Posted on August 23, 2012 in Doc Talk
Doc Talk: The Difference Between Adolescent and Adult Treatment in Addiction Recovery
Dr. Casey Green has worked with adolescent addiction recovery for six years and has helped The Right Step achieve its goals of reaching out to young teens who are battling drug and alcohol addiction and lead them to a safe and healthy recovery.
“We want to build upon the strengths (personal, family, community) that adolescents bring to treatment in order to equip them with the skills necessary to pursue lifelong sobriety,” explains Dr. Green. “Individually, we work with clients and their families to accurately identify what stage of change they are currently in (transtheoretical model, Prochaska), stabilize them at that stage, and then do what is necessary to move them to the next stage of change.
At The Right Step, this can include arranging ongoing intensive outpatient rehab; individual, psychiatric, or family care; or, in the cases where we cannot achieve stabilization, helping the family identify higher levels of care and educating them on the potential benefits of seeking additional treatment. Because of these factors and more, treating adolescents’ drug addiction and alcohol addiction requires a different and unique approach than with adults.
To start with, the actual structure of their brains is changing and adapting in accordance with their experiences and this can continue even into their early 20’s. This means that adolescents may come to treatment with a reduced capacity to process information in a logical ‘pros v cons’ manner. Establishing a period of sobriety will trigger healing in the brain that can aid in this process but, early on, it is vital to understand that adolescents must connect to recovery in an emotional way,” says Dr. Green.
Another factor in adolescent recovery that is often overlooked is that many of these clients lack the resources or power to pursue recommendations or construct a recovery network, according to Dr. Green. Since teens are dependent on caregivers for transportation, financial support, emotional understanding, and basic needs, engaging the family in the treatment process is absolutely crucial.
The final factor that makes residential adolescent treatment a different type of challenge for a clinical team is the fact that many adolescent clients have either had negative experiences with adults or can be naturally suspicious of adults. “You have to imagine teenagers who have been reprimanded, hurt, criticized, neglected, punished, etc. by adult figures in their lives. Then they are brought to treatment where another adult that they do not know calls them into a room and begins asking them difficult questions,” explains Dr. Green. “This makes rapport-building extremely difficult and clinicians face a very difficult task of first earning trust before they can begin to initiate therapeutic interventions. The phrase that best describes this is, ‘they have to know how much you care before they will care how much you know.’”
Another vital component is the spiritual component. “The mind-body connection has been established through research to the point that it is, essentially, fact. Spirituality is a key component in Twelve Step programming and is a part of most reputable recovery programs, as well. When you combine those two ideas, you quickly come to see that to pursue a comprehensive approach to recovery requires consideration of all avenues of healing that are helpful and meaningful to each client,” says Dr. Green. “At The Right Step, we introduce these concepts through meditation sessions, our Living in Balance curriculum, and openness on the part of our clinicians to explore the aspects related to total healing that each client connects with individually.”
According to Dr. Green, The Right Step’s adolescent addiction treatment program has a “To Do List” of: 1. Show them you care, and 2. Show them how to change. It really must be done in that order to be meaningful to an adolescent client.
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