Adolescent versus Adult Addiction Treatment

There are special challenges concerning drug treatment and the adolescent population. Attempts to modify existing drug treatment programs for adults and utilize them with adolescent populations would be largely ineffective. Adolescent populations have special needs that require special considerations when it comes to both treatment and aftercare. Understanding what makes adolescent treatment different from adult treatment programs is crucial in finding the most quality drug treatment programs for this population.

Differences in Treatment Between Adolescents and Adults

Attention to Development—adolescents and young adults are experiencing a critical stage in both body and brain development. Substance abuse can have the potential to cause significant impediments in these developmental areas. Those who work in adolescent treatment facilities recognize that because an adolescent’s brain is still developing into their 20s, the chances are that a “pro vs. con” approach in substance abuse treatment would be difficult to process.

Importance of Family—in general, the adolescent population in treatment may not have the resources when it comes to building recovery networks which they can turn to for support. Family engagement is a critical piece of what makes adolescent treatment different since they are largely dependent on their parents or caregivers for financial and emotional support, transportation, and other basic needs.

Building Rapport with Adults—many adolescents may have past negative associations and experiences with adult figures in their lives. Adolescents may come from environments in which trusted adult figures may have been verbally or physically abusive or may have experienced other forms of neglect. In turn, being put into a situation in which it is perceived as punitive may present formidable challenges. Counselors and therapists who work in adolescent treatment facilities make rapport building and earning trust critical cornerstones of the recovery process.

More Focus on Multidisciplinary Treatment—while the multidisciplinary approach is an important component of both adolescent and adult recovery, there are more considerations for adolescent populations. There is not only a focus on the medical and psychological aspects, there is an increased emphasis on academics as well as recreational aspects. There are also special considerations when it comes to issues such as self-esteem, peer pressure, eating disorders, depression, self-harm and other psychological issues that had significant impacts on adolescents, especially females.

Treatment Advances and Options for Adolescents

Drug and alcohol dependence and abuse among adolescents have consistently been a concern in the scope of national health policy. Given that degree of concern, there has been a movement towards creating treatment options that are specific to the adolescent population. Early exposure and initiation to drug use and abuse can lead to a myriad of behavioral problems down the road, including legal problems, driving under the influence as well as physical, sexual, and emotional abuses. Also given the fact that alcohol and drug use during adolescence can lead to changes and impairments in brain structure and chemistry, the need for quality treatment for young people is paramount.

In a historical context, treatment approaches for adolescents were culled from those serving adult populations. Adolescents were often sent to either correctional institutions or rehabilitation facilities that catered to the adult population. While drug treatment facilities and programs have their roots starting in the 1950s, the development of programs that specifically targeted the special needs of young people only and truly started to gain traction in the 1990s. Currently, an adolescent will be referred to one of five treatment levels as designated by the American Society of Addiction Medicine patient placement criteria.

This placement occurs after a professional assessment has been conducted. Those levels are as follows:

  • Early intervention services—consists mainly of educational and/or brief intervention services.
  • Outpatient treatment—treatment for a period of six weeks or less dependent on both progress and nature of the treatment plan.
  • Intensive outpatient—adolescents attend treatment during the day but live at home. This can have a duration anywhere between two months and one year.
  • Residential—programs are provided in a residential “in-house” setting where the patient lives and resides for a period of time (between one month to one year, again depending on progress and nature of the treatment plan among other factors).
  • Intensive inpatient—often medically supervised and is most appropriate for severe cases of substance use and co-occurring emotional and biomedical issues.

Based on this continuum, there can be a wide array of treatment and therapeutic options that practitioners have at their disposal. Common modalities include family-based therapy as well as cognitive-behavioral therapy (CBT). CBT is centered on the notion that thoughts are the root cause of addictive behaviors and thus thoughts determine how people perceive and act within the environment. Those thoughts that are maladaptive can be modified to change the thought process itself, even though the surrounding environment may not change.

Other interventions such as Twelve-Step programs (i.e. Alcoholics Anonymous, Narcotics Anonymous) may also be of value. Also gaining traction are the use of therapeutic communities (TC) or long-term residential programs that focus on emphasizing self-help and fostering shared values for a healthy drug-free lifestyle through individual counseling sessions, family therapy, and life skills education.

Questions to Ask When Looking for an Adolescent Treatment Center

Knowing the differences between adolescent treatment and adult treatment provides the basic framework in regard to finding the best possible treatment options. There are also other questions that need to be answered, which can include the following:

  1. What types of treatment do you have? Have there been any research studies on this type of treatment?
  2. What evidence do you have that your program is effective?
  3. How do you specifically address the needs of adolescents?
  4. Can you assess and treat my child’s mental health problems at the same time as his/her substance problem?
  5. How is the family involved in the treatment process?
  6. How long will this treatment last?
  7. What things do you do to help adolescents engage and stay in treatment?
  8. Do you have aftercare or a continuing care program for when this treatment ends?
  9. What happens if my child is not successful here? What other options do we have?
  10. How much does this cost and how much will I have to pay? Are there any state, county, or grant funds to help pay for this treatment?

With these differences considered and questions in mind, finding the best option for adolescent substance abuse treatment can be a more rewarding endeavor.

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