen Poss Kristen Van Damm Nancy and Richard Fryberger Jane Prager Katharine and Tony Pell Gail Garinger Rebecca and Weldon Pries Gary and Mary Pforzheimer Jacques and Margaret Gelin Catherine Riffin and Patrick Smith Jonathan and Amy Poorvu Dori Gerber David and Deirdre Rosenberg William and Helen Pounds Owen and Miriam Gingerich Stephen Rosenfeld Robert Pozen Robert Gittens and Dan Sanford Laura Prager and Frederick Millham Donna Latson-Gittens Lynda Schubert Pam Riffin Greystone and Company, Inc. Maggie Schulz Abby Rockefeller and Lee Halprin E. James Gruver and Kara Gruver Edward A. Shapiro and Debbie Benik Robert Silberman and Nancy Netzer Bethany Hadley Robert Shapiro Richard Wenger Suzanne and Easley Hamner Claude and Elizabeth Smith Marilyn and Irvin Yalom Howard Hiatt Maura Smith Lissa and Melville Hodder State Street Foundation SUPPORTERS GIFTS UP TO $250 William and Kay Hudgins Edward Stern Katherine and Ralph Hughes Robert Straus AmazonSmile Foundation David and Emily Hutcheson John and Judy Styer Sandy Bakalar Judith Hyatt and Fred Goldstein Charlotte and Peter Temin Jay Blitzman Jacquie Kay Katharine Thomas Sara Bursac Lawrence Kotin Myra and Richard Vonturkovich Paul and Katie Buttenwieser Thomas and Vera Kreilkamp Mark and Lynne Wolf Andre Caron Sam and Emily Leadholm Esther Chen Teresa Lopes and Denise Lotufo Colleen Clinkscale and Tim Lynch Joe and Rachel Martin Ellen Cohen and Daniel Haber Joyce and Dan Maxwell thank you! Grace Conway Joseph McOsker Alice DeLana 17

BOARD OF DIRECTORS ADVISORY COUNCIL Frances H. Miller, President Gerald Chertavian William H. Paine, Chair Roxann C. Cooke Jacquie L. Kay, Treasurer Nancy L. Donahue Jane R. Siegel, Clerk Robert Gittens Terrie Graham Joel Goldstein Daniel H. Jacobs Silvia M. Gosnell Elizabeth Keating Fatinha R. Kerr Leah M. Kelly Barbara Leggat Michael A. Lafleur Charles J. Ogletree, Jr. Lia G. Poorvu Kathy Pilarski Laura M. Prager Jorge Quiroga Mary M. Shahian Eggert Ragnarsson Charles K. Storey “Chip” Katharine E. Thomas David K. Wilcox Kathan Tracy ADOLESCENT CONSULTATION SERVICES, INC. 189 Cambridge Street, Cambridge, MA 02141 T 617.494.0135 F 617.494.0136 www.acskids.org /acsinckids @acsinckids