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With teens, accentuate the positive

October 27, 2015
by Johnny Patout, LCSW
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Johnny Patout

It takes more than academic achievements to work successfully with teenagers struggling with drug or alcohol abuse. It takes the difficult-to-define “it factor.” That’s our theory at New Beginnings Adolescent Recovery Center, a 21-acre treatment center for teenagers in Opelousas, La. When we recruit therapists to join our team, we require academic and training qualifications, including master’s-level education and experience in working with substance abuse patients, but there’s more to it than that.

The truth is, there are a lot of talented therapists out there who are highly effective in working with the adult population, but that doesn’t necessarily mean they have the temperament to work with teenagers. And that’s the “it factor”—the ability to bond, connect, relate and get through to teens who are enduring a tough time in their already-tough adolescent years. It is hard to define, but each member of our team must possess it.

Not only do our therapists have the ability to connect with teenagers, but our nurses, recreational therapists and administrative staff also must display this. Everyone who works on campus needs to have the skills to interact effectively with teenagers. The importance of treatment for teenagers who have substance abuse issues cannot be overstated, both for current health concerns and future development. As the National Institute on Drug Abuse (NIDA) plainly states, “Drugs can have long-lasting effects on the developing brain and may interfere with family, positive peer relationships, and school performance. Most adults who develop a substance use disorder report having started drug use in adolescence or young adulthood, so it is important to identify and intervene in drug use early.”

Catch-22 of adolescence

Yet most adults forget what it’s like to be a teenager. It’s an incredibly difficult period. Teenagers are operating with a not yet fully developed brain, which causes them to be impulsive, make irrational decisions and participate in risky behavior. It’s a time in their lives when they desire independence, but feel stuck depending upon their parents and other authority figures. It’s a Catch-22.

Although we have been highly successful, we embrace a continuous quality improvement mindset. That’s why at New Beginnings we have created what we refer to as the “Lean Forward” initiative to improve motivation of teenagers in treatment. The program is rooted in creating a positive peer culture and environment. We have seen improvement in satisfaction scores by patients and family members, along with improved staff satisfaction over the work environment. The initiative has resulted in longer lengths of stay and fewer incidents among patients, and demonstrates a more effective way of motivating young people to embrace the recovery process.

This approach begins the minute a teenager first enters our program. These individuals have often felt like the black sheep in the family. Their self-esteem is low, and they frequently display frustration and anger. But when they arrive at New Beginnings, they are treated in a different manner by staff.

Lean Forward uses an acronym to summarize the main tenets of the initiative: REALISM, which represents respect, empathy, acceptance, love, information, support and motivation. From the moment a teenager steps onto the New Beginnings campus, negative labels and associations are gone.

See problems as opportunities

From the perspective of the staff at New Beginnings, there is no such thing as negative or bad behavior. We prefer to look upon these behaviors as therapeutic opportunities. Similarly, we reward and recognize positive and responsible behavior. Regardless of the behavior, the interaction stays positive, and each teenager is regarded as a special human being with tremendous potential.

There are numerous elements to the Lean Forward initiative, such as our “recovery bucks” component. When the teen displays positive behavior, he/she can earn recovery bucks (with their photo in the center) to make purchases at the campus store or cantina. This type of boost can make a difference, but so can small, less obvious gestures. Something as simple as encouraging words can have a remarkable impact on a teenager. Through the positivity of the program and support from the staff, the teens are better equipped for success.

Speaking of words, we have eliminated use of the word “consequences.” In my experience, when a teenager hears this word, he/she hears “punish.” We avoid telling a teenager, “There are consequences for your actions.” Instead, we use “outcome.” It may sound like a small detail, but “outcome” simply does not have the same negative connotation.

Parents frequently ask why their child may be turning to drugs or alcohol. My response is simple: They like the way it makes them feel. But that cries out for an answer to a deeper question: “Why don’t they like the way they feel in the first place?” That’s where New Beginnings places particular emphasis. We try to uncover the emotional feelings that are causing these young people to be less satisfied with life than they would like to be.

Because New Beginnings is an abstinence-based program, we embrace the 12-Step philosophy and also offer a variety of therapeutic techniques, including cognitive-behavioral therapy (CBT), Dialectical Behavior Therapy (DBT), rational emotive behavioral therapy and art therapy. Our experiential therapy includes an on-site ropes course that emphasizes teamwork.