One of the most difficult things for a parent to encounter is the realization that their child has a substance abuse issue.
Questions and worries flood into the mind of any parent in this situation: When did this all start? Is this my fault? Do I need to be stricter? Am I being too strict? Why do we seem to keep getting back into this situation, no matter what I try?
If you are like most of the parents we work with, you have tried everything you can think of. Occasionally things might seem to get better, but before long, the sneaking, lying, and secrets start again, along with sleepless nights.
If this is the situation you find yourself in, we understand your concern.
You are not alone. Far from it.
Treating an Illness
One of the first steps for parents in this situation is understanding that substance use disorders are recognized by the medical community as an illness. This does not excuse the child’s behavior, but it does offer an explanation for why a child may be acting out of character. Understanding addiction as an illness can help parents begin to understand why it feels as if a stranger is living in their house.
The National Institute of Drug Abuse describes the addiction process as “chang[ing] the brain in fundamental ways.” This rewiring of the brain leads to “compulsive behaviors that weaken the ability to control impulses, despite the negative consequences” characteristics that are “hallmarks of other mental illnesses.”
A child with a chemical addiction could very likely be struggling with other undiagnosed mental health issues as well. Oftentimes, the substance use begins as a means to treat an existing mental health concern. When additional mental health issues accompany addiction, we refer to this as a “dual diagnosis” or “co-occurring disorder.” Since this is often the case with teens suffering from substance abuse, it is important that the child receive an comprehensive psychological evaluation and monitoring alongside any efforts to discontinue substance use.
If we can accept substance use disorders as a type of mental illness, then we can also start to accept that we are dealing with something beyond the scope of normal day-to-day parenting. Although behavioral issues always accompany addiction, it is important to remember that parents in this situation are not dealing solely with behavioral issues that can be addressed with stricter discipline. Discipline, structure, and experiencing consequences will certainly be part of the solution, but it’s also important to recognize that a child with a substance use disorder is in fact struggling with at least one untreated illness.
Dealing With Difficult Emotions
Of course, abstaining from drugs and alcohol is essential to recovery, but abstinence is only the initial step. If the mental health concerns are not addressed and emotional coping skills are not established, relapse is likely, if not inevitable.
Finding the right treatment environment can provide several advantages for beginning the recovery process. This gives medical and therapeutic professionals the opportunity to observe, diagnose, and create a treatment plan for the child.
The break from the routine also allows the child to learn the skills they need to cope with negative emotions they will experience in daily life. Without some means of processing unwanted emotions, a person with a history of addiction is likely to return to substance use in order to deal with those feelings.These unwanted emotions are particularly strong in the early days of recovery, and being in a safe, therapeutic environment that is focused on helping the child learn coping skills can be crucial for maintaining long-term sobriety.
Once a person with an addiction stops using, he or she will experience waves of powerful and overwhelming feelings. Fear, sadness, anger, confusion, and just a general sense of feeling overwhelmed often dominate daily life for the person in early recovery. During active addiction, the substance has been covering up these underlying emotional disturbances and a person with an addiction loses their ability to understand and deal with these difficult feelings.
Picture a garden hose that has been bent in the middle so that the water is being obstructed. Once the obstruction is removed, the water flows through more powerfully than ever before. Similarly, when a person with an addiction stops abusing substances, all those unwanted emotions come flowing through in the early days of recovery.
These emotions will likely be more intense at this point, which is why risk of relapse is high during this period. However, within the safety of the treatment environment, these strong emotions can provide valuable opportunities for our therapists to work with the child on developing the skills they are going to need to deal with the ups and downs of daily life once they leave treatment and return to normal life.
Four Skill Sets. Four Phases of Treatment.
At Eagle Overlook, alongside the psychiatric care that they receive, the counseling staff uses Dialectical Behavioral Therapy (commonly referred to as DBT) as an essential part of their treatment to teach our clients how to cope with their difficult feelings and reduce their interpersonal conflicts.
DBT is a well-researched therapeutic approach that gives clients clear and concrete ways to handle their emotions. In addition to substance abuse, it also has been proven to be effective in helping people cope with the difficult feelings that accompany a range of eating and personality disorders, bipolar disorder, and PTSD.
There are four primary components to DBT, and to ensure that our clients develop the necessary skills in each domain, we have broken up our treatment into four phases so that they have time to develop the skills in each domain.
The first component of DBT and the first phase of treatment at Eagle Overlook focuses on developing mindfulness. In this phase of treatment, we teach our clients skills to ground them in the present moment and accept what is happening right now. The primary idea behind this component is that when we can stop struggling against reality and accept it, our suffering begins to decrease.
The second DBT domain and phase of treatment focuses on developing emotion regulation. Our clients learn a set of skills to prevent them from “acting out” in harmful ways when they experience difficult emotions, and they learn ways to calm themselves in the presence of strong emotions. We also help them learn to refocus their attention so that they can still work toward important goals in their lives even while experiencing difficult feelings.
Distress tolerance is the third domain and phase of treatment. In this phase, we work with clients, building on their mindfulness skills, learning to accept even the most distressing events and crises. We all encounter distressing moments in life, and learning to accept them and find meaning in them is essential for long-term recovery.
The final component and phase of treatment is interpersonal effectiveness, in which we work with clients on how to effectively communicate with others. This domain draws on all the others, allowing clients to manage whatever feelings come up when dealing with others in healthy and productive ways. It focuses on treating others and oneself with dignity, while practicing directness and considering others needs as well.
Each of these phases contain numerous exercises and skills that allow the clients to practice reacting to life in different ways. Getting to work through these phases during the early days of the clients recovery, when their emotions are particularly strong, provides a very valuable opportunity to immerse the client in ways to handle the feelings that used to lead them to use drugs or alcohol. Our goal is to have our clients leave treatment equipped to handle whatever life may have for them.
Just like physical health, mental health is something that needs to be developed and attended to. Our goal is to give our clients the skills to do this well enough that they no longer need to rely on substances to escape from life.