From its start—out of a little red barn in Kirksville in 1979—Preferred Family Healthcare has provided longterm substance abuse services to adults in need. Since that time, the organization and its services have grown tremendously throughout Missouri and Kansas, with expanded care reaching young people in the forms of both prevention and treatment. One of the nonprofit’s efforts that is making a big impact in St. Louis is Team of Concern, a prevention, education and early-intervention program related to substance abuse primarily for students in middle school. “We started Team of Concern in the Ladue and Jennings school districts in November 2008 through a grant from Missouri Foundation for Health,” says Jean Sokora, who is a school teams liaison for Preferred Family Healthcare in Town & Country. “Missouri Foundation for Health has really paved the way for these services in St. Louis County—it’s sort of a front-runner in this field, and its support of what we are doing is very exciting.”

Sokora says Team of Concern provides various levels of prevention to students who have never used alcohol or drugs before, starting with its universal prevention, which is classroom-based education on alcohol and other drugs. The materials may also be presented at a school assembly or distributed at a booth in the school cafeteria. “We mostly stick with alcohol and marijuana because those are the drugs that most kids know about,” Sokora notes. “Sometimes a school asks for specific information or wants something other than our usual curriculum, like abuse of prescription drugs, which we know is on the rise.” Recently, Team of Concern visited a seventh-grade health class at Ladue Middle School. “They had just finished studying alcohol and other drugs, and then we came in and followed up with lessons on peer pressure,” she continues. “Often times, we have a huge banner on which all the students sign a pledge to be alcohol and drug free.”

With Team of Concern, Sokora explains that a staff is assigned to a district in order to establish a certain level of comfort between students and staff. “The staff is able to meet with students at their school, so they know one another,” she says. “We had a student at Ladue Middle School approach one of our staff members with a problem. That student sought out services as opposed to being referred by an adult—the familiarity really put the student at ease.”

Sokora speaks highly of a program through Team of Concern called Achieving Recovery Through Creativity (ARTC), which encourages students to use different mediums of art to express themselves. “We offered a six-week ARTC class last summer at the Ladue School District’s summer school program,” she notes. “We’ve had some really neat things happen as a result of it—it’s just a cool, innovative program that both the Ladue and Jennings districts have jumped on board and have been open to using.”

According to Sokora, Team of Concern also uses targeted prevention with groups of at-risk students. “In a five- to six-week group module, we provide information dealing with resiliency and refusal skills and more intensive-targeted drug education, giving that group of kids just a little more of a boost,” she explains. “We also do an individualized intervention when a student is really at risk. It’s a 16-week program that provides intensive education and intervention.”

A more specialized, direct assessment tool, Summary of Concerns, considers basic behavior, appearances and situations that might be present in the life of a child who is thought to be more at risk than others, Sokora notes. “Indicators can be a real mix of things,” she says. “Kids may suddenly change their friends, their appearance or their grades have dropped. Or maybe there’s been some kind of event in the home, like a separation. In these socioeconomic times, we’re seeing a lot more at-risk behaviors from kids because there’s a lot of trauma in the home, such as a parent losing a job. So we do a comprehensive assessment where we look at these domains, asking targeted questions to determine if the child is at risk for substance use.”

For someone who has more than experimented or is already looking at abuse of substances, Sokora says that Preferred Family Healthcare has outpatient substance abuse programs in St. Louis County funded through Children’s Services Fund and residential treatment in St. Charles County funded through the Department of Mental Health. “We have a full continuum of care so that when our clients come out of residential treatment they can step down into our outpatient programs,” she explains. “Once they’re back at school, we can follow up with them and give them more support. It’s really exciting because there isn’t a continuum of care like this anywhere else in St. Louis.”

With Team of Concern in 11 school districts in St. Louis County, Sokora says the nonprofit’s hope is that, as it becomes more established and continues to experience success, other districts in the area will want to have the Team of Concern in their schools. “And another hope,” she continues, “is to bring new and innovative practices in terms of the field of prevention and substance use issues to our area.”