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Egos and Fig Newtons: Working with a Young Adult Male Population

April 7, 2015
by Heidi Voet Smith
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I began my career working at female-only treatment center working with pregnant and parenting women who brought their children with them to treatment. Through this experience, I definitely developed what some might call an expertise in working with women’s issues in early recovery. From there I transitioned to a co-ed treatment facility where I learned how combining genders could be an incredible and redemptive tool in early recovery (I could write a whole blog on just this.) And now I find myself coming full circle in my career and am working with young adult men in early recovery. This has been a fascinating lesson for me in the dynamics of working with an all-male population and I am so grateful that I get a new perspective. Here are some of the things I am learning . . .

1.     When young men fall behind their peers in education and career, it shatters their confidence. When chemical dependency disrupts a guy’s education or career, as much as they might act like they don’t care, they feel like total losers. This is not a surprise, but it is an important factor to identify with young men because so much of their manhood is attached to their ability to provide. I see a pattern with guys trying to figure out other ways to make themselves “matter” in the world – for example, they may not be in school like the rest of the guys they went to high school with, but they are the best drug dealer in town. They will find a way to matter in whatever current situation they find themselves. I love seeing the light come on in the eyes of a young man when he begins to feel like he matters at his 12 step group, with his sponsor, and with his sponsees. This, I believe, is the first step to rebuilding vision and confidence in the lives of these guys.

2.     The bigger their ego appears to be on the outside, the more fragile they actually are on the inside. I find it very painful when I work with a young man who absolutely refuses to open up, utilize therapy, and become authentic. And unfortunately, this is more common with men. At any given time, I have a few male client’s who will not “go there” and talk about their pain, their insecurity, their wounds and their fears. These are the guys who need to talk the most. Their number one commitment in life is to never look weak. Which unfortunately, is the first indicator that there are wounds that need to be addressed. I pull out the best joining skills I have, get creative and try to dive in to their worlds. But unfortunately, there are not enough therapeutic tools and skills in the world to break through this barrier if the client is not willing. So I wait. I pray. And I talk to them about music.




The lead clinicians stubbornly refuse to change this life threatening protocol of chest compressions only for drug OD. Causing an increase in in morbidity and mortality as well as making the clinicians and everyone else victims.
Live human study chest compressions only for drug overdose.
My letter Emergency Medicine News Dec. 2015

Beyond grey medical literature live human study in Ontario, chest compressions only for respiratory emergency Can. J. Public Health 2013;104(3):e200-4
'Development and implementation of an opioid overdose prevention and response program in Toronto, Ontario.'

Was also published in the 2015 AHA & ILCOR CPR guidelines about this life threatening intervention.
Read all comments under this deputation Toronto Board of Health

Best Wishes


Heidi Voet Smith

Clinical Director Chapter House Counseling Center

Heidi Voet Smith


 Heidi Voet Smith, (LPC-S, MA), is the Clinical Director and Co-Founder at Chapter House Sober...

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