Responding to Risky Behaviors

Supporting students with addiction and emotional issues:

Parent Workshop

Kate Allen LCSW CADCI

Importance of Addressing the Issues in Schools

Referrals to social worker increasing. There are 127 new therapeutic schools

opening every year nationwide. School as providing basis of

relationships for students, both with peers

and adults.

Three issues of concern:

Drug/Alcohol abuse Depression and suicide prevention Fostering resilience in youth

Impact of D/A Abuse on Healthy Teen DevelopmentCore developmental tasks include:

individuation, sense of purpose, social skills

With drug and alcohol use teens: Remain emotionally immature (projecting,

blaming, grandiose ideas of self, “boring”) Use D/A as primary relationship instead of

people. Social life revolves around use. Reorganize priorities to fit using lifestyle

Signs of Drug/Alcohol Use

Less attention paid to dressing and grooming Loss of appetite or unexplained weight loss Red and glassy eyes and frequent use of eyedrops and

breath mints Decreased attendance, performance in class Loss of interest in school, sports, other activity Newly developed secrecy; deceptive or sneaky behavior Withdrawal from family/friends, new friends Lying or stealing Disrespectful behavior, worsening mood Lack of concern about the future

Drug and Alcohol Use: Typical or Troubled? Experimentation vs. abuse/dependency Trends at Gresham HS Nationwide trends show overall D/A use

decreasing:

“While the 2005 survey showed a continuing general decline in drug use, there are continued high rates of non-medical use of prescription medications, especially

opioid painkillers”. – National Institute of Drug Abuse

Alcohol and Marijuana: Most common drugs of concern Is it possible for teens to be addicts?

Tolerance and withdrawal Alcohol: Binge drinking and signs of

problem drinking Marijuana: State-dependent learning

and signs of trouble

What about the Meth epidemic and other uppers?

Trends at GHS Other drugs: ADHD drugs, painkillers

Interventions for Teen Drug and Alcohol Problems Prepare yourself for how to approach a

teen you suspect is high or drunk Address the issue immediately and

directly Assessment process, treatment options,

UA’s, school support services Confidentiality basics

How to Approach Youth with Drug/Alcohol Problems Separate the use/behavior from the teen – do

not shame the teen Be clear about your position on D/A use and

your responsibility as a parent Build in small rewards for positive behavior Expect emotional instability while recovering,

normalize ambivalence about sobriety, acknowledge relapse as part of recovery

Topic 2:

Depression and Suicide Prevention

Prevalence of Self-Harm Behavior Amongst Teens "As many as 40% of kids have

experimented with self-injury." - Jennifer Hagman, Medical Director of Psychiatry, Children's Hospital, Denver

"90% of self-abusers begin cutting as teenagers." - University of Missouri-Columbia Study

"More than half of self-injurers are victims of sexual abuse, and most report emotionally abusive or neglected childhoods ... contrary to the stereotype, self-injury is prevalent in all races and economic backgrounds." - Time

Why do Some Teens Intentionally Self-Harm? Releases tension/distress Not typically done with suicidal intent Self-soothing coping mechanism Externalizes internal pain Provides way to care for self and regain

control over unmanageable emotions

Common Characteristics of Students who Self-harm Hypersensitive to rejection Rigid emotionally, reactive, angry, easily

irritated Impulsive Strong dislike of themselves Tend not to plan for the future

How to Help Teens who Self-Harm Ask if they are self-harming, respond directly.

Avoid “why” questions. Refer to a professional as soon as possible.

Enforce a ‘no secrets’ policy. Ask, “How would you like me to respond to

that?” Say” Let me listen to you”. Build relationships – most often self-harm

happens in absence of people. School social worker response to self-harm.

Teens at risk for suicide

Gender differences Racial/ethnic differences Age differences How Oregon compares to national

data

Gresham-Barlow SD data

Oregon Healthy Teens Survey 2007

Seriously considered suicide in past 12 months:

11th graders: 12.4%

8th Graders: 13.1%-- Source: Center for Health

Statistics Oregon Dept. of Human Services

SAFE:TEEN at GHS

3 part program: staff, parents, students Evidence based program proven to

reduce teen suicide Social worker interventions

SUICIDALITY

1. Thoughts about death

2. Thoughts about killing oneself

3. Choice of method or developing plan

4. Carelessness5. Gestures6. Attempt7. Completion

SUICIDE IS…

AN ACT OF DESPERATE HOPELESSNESS AND OVERWHELMING PAIN

A CRY FOR HELP PREVENTABLE

SUICIDE IS NOT…

SELFISH SPONTANEOUS

Signs of Depression Withdrawal Sad, angry or irritable for 2+ weeks Loss of interest in usual activities Mood swings - may indicate bipolar depression Difficulty concentrating Substance abuse Sleep/appetite changes Cry easily

RESPONSE 03© Looking Glass Youth and Family Services

When to be ConcernedDevelopment of a planTalking, writing and/or reading about suicide or

deathTerminal StatementsPrevious Attempts

RESPONSE 04

© Looking Glass Youth and Family Services

When To Be Concerned Cont’d

Refusing help, feeling “beyond help”Giving away possessionsHaving tunnel vision - focused on painSuddenly cheerful after period of

depression

RESPONSE 05

© Looking Glass Youth and Family Services

Drugs and Alcohol Use

Increased risk if substances involved:Increased risk if substances involved:

Self –medicationSelf –medication Impact of drugs and alcohol on judgmentImpact of drugs and alcohol on judgment

55% of people who die from suicide have alcohol in their bloodstream when they die.

WHAT STOPS SUICIDAL TEENS FROM ASKING FOR HELP?

Don’t want to rock the boatDon’t want to disappoint parentsDon’t want to admit they need helpDon’t know what to expectDon’t understand what they are

experiencing

How to Help Listen without judgment Ask “Are you thinking of

killing yourself?” Say “I’m sorry you are

in so much pain.” “I’m here to help.” Let them know they are

not alone. Seek help together as a family.

RESPONSE 06

© Looking Glass Youth and Family Services

Video: A Life Saved

What two questions does Mary, the mother, ask Bill about suicide?

What stops the mother, Mary, from asking for help?

5 Steps to Helping a Teen

Stay calm Ask the question, “Are you thinking of

killing yourself? If yes, do not leave teen alone Listen and offer calming things to say Get professional help

RESPONSE 08

© Looking Glass Youth and Family Services

How to get help at school or in the community: Talk to the student’s counselor or the

school social worker Call the Suicide Prevention Hotline Call Multnomah County Crisis Line If immediate danger call 911

GHS support services

Support groups: Chrysalis, Grief/Loss, Guys group, Pre-Options

Mental health specialists: Multnomah County MH consultant

Drug/Alcohol assessment and treatment: Lifeworks NW

Teen advocates: Metropolitan Family Servcies, Asian Family Center, Native American Youth Center, El Programa Hispano

Topic 3:

Fostering resilience in youth

Power of relationships

Kids spend on average 23 hours doing “screen time” a week!

PADS Educate yourselves and your children

about consequences of D/A use and unhealthy coping

Spend time together as a family every week

Raising Resilient Kids

Talk to your child about your values regarding drug/alcohol use, honesty, sexual activity, and school.

Set high expectations, enforce limits consistently with appropriate consequences (positive and negative).

Help youth identify healthy coping skills when difficulties arise (distress tolerance skills).

Go through the 40 assets list with your child!