​Project Report

By Meena Venkataramanan

​​To those unfamiliar with the Spanish language, “sin puertas” sounds like a nonsensical arrangement of consonants and vowels strung together to make two words. But to those who understand its gist- “without doors”- the phrase takes on an entirely different meaning. The words “sin puertas” denote openness and easy access, which is exactly what Sin Puertas, a program of Pima Prevention Partnership (PPP) and Tucson behavioral health center that focuses on youth substance abuse treatment and recovery, intends to provide: an open environment and easy access to treatment and recovery resources for teenage victims of substance abuse.

On June 24, 2016, I got the opportunity to meet Charlie Alcaraz, the clinical director at Sin Puertas, and learn about the program as well as tour the facility. I was immediately impressed by the wide variety of helpful resources available to visitors as soon as they walk through the entrance. Brochures about dating safety, coping with stress, birth control, drug use, suicide prevention, and safe sex were displayed on the waiting room side tables and on a rack of their own, creating a safe haven for teenagers who are enrolled in Sin Puertas, quite literally, from the very beginning.

Charlie Alcaraz and I met in one of the teen lounges, where clients go to hang out and relax in a safe space. Positive messages decorated the walls, and a “feelings thermometer” poster was taped to the wall, which teens can utilize to rank how they’re feeling from “silence” to “ecstatic.” Beanbags were perched on the floor, and board games adorned the shelves. It was comforting.

Alcaraz has been working with the PPP for thirteen years. He mentioned that at Sin Puertas, “90% of the kids are in probation,” and demonstrate risk-taking behaviors. To him, these risk-taking characteristics are fascinating, because he can use them to encourage teens to take “healthy risks” instead of resorting to substance abuse. When I asked him to tell me about the program, he explained that there are about “a dozen evidence-based treatment models” that Sin Puertas uses to combat substance abuse among teens. “Everything we use is backed up by research,” he affirmed, “whether that’s therapy, support, or prevention.”

A typical day at Sin Puertas is filled with both fun and productivity. Around 3 p.m., teens start arriving at the center and stay until 8 p.m. “They usually congregate in the game room, where they can shoot pool or play ping-pong,” remarked Alcaraz, adding that “they might casually chat with staff” as well. The goal is to make teens feel comfortable before therapy begins. Four nights a week, meals are offered to teens as well as part of the program. “The one thing that makes Sin Puertas different than other centers is that we have a clubhouse feel,” said Alcaraz. Upon touring the facility, I couldn’t help but agree.

Before counseling sessions begin, the teens get a chance to talk about their day and how they feel (which is when the feelings thermometer comes into play). They also answer the thought-provoking question of the day, which recently was, “What was the last thing you did for the first time?” One teen mentioned that he had his “first clean drop” recently- a proud moment for not only himself, but also his family, peers, and staff at Sin Puertas. Sessions also include motor activities, because “getting teenagers physically engaged” is important. The night continues with social activities that shape behavior and language skills, as well as productive group discussions and brainstorming. When I remarked that the sessions sound engaging and fun, Alcaraz responded, “If it’s not fun, we’re not working.”

Although each client is different, there are a few key similarities that many of them share. Because most of the teens enrolled in Sin Puertas are involved with the justice system, the population closely reflects that of the justice system- about 80% males and 20% females. The majority of the clients have a family history of substance abuse, come from single-parent homes, live with grandparents, or are in foster care. “Only 20% of them live in traditional, fully intact families,” said Alcaraz, when I asked about the client demographic at Sin Puertas. Many teens at Sin Puertas have also experienced some form of trauma, including sexual abuse, physical abuse, or abandonment. They often start using drugs or alcohol at twelve years of age, but habitual patterns develop later on.

When I asked what the biggest challenge teens at Sin Puertas face with respect to overcoming drug and alcohol abuse, “motivation” was the answer I got. At Sin Puertas, there is a strong emphasis on self-motivation. Instead of forcing teenagers to quit using drugs and alcohol, Sin Puertas staff want them to realize the drawbacks of using on their own. Alcaraz’s catchphrase with respect to substance abuse is, “If it’s okay with you, it’s okay with me.” He translated: “if the negative circumstances in your life due to your substance abuse are okay with you, they are okay with me.” He essentially wants teens to realize that, ultimately, “it’s their life,” and they have to make decisions on their own. That being said, Sin Puertas’ goal is to help put their clients on the right track again by getting them to link their substance abuse with the negative circumstances in their lives and make their own decision to stop using. Motivational interviews are common in order to ask teens whether their passions align with their substance abuse, and if not, help them stop using. “The program is very nonconfrontational,” said Alcaraz.

Sin Puertas has a 70% successful completion rate, which, Alcaraz cautioned, does not always equate with complete sobriety. Sometimes, successful completion means decreasing the amount and frequency of substance use, or going from, say, frequent heroin use to occasional marijuana use. It’s not perfect, but it’s a start. For others, however, total termination of substance abuse-related activities is achieved. For example, Alcaraz recalls a young man who was on Juvenile Intensive Probation Services- the highest form of probation- and had recently come back from residential treatment. “He lived with his uncle and had a limited support system, and was also entrenched in a group of young people who consistently used drugs and alcohol. After coming to Sin Puertas, he connected with a couple of staff members immediately and started to have fun at counseling sessions. After six months, he completed the program and was completely sober. Now, he is 23 years old and has been checking in with us every month since he completed the program. He still asks staff members for life advice, and now is a great dad who is raising two kids.” That is just one example of a success story at Sin Puertas.

Here, feedback from youth is important. Follow-up interviews with former clients are conducted every six months, and usually, “significant decreases in substance abuse and increases in mental health” are seen. There is also a youth leadership council, called “FreeMind,” at Sin Puertas, that participates in annual focus groups where it provides feedback to the management staff and helps shape new treatment strategies.

And at Sin Puertas, there is a holistic approach to clients. For example, there is a bike shop located within the facility, where teens can learn employment skills and apply them through building and repairing bikes. Teens can even get paid to work in the shop, and, upon completing the Sin Puertas program, may be rewarded with the opportunity to build and take home their own bike. In this way, teens are not only provided an alternative to substance abuse, but are also taught valuable mechanical skills that can prove to be an asset when searching for a job in the near future.

When I asked Alcaraz what advice he has to teens who face a constant pressure to try drugs and alcohol, he mentioned that they should reflect on whether using drugs and alcohol will “help them achieve their goals or not.” As for teens who want to help make a difference by promoting awareness and prevention of youth substance abuse, Alcaraz believes that “creating other avenues of engagement for young people” is important, especially for risk-taking youth who seek out new adventures. Providing safe, adventurous activities that are easily accessible to youth within the community is a great way of preventing youth substance abuse. After all, easy access is key, and is exactly what Sin Puertas, its name literally translating into “without doors,” hopes to provide.

Sin Puertas Visit: JUNE 24, 2016

Thank you to Charlie Alcaraz from Sin Puertas for making this visit and project possible. For photos from the visit, click here.

Project Details

Where: Sin Puertas, a program of the Pima Prevention Partnership, in Tucson, AZ.
When: June 24, 2016
Who: Charlie Alcaraz, Clinical Director
Objective: Learn about local youth substance abuse prevention efforts in order to educate peers about youth substance abuse prevention.
Takeaway: I received inspiration for how to spread awareness of youth substance abuse and discovered a good resource for youth substance abuse prevention. I also received a tour of the facility and got to witness prevention and recovery efforts in action.

For more photos from the visit, click here.