Dramatic rise in substance abuse in America – Teen Drug Use Number One Health Problem
Have the 12 steps been studied in adolescents?
Several studies on 12-step approaches were associated with positive treatment outcomes. Fiorentine found that adolescents with prior 12-step involvement remained in a substance abuse treatment program longer and were also more likely to complete treatment than those without such prior involvement. Both pretreatment 12-step meeting experience and longer duration of participation in drug treatment were positively associated with subsequent 12-step involvement. Adolescents who were involved in a combination of formal drug treatment and 12-step approaches were more likely to have high rates of abstinence than those who participated in either drug treatment or in a 12-step approach alone. Weekly or more frequent 12-step attendance was also associated with drug and alcohol abstinence. A 12-step recovery support group combined with Relapse Prevention treatment resulted in an earlier decrease in drug use.
Adolescents who attended AA/NA meetings after substance abuse treatment have higher rates of abstinence and productivity compared with those who did not attend such meetings. For adolescents who received inpatient substance abuse treatment, 12-step attendance was the most powerful predictor of drug abstinence at 6- and 12-month follow-up.
In another study, adolescent in patients who had a prior history of substance abuse treatment, more feelings of hopelessness, friends who did not use drugs, and less parental involvement while in treatment were more likely to attend AA than other adolescent inpatients. Three spirituality-related characteristics-feeling connected to others, frequency of meditation and prayer, and spiritual orientation to life-distinguished the subjects who expressed preference for both spirituality and 12-step approaches being integrated in TC treatment.
How effective are group therapies?
Group therapy can be nonstructured or process-oriented groups aiming to break denial. Other goals include expressing and clarifying feelings, especially painful affective states, developing relationships, and confronting negative characteristics or behaviors impeding recovery. This is often confrontational. It seems that the adolescents with whom I work are more likely to believe other adolescents sharing similar experiences than the treating staff. A major hurdle for adolescents is the degree with which they will risk trusting others and disclosing personal information that they hold on to strongly.
How can I be a part of my child’s treatment?
In previous questions, I have repeatedly touched on this. Family interventions are key components of adolescent substance abuse treatment as a number of family-related risk and protective factors have been identified. Commonalties in family treatment include psychoeducation about drug use, assisting families to initiate and maintain treatment of adolescents, and providing parent training to improve communication.
Goals of family treatment include:
1. Decreasing the family’s resistance to treatment
2. Redefining substance use as a family problem
3. Reestablishing parental influence
4. Interrupting dysfunctional sequences of family behavior
5. Assessing the interpersonal function of drug abuse
6. Implementing change strategies consistent with the family’s interpersonal functioning
7. Providing assertive training skills for the adolescent and any high-risk sibling
It can be difficult to find programs that specifically provide these services. It is important to find those programs that can address these goals as described. A review of combined data on family literature showed its superiority over other modalities and also noted that it can enhance the effectiveness of other approaches. Treatment can involve all family members, as drug use is related to family dysfunctional relationships and interactional patterns. Examples of family treatment within this include multidimensional family therapy, multisystemic family therapy, and structural strategic family therapy. It is important to continue being a part of your child’s treatment.
You need to empower yourselves to learn about drug use, how to monitor your children, know the early warning signs, and participate in scheduled family meetings and therapies. It may well be that you need to take a proactive role in pursuing family meetings with providers. To merely expect the provider to do the work and come back when your child has been “fixed” will not be beneficial to your child.
Jo’s comments:
I realize that I have to be part of my child’s treatment for it to work. I got angry after finding out that my son John was using. I gave him everything, and being a single mother,
it has been tough for me to provide the things he needs and wants. I feel betrayed. When I decided to bring him for treatment, my attitude was like “Fix him. I’ve been there for him; this time, he needs to do this on his own.” I now realize that as the parent, I also undergo adjustment. If anything, he now needs me more than ever. I have to heal with him.
What is multisystemic family therapy?
Multisystemic family therapy t akes i nto a ccount broader social relationships including teachers, neighbors, and other social units interacting with the drug-dependent adolescent. It is often incorporated in outpatient community-based settings and also includes case management. Treatment is made accessible to the families and is provided where they live. Case managers work with the families and other involved individuals like probation and parole officers and school officials. Adolescents are also provided with vocational services. The goal is to keep the adolescent in the community in which he lives and keep him in school. This family intervention has been most successfully applied among juvenile legal offenders and has not been routinely applied in traditional outpatient settings.
Terms:
Multisystemic family therapy – Treatment that takes into account broader social relationships including teachers, neighbors, and other social units interacting with the drug-dependent adolescent. The goal is to keep the adolescent in the community in which he lives and keep him in school. This is a very intensive treatment that has been supported to meet the needs of youngsters with multiple issues and legal problems.
Cognitive behavior Therapy – Therapy that uses cognitive and behavioral interventions to improve skills and change maladaptive behaviors, which hinder cessation of drug use.
