August 31, 2016
There are many factors that contribute to treatment success when it comes to addiction: program quality, financial resources, complicating mental health factors, and so on. However, there is one factor that remains a relatively untapped resource given the dramatic impact it can have with regard to improving treatment outcomes, and that is family involvement.
Granted, family programming is a standard part of most addiction treatment programs today, and many of these programs are doing excellent work in this area. However, there is more that can be done with regard to the role the family can play in providing effective support for their loved one. Improvement in this area has direct implications for lowering the high recidivism rates currently seen in the addiction treatment industry.
September 6, 2016
There's no denying that substance abuse treatment “success rates” can be alarmingly poor. It is an all-too-common scenario to see a client go through residential treatment for a month or two, and be back using within a few weeks. Compounding this tragedy is the fact that it is not uncommon for families to spend literally tens of thousands of dollars—out of their own pockets—on care for their loved one, only to have everything blow up before the ink is barely dry on the discharge papers.
“What's wrong with this picture!?”
Getting clear about some of the reasons that contribute to poor treatment outcomes is a matter of vital importance, and I have found that The Stages Of Change Model (SCM) provides one of the most effective explanations for how and why this occurs. Accordingly, it also offers a remarkably logical solution for achieving treatment success.
"As I stand in the East, and the first rays of sunlight dance upon the horizon, I feel welcome. I feel connected. I feel like I belong."
The Journey is a rock musical I wrote about addiction and recovery. The stage production opens with the sun emerging over the horizon, gradually illuminating the silhouette of a lone figure standing with arms solemnly outstretched, reaching towards the sky. Narration refers to the sun's journey across the sky, likening this to the spiritual journey upon which this soul is about to embark.
The reference is to the Native American Medicine Wheel, a cyclical model that reflects the concept of the "circle of life." The Four Directions represent the four stages of a cycle: The sun rises in the East, the place of beginning. The day grows as the sun reaches a highest point before descending into darkness of the West and the day transitions into night.
When dealing with substance use disorder, the term "recovery" gets thrown around a lot. "His recovery is going OK." We're concerned about her recovery." "You need to focus on your recovery!" We all want our teens who have developed a substance use disorder to "be in recovery", but what exactly does this mean?
Becoming clear and improving public understanding about this key issue when it comes to adolescent services can go a long way towards improving overall success rates when dealing with teen substance abuse. To the contrary, not understanding what the overall goal is when treating a drug problem plays a significant role in contributing to the alarming rate of recidivism seen in the field of adolescent substance abuse treatment.
Of Adolescent Drug Treatment
I met with a teen this week who had just got out of two months of residential treatment. She sat in my office and demonstrated she had no clue about recovery: She saw no need to continue in outpatient treatment, go to meetings, give up using friends (including a boyfriend "says he quit"), and so on. I called BS, told her I know they taught her that stuff in residential, and she just thinks she doesn't have to follow through because her parents didn't learn any of this. I told her I have no reason to work with someone who is sounds like she needs to be at the beginning of inpatient treatment. I told her mom to send her someplace else. Mom had already checked out other outpatient treatment options and recognized they would not get the structure and accountability needed to follow through with what was begun during the first phase of treatment.
I have made a career out of using experiential activities such as music and storytelling as the basis for most of my work in addiction treatment. For many years I just sort of cruised along, aware of how well this approach worked, but never really paying much attention to why it works.
Last year I heard Dr. Tina Bryson give a talk on the book she co-wrote with Daniel Siegel, MD titled The Whole-Brain Child. She talked about recognizing the respective differences between right and left-brain functioning, and employing strategies that make the best use out of this incredible machine in our head to facilitate behavioral change. In short, the premise is summed up in the phrase "Connect with the right; redirect with the left." This means:
1. Connect with the child through actions that engage right-brain functioning (creative, emotional actions);
2. Redirect behavior through logic and reason, actions associated with left-brain functioning.
anuary 22, 2017
It's becoming an all-to-familiar scenario: A teen is placed is in treatment for a substance use disorder. The family spends lots of money, invests lots of time, and becomes hopeful that they are “getting their child back.” The teen is discharged, and within weeks everything has blown up and they're right back to where they were a few months earlier.
It doesn't have to be this way.
In over 20 years of working with teens in outpatient substance abuse treatment, I've learned a few things about what works and what doesn't work when it comes to helping a young person achieve successful recovery. Here are a few key points I'll offer for parents who want to give their child the best chance for treatment success.
August 21, 2017
I worked with some parents last week whose 21-year-old son is currently in is eith treatment placement in the past five years. This young man has made the rounds in some of the country's finest programs including residential drug treatment, therapeutic boarding schools, extended care, wilderness, and IOP. The parents were on their way to family week, and dreading an ordeal over whether or not he will follow the staff recommendation of transferring to a particular extended care program. The boy is making noise about wanting to do something else.
The amount of treatment this child has had was somewhat mind-boggling as a listened to the case history. I was meeting these folks for the first time, and they were off to family week the following day, then off on a 2-week vacation, so I had to figure out what I might offer them in this one-time shot.