Most American youth try drugs and alcohol when they are teenagers; some will develop serious substance use problems. But treatment for teens is scarce and often hard to find: although more than one million teens need drug treatment, only one in ten actually receive help.
Why is adolescent treatment so scarce? Lack of state and federal funding for treatment programs as well as shrinking insurance benefits for drug treatment are two major reasons. Without adequate insurance, many parents simply cannot afford to get the kind of help their children need.
When parents realize their children have drug problems and must find treatment, they frequently do not know where to turn. The family is often in a crisis situation, when decisions must be made quickly. Yet very little information is available about what parents should look for in choosing a program. Most parents are concerned about cost: do their employee benefits cover drug rehabilitation? If so, for how long? If their coverage is limited, will they be able to pay to get the best possible treatment for their teenager? What kind of treatment will work? Should their teen be sent away to a residential program or can he or she be treated in his or her own community while still living at home? How long will treatment take – a few weeks, months or even years? Parents face bewildering questions they don’t know how to answer, or even how to find answers. They may also feel frightened or ashamed that their teen has substance use problems. And they may also recognize that their own alcohol and drug use problems have contributed to the problems their child is experiencing.
In order to help parents and other concerned adults find help for their teens, Drug Strategies, a nonprofit research institute, developed Treating Teens: A Guide to Adolescent Drug Programs. This guide describes nine key elements that are important in successful teen drug treatment and provides reliable information on 144 adolescent drug programs. Treating Teens gives hotline telephone numbers to find treatment in each state; definitions of frequently used treatment terms, and 10 important questions parents should ask when selecting a program for their teen.
FIVE QUESTIONS PARENTS SHOULD ASK A TREATMENT PROGRAM
1. Is your program specifically designed for teens? If so, how?
Most treatment programs are designed for adults, not teens. Even if programs say they treat teens, they may in fact just be including them in adult programs that have a few activities for younger people. Adolescents have unique challenges, such as relating to their families, dealing with peer groups, getting an education, finding a job. They also are different developmentally than adults. Effective adolescent programs should address not only drug use problems but also the many aspects of a teen’s life.
2. What questions do your staff members ask to determine the seriousness of the teen’s substance use problem and whether the teen will benefit from this particular program?
Good programs usually ask a brief set of initial questions to explore the severity of the youth’s drug use. How long has the teen been using? Is he or she addicted? What other kinds of problems does the teen have? Is he or she involved in delinquent behavior? Answers to these questions will help a program decide if they can provide the kind of help needed. Once the teen is admitted to the program, the teen’s problems will be examined in much greater depth. This kind of assessment should include a physical exam to determine if there are any medical conditions related to the substance use problem; a psychiatric exam to determine if there are mental health problems, such as depression, that must also be treated; a review of the teen’s educational progress, and a review of the teen’s relationships with his peers. Does he have friends? Are they involved in drugs? The program may also ask in-depth questions of the family about how well family members communicate, whether there are discipline problems, whether there is a history of substance use within the family. The program will develop as complete as possible a picture of the adolescent’s problems so that the counselors can design a treatment plan to address them successfully.
3. How does the program involve the family in the teen’s treatment?
Family involvement in the teen’s treatment is critically important. Regardless of how well or badly the teen and the family relate to each other, parents are the dominant reality in the lives of most teens. Parents are also the major source of financial support, including medical insurance, if any. Most teens live at home, and their recovery will depend on how supportive the home environment will be in helping them build new lives free of alcohol and drug use.
Recent studies of adolescents who stop using drugs report that parental involvement, new friends and motivation are keys to success. Programs should encourage parents (or other caregivers) to participate in counseling, group meetings, drug education and other activities offered by the program. Occasional telephone calls between the parents and the program counselors are not enough. Families should also be asked to examine their own alcohol and drug use and to get treatment themselves when necessary. Programs should teach the family how to be more effective parents, including how to discipline children reasonably. The more the family is involved in the treatment process, the more likely the teen will succeed in treatment.
4. How does the program provide continuing care after treatment is completed?
The period after treatment is vitally important: most adolescents relapse in the first three months after treatment. However, continuing care services can greatly increase the likelihood of sustained recovery. Developing follow-up plans while the teen is still in treatment is important in providing a structure for the teen and his family, so that treatment gains continue. These plans may include relapse prevention training, referrals to community resources and periodic check-ups by the program with the adolescent and his family. Twelve-step meetings can also be helpful for some teens in recovery, although finding 12-step meetings specifically for teens can be difficult in some communities. Unfortunately, many programs do not provide continuing care, and parents must try to support the teen’s recovery as fully as possible. Parents can identify services within their community that will help the teen live without drugs, including well supervised recreational programs, counseling, and community service. Parents should stay in close touch with their children every step of the way. Parents who believe that their children can overcome their problems and be successful in school make a powerful difference even when faced with difficult circumstances. (In Treating Teens: A Guide to Adolescent Drug Treatment the help hotline numbers can provide referrals to resources in each state.)
5. What evidence do you have that your program is effective?
Very few programs have formal, scientific evaluations that measure their treatment success. However, even without such evaluations, other information can be helpful. For example, completing the entire course of treatment is closely related to success. Retention rate is an important indicator of whether a program is effective. How many teens drop out? How long do they stay in treatment? How many actually complete treatment? Other useful things to ask about are whether teens in the program show improvements in school performance (better attendance and grades) and family relationships (better communications, less aggressive behavior). How does the program monitor drug use among teens in treatment? Do they conduct drug tests? If so, how often do they test? What are the results? Good programs should have test results that show that teens in treatment are staying clean.