Today’s guest blog post is by Drew Horowitz, MA, LADC, RAS, CIP, a Twin Cities-based substance use and mental health professional. Welcome to the #OYACommunity, and thank you for sharing part 2 of a 3-part series with our readers.
Recently I had a conversation with a mom from North Dakota, and truthfully, it’s a typical conversation I have with parents all over the country.
The mom asked, “Would you be able to come pick up my 22-year-old son and bring him to treatment in Minnesota?”
“Sure.” I replied. “I would be happy to help your son get the treatment he needs. What day are you thinking?”
Her reply: “Well that’s the thing, he doesn’t exactly want to go nor does he think he has a problem”
“Oooookay,” I said with an extended tone. “Well how exactly do you want this to happen?”
The parent went on to explain her utter exhaustion with her son’s addiction and reported that she and her husband were simply “done.” She wanted her son out ASAP and in a treatment center by the end of the week.
I asked the mother, “Have you tried to encourage your son to seek treatment, and if so what did he say?”
Her words: “I have told him over and over again that he has a serious drug problem and he is not the son we raised”.
Enough said, I understood.
The Traditional Approach to Intervention Doesn’t Work Well with Teens
In previous years, my common response entailed an immediate plan of action to quickly intervene and remove the young adult from the environment. The plan would have been simple, either he would come with me to Minnesota or exit the home and live independently (potentially with police involvement). Additionally, I would have placed the element of fear inside his head, by letting him believe that he either came with me or he positioned himself near death.
Using this traditional approach, I have conducted countless interventions nationwide. Repeatedly, I showed up at homes around the country and informed young adults that they had two choices: A. Go into treatment TODAY or B. live independently on the streets without the support of family or friends.
Addicted or not, almost 80% made the choice to reluctantly enter treatment. Leveraged into a corner, the young adult considers living independently on the streets, however, generally sees that treatment may be a better option.
That being said, it’s almost never a fairy-tale ending.
An extremely high percent of those admissions did not stay sober or even remain in treatment.
Families would call me a few weeks later and ask for help – in complete despair with the rebellious nature of their son or daughter.
A Realization in the Making
Continually, I was saddened by what I was seeing and it personally effected me. I realized that I was not actually providing a beneficial service to families as THEY, the families, were essentially dictating the course of action.
I posed the question to myself, “Shouldn’t it be I, the professional, to provide the family with the best option to support their son or daughter?” I pondered on that thought and knew that there must be a better way to do this!
Launching a New, Improved Approach to Helping Young Adults with Addiction
In August 2014, when I founded Drew Horowitz & Associates, I decided that my method of intervention would change. My objective would be to incorporate a strength-based, empowering approach to intervention.
The new approach is called the “Teen Environmental Advancement Model” (T.E.A.M) and it’s designed to help teenagers and young adults seek treatment for their existing substance use disorder.
It does not use leverage or force to move them into a recovery setting. Instead, this model works to educate people on themselves, identify values and aspirations, draw discrepancy between existing behavior and goals and learn about steps that best position them to be successful in life.
In my professional opinion, it made much more sense to “meet the client where they are at” and guide them through a process to begin understanding the detriment of their behavior. Not only does this model help the individual make their own decision to enter treatment, but also it increases the odds of long-term sobriety.
T.E.A.M. Work (Teen Environmental Advancement Model)
Let me share the approach with you in with the counselor applies empathy, genuineness, self-disclosure and compassion and in which we continually work to strengthen rapport and alliance with the young person.
- Preparation: This consists of the counselor gathering information from family and friends regarding the condition of the identified young person. This process helps the counselor come to understand the person of concern.
- Introducing the idea: The counselor provides a suggested script for families to use when they introduce their loved one with the idea of meeting a counselor. The counselor then coaches parents and other family members on how to answer the person’s questions and address their objections, thereafter helping families overcome those barriers and create a segue for the counselor to meet with the person.
- Meeting the Young Person: Next, we schedule a first meeting between the person of concern and the counselor. The counselor begins building rapport and establishing trust, taking an empathetic and person-centered approach that differentiates between the people being “sick” versus “bad.”
- Building Discrepancy: At this point, the counselor meets with the person of concern to help identify goals, aspirations and personal values, continuing throughout to build rapport and validate the person’s thoughts, feelings and frustrations. While encouraging the person to attain their vision, the counselor begins the process of building discrepancy between the ways the person is living versus their values. The counselor methodically works to help the person see that their current behavior isn’t allowing them to be the person they want to be. In most cases, the person of concern starts to become self-aware of their destructive behaviors and agrees with some need for change.
- Making a Recommendation: Now the counselor recommends a course of action. This involves remaining non-confrontational and compassionate while informing the person that the next step in moving forward and accomplishing their goals entails entering a treatment program of some type. Opposition and frustration are typical responses, to which the counselor reminds the person that by seeking treatment they best position themselves to be successful in life and attain goals. However, the person is never forced into treatment, but instead is encouraged to keep an open mind about the process. It is not uncommon for the person to start at a lower level of care and work up to an in-patient setting.
- Entering Treatment: The counselor arranges transport to the treatment facility and, in the interim, prepares the person for their treatment experience, investing considerable time in articulating to the person how much courage and strength they’re demonstrating by taking this life-changing step.
- Moving Forward: At this point, the person of concern is under the care of the treatment provider and it’s critical that they remain on track. Toward that end, the counselor’s role changes to that of a clinical case manager for the person and a family educator for their loved ones. Ideally, the counselor visits the person in treatment weekly or biweekly, depending on the facility’s location.
- Providing After Care: As primary treatment concludes, the person of concern receives a recommendation for continuing care. The counselor supports the treatment program’s recommendation and encourages the person to follow through, applying intervention tactics and working with the family as needed to ensure that they take the appropriate aftercare steps.
- Turning it Over: The counselor’s involvement isn’t intended to be long-term. The hope is, after a period of time, the person of concern will no longer be a concern. The counselor defers to the recovery community and encourages the person to lean on their new found community—their sponsor and peers—for ongoing support. That said, the counselor never declines a phone call or meeting request.
Using the T.E.A.M. model, I have seen a massive increase in positive outcomes among young adults: Pleasant goodbyes from home, motivation in treatment to get healthy, abiding by aftercare recommendations and active participation in the recovery process.
In order to be effective with today’s vulnerable young adult population, we must promote autonomy, strength and mutuality. I now leave interventions with a sense of inner peace and hopefulness that I had never experienced in the past. More importantly, our young loved ones and their families are finding a similar inner peace and hopefulness, too.
Drew Horowitz, MA, LADC, RAS, has a vast range of experiences working with addiction and mental health. He gained a wealth of knowledge through his own recovery coupled with extensive training: a master’s level education from the Hazelden Graduate School of Addiction and an undergraduate degree in psychology and human development from Hofstra University. Following a career with several substance abuse and mental health organizations, he formed Drew Horowitz & Associates, LLC, an organization designed to assist young men who struggle to overcome addiction and mental health.
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