2009 - December

Adolescent Care and Developmental Reality

Research on adolescent development points to treatment for early and ongoing chemical use as highly important. Many in our society have the view that teens will just ‘grow out of’ their struggle stages in life. Well, some don’t, and proportionally few enter clinician’s offices later as highly impaired adults who are raising their own children. The importance of adolescent care is, firstly, about their development. The growth resources adolescents accumulate in childhood are hopefully life-building mental and social skill assets, but sometimes are not, and teens can’t go back to get more of the best if they don’t have it already.

Consider the adolescent brain undergoing a patterning based on what researchers call a “use it or lose it” template: brain areas are strengthened when used or wither when not. This shaping of a teen’s neurological character is ongoing with the most emphasized brain areas becoming practiced and dominant. So, about adolescents the question is simple: what brain areas are being developed through repeated chemical use, and what areas are not? Brain plasticity acknowledged, this doesn’t mean that an addicted brain has the flexibility to return to a prior, non-addicted state. The “importance” in adolescent care is an old concern…what teens can become given inborn potentials, and what they do become with ongoing alcohol and drug use.

Current information prompts the need for more adequate adolescent care. Note the strong association of marijuana use and psychiatric/behavioral disorders (depression, anxiety, ADHD, Bipolar Disorder, Conduct Disorder, psychosis). Kevin Gray, M.D., reports marijuana use as predisposing or worsening a psychiatric disorder, or such a disorder increasing the risk of the drug being used. Note information from the National Survey on Drug Use and Health 2007: an estimated 7.2 million young people ages 12-20 binge on alcohol during any month and 2.3 million engage in heavy alcohol use. Note further, research findings reported by Join Together, Sept. 25, 2009: A researcher studying twins concluded that early drinking “may induce changes in the highly sensitive adolescent brain, which may also modify an individual’s subsequent genetic vulnerability” to addiction.

This is a small mention of recent survey and research information indicating in a no-nonsense manner why adolescent care is so important. We must either help teens now through adequate prevention and treatment, or we will have to help many later as adults when they have experienced the debilitating advance of addiction. Treatment in later life stages means more burden on the social and healthcare system we all live with, with years of damage due to chemical use placing huge challenges on individuals, families and communities. Delaying treatment to later life means that serious losses in the life quality of our teens will surely lie ahead for them.

Needed: Family Involvement in Treatment

Next, incorporating family work into adolescent treatment is vitally important. A teen is a part of a family unit, not a separated individual. Abraham Maslow placed family under Safety and Love/Belonging in his Hierarchy of Needs. He understood the importance of having safety, security, order in the family/home environment, and the benefit of connectedness with a family as critical experiences needed in moving toward self-actualization. The National Center on Addiction and Substance Abuse at Columbia University (CASA) reported these study findings in September 2009: Teens who participated in family dinners less than three times a week were two times likelier to use tobacco or marijuana and one-and-a-half times likelier to use alcohol than teens who ate dinner with family five or more times per week The relevance of these findings is about the significant needs being met when a teen has a sense of belonging to a family unit; this highlights the importance of family identified in Maslow’s Hierarchy. Howard A. Liddle, EdD spent years researching best practices in treatment for drug-abusing adolescents, his findings published in the American Journal of Drug and Alcohol Abuse in 2001. Liddle’s study compiled outcomes comparing the effectiveness of multidimensional family therapy (MDFT), adolescent group therapy (AGT), and multifamily educational intervention (MEI). While the three modalities each showed improvements for teens, MDFT resulted in significant overall movement forward. The findings highlighted a reduction of drug abuse and related impairments as well as pro-social behaviors that included school performance and family functioning. This substantiates the benefit and usefulness of family therapy when treating drug-abusing teens.

Research clearly shows that comprehensive, family-based treatment is useful and effective in treating drug-abusing teens. We have a responsibility as a profession to ensure that quality care is provided to the teens we are working with. This includes having culturally competent clinicians who understand addiction, family dynamics and the treatment needs of the adolescent population.

Adolescent Treatment Options Going “South”

Dateline April 2, 2009 – Huntsville, Alabama. “Three Springs Announces Closure of New Dominion School Campus” (reported on http://www.threesprings.com: Today Three Springs announced plans to close its New Dominion campus located in Dillwyn, Va., effective May 20, 2009. For the past 30 years the facility has provided year-round outdoor therapeutic programs for troubled teens and their families.

“This has been a difficult but very necessary decision,” said Mark Horner, Ph.D., Vice-President of Private Programs. “Recent changes in the state’s referral model will drastically reduce enrollment in the program in the very near future.”

Horner noted 80% of the current student population came to the New Dominion program through state or local government referrals. Difficult economic conditions are also making it challenging in the private referral sector.

Consider that Three Springs is not alone. Across the United States, the current economic downturn has forced programs and some entire organizations to close their doors on a clinical modality already struggling to serve community needs: adolescent substance abuse treatment. OdysseyNH in Hampton, N.H., is closing an adolescent residential substance abuse treatment facility that has been in operation for 39 years:

“The recession and a shift in New Hampshire state funding priorities are the prime reasons for the closure.”(from organization press release)

While treatment and employment options continue shrinking, not only do teens have less access to treatment, but those who specialize in treating adolescents struggle to find new positions to serve this population. It is imperative that we lend our support to those still employed with encouragement to continue on the path of adolescent care.

About the Author

Chris Bowers, Margi Taber, Tiffany Howard and Kansas Cafferty serve on the Adolescent Specialty Committee of NAADAC, the Association for Addiction Professionals. For more information on the committee, to sign up for the committee’s newsletter or to join the committee’s listserve, please contact This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


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Comments (6)
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