21st century teens
DESCRIPTION
Presented 9/10/10 at the North Shore Medical Center, Salem, MATRANSCRIPT
Texting, Tweeting and Robo-tripping:Substance use disorder treatment
for the teen of the 21st century
David R. Selden, LICSWDirector, SOAP
Health and Education Services, Inc.
Key Issues
• Short attention span• Tweet, Text and You
Tube• Co-occurring disorders• Family systems
The Ten Key Elements for Effective Treatment of Adolescent Substance Abuse
Community based, substance abuse focused
Individualized treatment
Self Help/12 Step Opportunities
From: SAMHSA
Evaluate Outcomes
Engage & Retain
Continuity of Care
School Liaison
Gender & Culture
Qualified Staff
Assessment at Beginning
Program Foundation Elements
Co-occurring disorder/CCISCCo-occurring disorder/CCISC Harm ReductionHarm Reduction
Needs of teens & Young adultsErikson's stages
TAY
Needs of teens & Young adultsErikson's stages
TAYMotivational
Enhancement Therapy
Motivational Enhancement
TherapyRelapse
Prevention
Relapse Prevention
Family WorkFamily Work Group TreatmentGroup TreatmentMilieu TherapyMilieu Therapy
Case ManagementCase Management
Self HelpSelf Help
The Needs of Teens & Young Adults
• Erikson’s Stages
– Ages 5-12: Industry vs. inferiority
– Adolescence: Identity vs. confusion
– Young adulthood: Intimacy vs. isolation
The Needs of Teens & Young Adults
• Transitional Age Youth– Engage– Tailor services and supports– Personal choice and social
responsibility– Safety-net of support– Enhance competencies to achieve
greater self-sufficiency and confidence
– Outcome focus– Involve young people, parents, and
other community partners
From: Transition to Independence Program,
Rusty Clark
Relapse Prevention
• The Stages of Relapse–Emotional–Mental –Physical
Relapse Prevention
“If you are not working on
your recovery, you are
working on a relapse”.
Harm Reduction
• The continuum of risk• Abstinence is final
step• Any change is positive• Not everyone may
attain sobriety• Goal= reduce harm of
habits as much as possible
Motivational Enhancement
• Express empathy• Develop discrepancy• Roll with resistance• Support self-efficacy
Group Treatment
• Provide positive peer support• Reduce sense of isolation• Learn to cope by allowing them to
see how others deal with similar problems
• Provide useful information• Offer positive family-like
experiences• Opportunity to learn or re-learn the
social skills they need to cope with every-day life instead of resorting to substance abuse
• Instill hope
From: Substance Abuse Treatment: Group Therapy. TIP41. US Dept of Health and Human Services
Co-occurring Disorders
• Comprehensive, Continuous, Integrated System of Care (CCISC)
• Kenneth Minkoff, MD• www.kenminkoff.com
Co-occurring Disorders/CCISC
1. Dual diagnosis is an expectation, not an exception
2. Empathic, hopeful, integrated and continuing relationships
3. Treatment must be individualized and structured
Co-occurring Disorders/CCISC
4. Balance case management and clinical care
5. Each disorder is “primary”
6. “Disease and recovery” model
1.Match to phase of recovery and stage of change
7. No one correct approach
Milieu Treatment
• Multi-disciplinary team• Individualized interactions and
understanding of the emotional conflicts that are activated in such human interactions
• Examination of client/client, client/staff and staff/staff interactions
Family Work
• Being Family Focused– Family involvement– Family-focused
treatment– Family driven– Broad definition of
family– Empowering parents– Family voice
• Ensuring ongoing family involvement– Family/parent support– Family/parent
counseling– Family team– Family preservation– Sibling services– Family/marriage
educationFrom: SAMHSA: Designing a Recovery-Oriented Care Model for Adolescents and Transition Age Youth with Substance Use or Co-occurring Mental Health Disorders
Case Management
• Planning • Linkage• Advocacy • Support• Monitoring• Assessment• Outreach
Self Help
• Counters feelings of isolation, powerlessness, alienation
• Reciprocal helping exchange
• Support sense of self-efficacy
• Provides resource to meet like-minded peers
• Provides sobriety focused activities
SOAP
• A two week intensive after-school program designed to meet the specific needs of teens and young adults. SOAP provides a safe place for teens and young adults to spend their after school hours where they can learn and develop skills to support recovery from substance use disorders.
SOAP Class Rooms
SOAP Class Rooms
SOAP Gym
SOAP Activity Room
SOAP Music Room
Monday Tuesday Wednesday Thursday Friday2:00-2:30 PM Staff Meeting Staff Meeting Staff Meeting Staff Meeting Staff Meeting
2:30-3:30 PM Individual andIntake Mtgs
Individual andIntake Mtgs
Individual andIntake Mtgs
Individual andIntake Mtgs
Individual andIntake Mtgs
3:30-3:45 PM Check-In Check-In Check-In Check-In Check-In
3:45-4:15 PM Personal Assessment Life Skills Personal Assessment Life Skills Personal Assessment
4:15-4:25 PM Break Break Break Break Break
4:25-4:55 PM Substance UseEducation
Therapy Group Activities Therapy Group Activities
4:55-5:05 PM Break Break Break Break Break
5:05-5:35 PM SobrietyPlanning/Using
the Steps
Relapse Prevention Family Group Relapse Prevention Weekend Planning
5:35-5:50 PM Wrap-up Wrap-up Wrap-up Wrap-up Wrap-up
Weekly Schedule
Web Sites
Mouse Party:http: //learn.genetics.utah.edu/content/addiction/drugs/mouse.html
Intoximeter: http: //www.intox.com/wheel/drinkwheel.asp
SAMHSA Report:http://www.chestnut.org/LI/downloads/SAMHSA_Recovery_Report_on_ Adolescents_and_Transitional_Age_Youth.pdf