Practice Profile

In 2002, the documentary "Devil's Playground" wreaked havoc on the heart of northern Indiana Amish country by portraying Amish teens as uncontrolled drug and alcohol abusers. Embarrassed by the attention the film brought to the town of Shipshewana, Ind., and concerned for the well-being of the area's Amish adolescents, town manager Norm Kauffmann encouraged community leaders to do something few Amish want to do: Seek outside help.

They did, in the form of clinical psychologist James Cates, PhD, and Indiana University–Purdue University, Fort Wayne, nursing professor Linda Graham. The Amish Youth Vision Project they launched in 2006 offers alcohol and drug education through eight weekly, two-hour counseling and education sessions for small groups of Amish teens, typically age 16 to 19. That's the time when Amish youth enter "rumspringa," or running around, a period of exploration that often involves the use of alcohol, limited drugs and other "English" or non-Amish vices before they decide whether to be baptized in the Amish church.

The transition to adulthood can be challenging for any adolescent, but among Amish teens the shift takes place very rapidly because these youth often have little experience outside their communities. As a result, the project designers could not just build off other models of drug and alcohol education, such as Drug Abuse Resistance Education, or DARE, Cates says.

"Most programs assume a gradual trajectory into alcohol and drug use: occasional use with peers, a stolen cigarette here or there, a beer or two on the sly," he says. "They do not assume the first experience will be a party with peers at age 16, which may last all night and involve heavy drinking, and that this can be the norm for drinking for several years."

That's why the project's counseling sessions are co-led by young adults who have already been baptized into the Amish church. These leaders speak Pennsylvania Dutch and act as a bridge between the Amish youth and their non-Amish counselors when it comes to dealing with some of the program's more emotional topics, such as communicating with parents or resisting peer pressure.

"The Amish learn at a very early age to keep a flat expression and not portray emotion when they're dealing with the English and they're uncertain," Cates says. "It takes someone who's Amish and been around it for years to be able to interpret what's going on behind the mask."

Since the program began, more than 175 Amish youth have taken part. Preliminary data suggest increased knowledge among youth about the effects of drug and alcohol abuse and enhanced awareness about ways to protect themselves from harm, says Cates. Anecdotally, leaders of the northeast Indiana Amish community have expressed satisfaction with the project, mainly by being open to the program's growth and staying engaged in its success.

"Because they are Amish we don't have the 'You're doing a great job' comments," Cates says. "But several bishops and ministers as well as a number of influential lay people have remained available to us as consultants as we have progressed with the program."

At this point, Cates says, the program has only been initiated in Indiana's LaGrange and Elkhart counties, but his hope is that the model will be used by other Old Order Amish communities nationwide. The model for the program is in review for publication in the Journal of Groups in Addiction and Recovery with the hope that as the involvement of psychologists within the Amish community grows, so too will the program's validity, he says.

"As a psychologist, I'm looking to provide services with an eye to evidence-based practices," Cates says. "Hopefully, if enough of us are out there doing it, we can begin to see more research on this."