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Existential Therapy Can Work for Youths

September 1, 2007
by David D. Cook
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Use of creative activities can make important treatment concepts come to life

Teetering on the boundaries between philosophy and psychotherapy, existential therapy involves helping clients find meaning in their lives and emphasizes that the driving force in life is an innate spiritual desire to find this meaning. Because this therapy's roots are planted firmly in the concepts of existential philosophy—a philosophy that deals squarely with questions of human existence—it might be easier to think of existential therapy as more of a counselor's philosophical approach to therapy than a well-defined school of therapy with specific techniques at its disposal.1

Considering this perspective, it is easy to see why many addiction counselors who serve adolescents might initially shy away from any thought of using existential therapy. The reasons for their hesitation are obvious, because the concepts of existential therapy just seem too nebulous and abstract for their adolescent clients to comprehend—and too boring to hold their attention for long. This hesitation is unfortunate, because nothing could be further from the truth.

David d. cook

David D. Cook

There are five strong arguments in favor of using an existential approach with adolescents. First, the very nature of addiction's underlying causes in both adults and adolescents is strongly existential; it is generally well-recognized among professionals that people in the throes of addiction got that way looking for some sort of meaning in life. A pharmacological blindfold is used to deal with the emptiness that accompanies this lack of meaning. Second, many adolescents are not necessarily incapable of comprehending the abstract concepts of these philosophical approaches. By age 15, most have developed the ability to handle abstract concepts. Third, once adolescents taste their newfound ability to think abstractly, they quickly become enthralled with their expanding talent to explore the world on a different level. A ubiquitous curiosity and a sometimes annoying attitude that they know more than adults about the world are hallmark characteristics of normal teenagers. Fourth, many addiction treatment programs, both adult and adolescent, already have had success using a disguised version of an existential approach for years without realizing it: the spiritually based 12-Step recovery program. Finally, existential concepts, probably more than many other therapeutic concepts, can be easily conveyed through a variety of stimulating vehicles that appeal to adolescents and help the counselor hold their attention. These vehicles are limited only by a counselor's creativity.

The experiences of the staff at an adolescent residential substance abuse treatment center in rural Mississippi, Sunflower Landing, demonstrate just how easy, effective, and rewarding a use of creative vehicles to convey existential concepts can be. Staff members have been using such approaches for more than a decade, and the adolescent counselors will readily attest to their success.

Since 12-Step treatment forms the cornerstone of the treatment approach at this facility, counselors have always welcomed any way to clarify, expand, and add substance to the existential thrust of that program. However, like anything worthwhile, the process is not without effort. It dares the counselor to be brave enough to try something different and to unleash his/her full imaginative potential. On top of this, it requires a sound understanding of the adolescent developmental period and the unique nature of adolescents' substance use.

Understanding adolescents

Photographs taken by sunflower landing clients elicit discussions of existential concepts.

Photographs taken by Sunflower Landing clients elicit discussions of existential concepts.

One of the crucial tasks of adolescence is to find an identity. Adolescents who fail to find a healthy identity are at a significantly higher risk for problems such as delinquency and substance abuse than are other adolescents. These high-risk adolescents often find substitute identities, considering them better than none at all. Their thin veneer of substitute identity does a poor job hiding the emptiness that exists on the inside. They often attempt to escape their meaningless identity through loud music, promiscuity, violent video games, the Internet, fast driving, rebellious behaviors, and drugs.

Drug use is inevitable with high-risk adolescents for many reasons. These include the quick, surefire reprieve drugs offer from depressive emptiness; the false sense of self-confidence induced by drugs; and the semblance of acceptance, which adolescents so desperately crave, from drug-using peers.

It is only logical to presume that adolescents who fail to find healthy, real identities will also fail to find any real internal meaning in life. When they fall short of finding it on the inside, they will look in many places on the outside, but usually in places such as the beer can and the blunt. Underneath their substance abuse lies an existential dread. If an adolescent counselor really wants to get to the root of a client's substance abuse, this is where it will be found. It could be considered a therapeutic travesty not to address this important fundamental factor with those adolescents who are willing and cognitively capable of going there.