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Adolescent and Family Treatment

The SAMHSA DASIS Report: Adolescents Treatment Admissions states:

All substance abuse treatment admissions increased 23% between 1992 and 2002. The number of adolescent treatment admissions, however, rose by 65%, and by 2002 accounted for 8% of all admissions reported to SAMHSA's Treatment Episode Data Set (TEDS).

In 2002, 54% of adolescent substance abuse admissions were referred to substance abuse treatment through the criminal justice system, compared with 40% in 1992. 

TCA News will be featuring an article on therapeutic community treatment, with regard to special populations, throughout the year. With the increase in the number of adolescents seeking treatment through the criminal justice system, it is important that treatment include special components that can improve success rates for this special population, and that research opportunities are available to evaluate those efforts. John Venza, MSW, LCSW, Outreach Project, Inc., New York shares with TCA NEWS his experience with treating adolescents. 

Treating the Adolescent and their Family in the Therapeutic Community: “A Parallel Process.”

As many youth service systems review the efficacy of their treatment approaches, the overwhelming consensus is that family therapy must be included when treating adolescents (Treating Teens, A Guide to Adolescent Drug Programs, Drug Strategies, 2003).

The practice of treating adolescents and their families is a novel concept for the many therapists and treatment programs that have traditionally worked with adolescent clients on a singular basis. However, working solely with the adolescent while ignoring the family has a major limitation that becomes immediately apparent when the treatment program has ended and the adolescent returns home to their family. Without systemic family therapy, the adolescent’s accomplishments in treatment may be jeopardized by the unchanged and often unhealthy family system they return to.

Treating adolescents in a residential Therapeutic Community (TC) has its own unique challenges, most notably the difficulty of engaging the entire family in treatment. By the time the adolescent enters a TC, they and their family are usually quite angry and distant from one another. Communication has usually eroded and the ability of the parent(s) to set and enforce limits has become severely compromised. It is not uncommon for families to resist participating in treatment due to the erosion of the family’s functionality. To overcome these challenges, effective engagement of the family in a parallel treatment process requires a well-defined approach and trained staff.

It is important to remember that the adolescent’s entrance into the TC is usually the first time that they have been apart from their families for an extended period. For this and other reasons, it is crucial that the program engages and treats the adolescent alongside their family, from assessment through continuing care. Parents should be engaged in a parallel, ongoing process of change for themselves while participating in treatment. For the family, treatment should include individual-family and multi-family counseling, parent support groups and chemical dependency education. In addition, family members should be integrated into a variety of activities and social events that will serve to further the communication process and to reinforce the family’s ongoing commitment to the recovery process.

Without the support of the family system, long-term recovery and the destruction of the inter-generational cycle of dysfunctional behavior and addiction is nearly impossible for the adolescent. By treating adolescents alongside their families, TCs can both resolve underlying family problems and give their younger clients the tools they need to successfully lead positive and drug-free lives.