Clinical Services
DYS Clinical Services are fully integrated into the DYS Continuum through state and contracted provider employees to care for and provide behavioral health services to detained and committed youth within residential programs and community placement. The Clinical Department relies on evidence-based clinical practices, individualized assessments, collaborations between all direct care teams, and, when necessary, external state agencies and specific consultants to provide the best care possible for our youth. These practices are woven through the continuum and inform clinical work from initial intake to youth transition into young adulthood. The clinical department across DYS comprises both state and contracted provider employees.
Overall Clinical Services
DYS completes a thorough clinical intake with every youth entering our care. Every youth is assessed in various categories of behavioral health, including substance use, history of trauma, suicide, and aggression risk, as well as risks, needs, and responsivity factors related explicitly to delinquency. Tools administered include the Detention Placement Recommendation (DPR), the MAYSI-II (MA Youth Screening Instrument), and the Prison Rape Elimination Act (PREA) Questionnaire. All committed youth are assessed for substance use utilizing the Juvenile Automated Substance Abuse Evaluation (JASAE) to determine if they receive prevention or treatment services. Committed youth are also assessed on the YLS/CMI 2.0, Clinical Attitude Battery (CAB), Mississippi PTSD-Civilian Version, Limbic Scale Checklist -33, Adverse Childhood Experience Scale (ACES), and receive a comprehensive biopsychosocial clinical assessment. These tools are utilized to assess behavioral health needs, risk for re-offense, and protective factors and are integrated into a comprehensive assessment, called the DYS Clinical Assessment of Needs, that helps determine the most appropriate treatment plan for youth.
DBT as the Primary Therapeutic Model
Dialectical Behavior Therapy (DBT) is the primary therapeutic model used in residential placement, providing structures for individual and group therapy and the principles and practices that comprise the program’s Behavior Management Systems. DBT aims to validate young people and their families, helping young people to accept their emotions, thoughts, and behaviors and feel seen and understood within their community and cultural context. Mindfulness and Distress Tolerance skills enable youth to recognize and cope with social and emotional difficulties.
Treatment Goals Assessed by the YLS/CMI 2.0
Treatment goals in DYS are driven by risks, needs, and responsivity factors assessed by the YLS/CMI 2.0. They are developed to support a safe and efficient transition from programming to community placement.
Clinical Service Range
DYS Clinicians provide a range of clinical services, including Assessment, Individual Therapy, Family Therapy, Group Therapy/Skills Training, Clinical Case Management, and Coaching in the Residential Milieu and/or Community. Licensed Clinicians working in Detention may conduct 68a Evaluations upon request by the courts, assisting judges in understanding a court-involved youth’s unique background, struggles, and strengths.
Clinicians working in Treatment and Revocation may coordinate services and engage in consultation with sister state agencies, including the Department of Children and Families, the Department of Mental Health, the Department of Developmental Services, and the Department of Public Health.
Educational Services
Providing high-quality, equitable education to DYS youth is a primary focus of the Department of Youth Services (DYS). Research shows that positive educational experiences and academic achievement significantly foster positive life outcomes for our youth. We aim to deliver a comprehensive education program aligned with state educational requirements that addresses the unique strengths, needs, and aspirations of the youth in our care and custody. Under the leadership of the DYS Director of Education, DYS collaborates with partners, including the Collaborative Educational Services (CES), the Department of Elementary and Secondary Education (DESE) (including Special Education in Institutional Settings (SEIS)), local public schools, community-based organizations, and families to meet youth where they are and support their educational attainments.
Comprehensive Program
DYS, in partnership with the Collaborative for Educational Services (CES), provides a structured and comprehensive education program aligned with the rigorous curriculum standards of the MA Department of Education (DESE). Our educators teach students of diverse ages, grade levels, reading abilities, languages, learning capacities, trauma histories, and educational backgrounds in each of our classrooms. Despite these challenges, our youth consistently achieve academic milestones. They take and pass high school coursework, advance to higher grades, earn high school diplomas or equivalency diplomas (HiSET), enroll in postsecondary education, and explore career opportunities.
Curriculum, Instruction, and Assessment
DYS through CES provides a standards-based secondary education program that meets the Massachusetts Department of Elementary and Secondary Education (DESE) 's curriculum, instruction, and assessment requirements.
Our instructional model is designed to be flexible, culturally responsive, and personalized, meeting the diverse needs and experiences of the youth we serve. The school year academic calendar provides 5.5 hours of structured learning daily, including:
- A minimum of three hours of core content instruction
- Targeted support in reading and mathematics
- College and career readiness seminars
- Enrichment programming in health, wellness, art, and other approved electives
- Longer-term detained youth may also access HiSET preparation, career readiness, and college-level coursework.
Curriculum and instruction are guided by ongoing assessment, ensuring that teaching strategies and learning materials reflect each student’s progress and potential. Technology is integrated throughout to create engaging learning experiences that help students develop academic skills, build confidence, and strengthen their sense of agency. This layered approach guarantees that every youth has access to high-quality instruction, equitable learning opportunities, and the supports needed to succeed during and after their time with DYS.
Summer Programming
In addition to the traditional school year, DYS offers a six-week summer program that runs four days per week. All DYS youth in residential placement are required to attend summer programming if they have not achieved high school attainment. It provides academic enrichment tailored to each youth’s needs, such as HiSET Academy, MCAS Math and Science remediation using ALEKS Math and STEM-focused curricula, and ELA reading and literacy instruction in the morning. The afternoon features a selection of electives designed for various programs and project-based, interest-driven activities that develop valuable career readiness skills and competencies.
Classroom Environment
In a DYS setting or program, the classroom environment is structured yet supportive and designed to address the unique needs of our youth. Our classroom environment is focused on providing stability and individualized attention to help students who may have experienced trauma or inconsistent education. Classroom teachers are supported by residential program staff during the school day, including clinicians, nurses, and juvenile justice youth development specialists. This support bridges education, well-being, and security, which is conducive to creating a positive learning environment. Class sizes are generally small to foster personal relationships between students and teachers, allowing for tailored instruction that meets academic and emotional needs. The curriculum often includes standard academic subjects, life skills, social-emotional learning, and vocational training.
Post-secondary Education
DYS promotes college access and success for its eligible students. Through the DYS College Program, youth in residential and community placements may enroll in contracted college classes with Berklee College of Music, Massachusetts College of Art and Design, Bristol Community College, and Urban College of Boston. Postsecondary students in the community may enroll at any approved postsecondary institution. Post-secondary and dual-enrolled students can earn college credit for the courses they pass and use it to pursue career and technical education programs or an associate’s degree.
Special Education Services
The Massachusetts Department of Youth Services (DYS) is committed to ensuring that all youth in our care, including those with disabilities, receive a high-quality education tailored to their individual learning needs.
The Department of Elementary and Secondary Education (DESE) provides special education services for DYS youth in residential programs through its Special Education in Institutional Settings (SEIS) program. DESE contracts with the Collaborative for Educational Services (CES) to deliver these services within DYS facilities.
Section 504 Process
Section 504 of the Rehabilitation Act of 1973 ensures that individuals with disabilities have equal access to programs and services. Following these requirements, DYS has a comprehensive 504 process to promote inclusive learning environments across our programs.
Title I Services
DYS partners with the Collaborative for Educational Services (CES) to provide a broad range of instructional support for eligible youth through the federal Title I, Part D program. Title I provides supplemental resources to help students meet state academic standards, transition successfully to community schools, and prepare for postsecondary education and employment.
Employee Assistance and Support Services
DYS Safety Administrator
Preventing and Responding to Incidents of Workplace Violence
Safety for youth and employees in residential programs, the community, and anywhere Commonwealth business is conducted is a priority for the agency. The DYS Safety Administrator works closely with the Research Team, Investigations Unit, Legal Unit, DYS Safety Committee, and key regional representatives across the state, focusing on ensuring Workplace Violence is appropriately identified and responded to, and that relevant policy and procedures around Serious Incidents, investigations, and the Workplace Violence policy and Crisis Response Plan are applied with consistency and equity.
Safety Council and Safety Committee
Safety Council, which chairs the monthly Safety Committee meetings, is comprised of the Senior Directors of Residential and Community Operations, the Senior Director of Systems Operations, the DYS HR Liaison, and the Director of Employee Assistance and Support Services. The Safety Committee addresses employee and workplace safety issues through surveys of safety and health hazards, reviews of agency safety measures, and recommendations on ways to improve employee safety, health, and wellness.
Strategic Plan/Safety Intervention and Prevention Subcommittee
The focus of the work was to assess if the repair process was fair and equitable across programs and regions; determine if there should be standards, guidelines, or general expectations; and decide whether the repair process incorporates restorative principles and practices and reflects DBT and PYD concepts consistently; and prepare a set of recommendations based on that information. As a second step in this review and analysis, a draft of Statewide Practices for Youth Completing Repairs and Process for Completing Repairs Following a Change in Placement was developed.
Employee Assistance and Support Services
In FY24, DYS established three additional positions – Trauma Response Specialists (TRS) to support this work in residential and community locations across the state. In FY25, the Trauma Response Specialists became Employee Assistance Specialists (EAS) within the DYS Support Services Division, under the Director of Employee Assistance and Support Services, as part of the new Employee Assistance and Support Services Unit. The Employee Assistance Specialists’ work now focuses on Specific Incident Response, Direct Support, Racial Equity and Inclusion, and the Development and Facilitation of Workshops, as part of a broader, more proactive approach to foster employee wellbeing.
Health Services
Youth in the juvenile justice system are a high-risk population and have unmet physical, developmental, and mental health needs. Youth of color typically come from medically underserved backgrounds, are overrepresented within DYS residential programs, and as a result present to the Department with a range of physical and mental health conditions, which have not had the benefit of consistent community-based medical management before admission. In addition to integrated primary and behavioral health care, DYS Health Services utilizes public health prevention and intervention strategies to promote overall well-being and to address health disparities among juvenile justice-involved youth. DYS Health Services staff also provide infection prevention and control in DYS residential facilities.
DYS Health Services Central Office staff consists of the Director of Health Services and the DYS Medical Consultant. The DYS Director of Health Services oversees and manages DYS Health Services' statewide operations. Through partnership with UMass Chan Medical School’s Health Consulting, the DYS Medical Consultant works with the Director of Health Services to oversee the quality of health care provided by Health Services' regional contracts. The Director of Health Services and the Medical Consultant review DYS medical protocols, policies, and standards of care in collaboration with the regional Health Services staff, for effectiveness, agreement with current evidence-based recommendations, and evolving Medicaid requirements. They work with staff to revise current health policies and develop new policies as needed. The Director of Health Services and the Medical Consultant provide technical support to regional Health Services providers as needed for day-to-day operations. They also participate as needed in the determination of youth medical needs in individual cases. They adopt healthcare-related federal and state guidelines and mandates for agency use. The Health Services Central Office is responsible for ensuring that the appropriate linkages are in place with contracted and community-based healthcare practitioners to provide DYS-involved youth with the necessary access to emergent, urgent, and routine healthcare.
Health Service Providers
The DYS interprofessional health care team includes a diverse group of contracted healthcare providers and state staff (pediatricians, nurse practitioners, registered nurses, psychiatrists, psychologists, clinical social workers, dietitians, and other health professionals). Health Services staff remain up to date in mandatory trainings, including Prison Rape Elimination Act (PREA) Standards, required licensure trainings, and ad hoc trainings on timely health topics affecting the DYS population.
Each of the five DYS Regions is serviced by an individual Health Services contract.
Primary Care
Primary care is provided through DYS Health Services contracts and is delivered by a team of pediatricians, certified pediatric nurse practitioners, physician assistants and registered nurses with specific expertise in the treatment of children and adolescents. Primary care is provided in accordance with the American Academy of Pediatrics (AAP) guidelines, including Bright Futures Standards for Primary Care and the MassHealth Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Medical Protocol and Periodicity Schedule. There is an emphasis on youth wellness, continuity of care, health care coordination and transition to community. Additionally, the youth receive trauma-informed and culturally appropriate health services.
Chronic Conditions
A large proportion of youth admitted to DYS have chronic medical conditions. In fiscal year 2025, the most common medical conditions among youth enrolled in DYS residential programs included ADHD (40%), other mental illness (9%), asthma (24%), medication allergies (13%), and obesity (12%). In FY2025, 87% of youth admitted to DYS were found to have a level of substance use serious enough to assign them to DYS’ Substance Use Treatment Track. In addition, around 1% of the total youth population was diagnosed with hypertension, 2% had severe caries, and 24% needed corrective lenses. In FY2025, DYS Health Services also provided care for three youths with diabetes and six youths with seizure disorders.
Telemedicine/Virtual Services
DYS has used a telemedicine program since March 2020 which allows healthcare providers to deliver clinically appropriate medical services to youth in DYS care and custody via telehealth. DYS psychiatrists, clinical nurse specialists, or psychiatric mental health practitioners may conduct follow-up psychiatric visits via telehealth if their ability to travel to programs is limited. Youth who have behavioral health practitioners or need specialty care for medical needs can continue treatment with community providers via telehealth visits.
Nutrition Services
Substance Use Services
DYS Substance Use Services Department is an essential support for our youth and employees due to the high level of substance use by DYS youth and the evolving needs and services around substance use and misuse. The Director of Substance Use Services is established through a contract between DYS and the Institute for Health and Recovery (IHR). IHR has partnered with DYS for nearly two decades to consult, manage, and promote substance use services, and also contracts with the Bureau of Substance Addiction Services (BSAS) of the Department of Public Health (DPH). The DYS Substance Use Services Director collaborates with the DYS Health Services Department, Director of Clinical Services, Regional Clinical Coordinators, Residential and Community staff, and external agencies such as BSAS and DMH on specific individual youth cases, overall training, policy, and process, identifying substance use treatment, harm-reduction approaches to youth, and new community resources.
DYS's approach is to provide substance use prevention, intervention, and treatment that is both realistic and optimistic, recognizing that wellness is our ultimate goal.
The DYS Policy on Youth Substance Use Assessment, Prevention, and Treatment seeks to enhance public safety and the health and welfare of DYS youth by educating all youth concerning the impact of substance use, identifying youth with substance use disorder treatment needs, ensuring youth committed to its custody receive appropriate substance use disorder treatment, and monitoring treatment plan compliance.
Substance Use Prevention and Treatment
About 87% of committed youth currently end up on the Treatment Track, and about 13% end up on the Prevention Track.
From 2016 to 2025, the percentage of youth identified as being on the Treatment Track increased from approximately 75% to 87%, while the number of youths on the Prevention Track dropped correspondingly. We believe that this is due to several factors, including the older mean age of DYS youth, the increasing complexity of behavioral health challenges our youth suffer from, and the normalization of cannabis use in the larger community.
The READY Program
The READY (Recovery, Engagement, and Alliances with DYS Youth) Program is a collaborative effort between the Bureau of Substance Addiction Services and the Department of Youth Services to provide specialized substance use case management for at-risk youth and young adults committed to the Department of Youth Services.
Program goals are to:
- Reduce substance use, to reduce delinquency by individuals receiving program services
- Improve school performance and attendance among individuals receiving program services; and
- Improve employment readiness and job placement among individuals receiving program services.
The READY program operates in 3 DYS regions: the Western, Northeast, and Southeast Regions. During Fiscal Year 2025, the total number of young people served was 75.
| Date published: | April 23, 2026 |
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