Brandon Bruce Dellario LMSW LASAC
Teens can find substance abuse treatment in different ways for various reasons. One of the biggest motivating factors for young adults is our legal system. A study in 2002 showed most adolescents (53%) seeking treatment were referred by the criminal justice system, 17% were self referral, and 11% were referred by schools.
(1)
For some, the courts are the only encouraging thing they have found to quit using. Since youth may only be exposed to the juvenile justice system for a brief period, “. . . it is best to focus on pretreatment services such as assessment, engagement, and getting the youth to commit to changing their behavior.”(3) It is very important to keep them occupied and motivated by continuing contact with a support network and writing assignments while they are awaiting a treatment program. Continuity of treatment can have a major effect on teen recovery.
For some, the courts are the only encouraging thing they have found to quit using. Since youth may only be exposed to the juvenile justice system for a brief period, “. . . it is best to focus on pretreatment services such as assessment, engagement, and getting the youth to commit to changing their behavior.”(3) It is very important to keep them occupied and motivated by continuing contact with a support network and writing assignments while they are awaiting a treatment program. Continuity of treatment can have a major effect on teen recovery.
“Adolescents ages 12 to 17
admitted to substance abuse treatment increased 65% between 1992 and
2002.”(1) All other admissions increased
only 23% in the same period.(4) They are
coming into treatment as poly-drug abusers.
48% of these admissions reported the use of alcohol and
marijuana.(1) Cocaine is also on the
rise with youth. Many youngsters see
cocaine as harmless or fashionable. MDMA
(Ecstasy), GHB, Rohypnol, ketamine and other synthetic “club” drugs are very
popular among young people today.
Michigan is one of the highest ranking states for illegal prescription
drug abuse amongst teens. One study
shows that “12% of Michigan teens abuse prescription drugs.”(2) These “scripts” are hazardous when used
without a doctor’s supervision, especially when mixed with alcohol and other
drugs. For teens, prescription drugs are
easy to get and mistaken as being safe.
Treatment plans for teens
should include focus on, “sequence of interventions, length of treatment,
voluntary versus mandatory treatment, and pretreatment services.”(4) With sequential treatment, youth
receive services from one system at a time.
Whomever the patient comes into contact with first determines the severity
of his or her symptoms. The service
provider makes a determination about what services the teen should receive and
in what order. This kind of treatment
works well for the young person in the juvenile justice system with mental
health issues.(4)
Length of treatment
is an important factor when considering a program for an adolescent. While there are in-patient programs which
give the client months or even years to gain recovery, outpatient programs
don’t always have a long-term benefit. A
lengthy outpatient program can have a negative impact on a teenager.(4)
When it comes to voluntary
versus mandatory treatment, adolescents like to feel they have some say so
in their own treatment process. Most
don’t respond well to being told what to do.
Perceived choice is a successful method in working with teens,
especially those in the criminal justice system. They feel better about making a personal
decision to change their behavior, as oppose to listening to someone else. Perceived choice accelerates the
teen’s motivation and commitment. It’s a
motivational enhancement approach. In
such a case, the counselor shows empathy, points out discrepancies in the
child’s lifestyle, and negative consequences of behavior, all in a
non-judgmental and non-confrontational approach.(4)
“High school and college students with
substance use disorders are different from their adult counterparts, with their
problems stemming from various causes.
Stronger peer influences, physical and mental development issues, the
presence of other disorders, and diverse value sets all need to be considered
when treating youth with substance use disorders. Because of this, young people in treatment
for substance use disorders need more specialty support than others.”(4)
Therefore, programs in the
treatment center should be specifically designed for teens. Distinctive programming for their individual
needs include: Family programming,
psychiatric services, recreational activities, coordination of care, and other
health care services. Effective
treatment programs for teens implement 9 elements listed below:
1) Assessment and matching - where a youngster’s
needs are matched to services and amount needed.
2) Comprehensive and integrated treatment approach - holistic
approach to all an adolescent’s problems.
3) Family involvement in treatment - engaging the patient’s family
in his or her recovery.
4) Developmentally appropriate programs - programs that address a specifically teenage circumstance.
5) Engaging and retaining teens in treatment - ways treatment can make sense to teens.
6) Qualified staff - staff with specialized
training and experience.
7) Gender and cultural competence - addresses the
important differences among patients.
8) Continuing care - support networks, relapse prevention, and
follow-up plans.
9) Treatment outcomes - analysis in the success
of treatment programs.(4)
Like other addicts in
recovery, teens participate in 12 step programs. Alcoholics Anonymous, Narcotics Anonymous and
Celebrate Recovery to name a few. We
created a questionnaire and gave it to 4 teens in the program of Narcotics
Anonymous. The age of first use ranged
from 8 to 16 years old. The reasons they
think they used were primary named as peer pressure and to cover emotional
problems. All of them obtained drugs and
alcohol from family members. When we
asked them about treatment, 2 of them had some form of treatment
experience. They were both open-minded
to the idea of treatment when referred to treatment by friends or the
court. They both had peers of a similar
age with them while in treatment.
http://alcoholism.about.com/od/teens/a/blsam040901.htm
About.com: Alcoholism & Substance Abuse
http://www.adolescent-substance-abuse.com/blog/labels/teenagers.html
Adolescent Substance Abuse Knowledge Base
http://www.ncmhjj.com/curriculum/juvenile/mod_03_E_07.htm
The National GAINS Center for People with
Co-Occurring Disorders in the Justice System
http://www.recoverymonth.gov/2006/kit/html/Targeted_Outreach/yoouth.aspx
National Alcohol & Drug Addiction
Recovery Month, September 2006
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