Substance abuse and mental illness treatment is often different for adolescents as they are exposed to different risk factors, environments, and situations than adults and seniors. Adolescents as a group are, however, a high-risk group for these issues. According to the National Institute on Drug Abuse, almost 70 percent of high school students will have tried alcohol by the time they are seniors, half will have taken an illegal drug, nearly 40 percent will have smoked a cigarette, and more than 20 percent will have taken a prescription drug for a nonmedical purpose. In addition, many mental health disorders affect adolescents or have their onset in the teenage years. According to the Office of Adolescent Health, 1 in 5 adolescents has a diagnosable mental health disorder.
Adolescence is an important time in one’s life. Biologically, the adolescent brain is still developing and is in an important, impressionable stage. Behaviorally and socially the teenage years are characterized by a desire for new experiences, taking risks, learning who they are, and dealing with personal and social pressures. For these reasons many teens try drugs or alcohol, and some end up abusing substances, but they may also be at a higher risk for problems later in life.
Adolescents and Substance Abuse
Drug Abuse and the Teenage Brain
The teenage years are particularly vulnerable as the brain is still developing at that time. A report from the National Institute on Drug Abuse writes that the brain matures into adulthood. The last region to develop is the prefrontal cortex, which governs self control and judgment. On the other hand, one of the earliest parts to mature is the part that processes reward and pain. These two factors highly contribute to substance abuse as teenagers are likely to process and respond to pleasure and pain but still have an impaired (when compared to an adult brain) ability to make sound decisions.
Factors that influence teenage substance abuse:
- Availability of drugs in the community
- Influence of peers, whether or not a teen’s friends are using substances
- Drug or alcohol abuse in the household
- Level of emotional support vs. emotional abuse at home
- Mental health, mental illness
- Genetic vulnerability
Dangers of Adolescent Substance Abuse
While teenage substance use and experimentation does not always lead to repeated use, in some cases it does. With repeated use, it can also lead to addiction. In any case, abuse of drugs and alcohol is potentially dangerous, and their repeated use is even more so. These risks increase as a teen’s pattern of use increases:
- Problems in school
- Relationship issues, problems with family and/or friends
- Loss of interest in normal and healthy activities
- Impaired memory and cognitive function
- Increased risk of contracting disease through risky sexual behavior or injection drug use
- Mental health problems
- Death by overdose or other accidental, drug or alcohol related cause of death (such as in a car accident)
Adolescent Substance Abuse Treatment at Rehab Centers
Adolescents face a number of unique influences in their daily lives and are constantly developing, changing, and figuring out who they are. Rehab centers for adolescent substance abuse recognize that reality, and work to help teens heal by addressing these influences and the issues specific to their age group. According to the Substance Abuse and Mental Health Services Administration, treatment providers should address cognitive, social, emotional, physical, and moral development as well as family and peer environments to effectively treat the adolescent population.
Treatment for adolescents takes into account the specific age of the adolescent, their gender, ethnicity, cultural background and readiness to change. As some delay in cognitive and social-emotional development is sometimes associated with adolescent substance abuse, according to a study by Newcomb and Bentler, treatment should identify those delays if present and keep in mind the effect they could have on other aspects of an adolescent’s life.
Involvement of a teenager’s family is an important part of adolescent treatment. The family can act as an agent of change in the adolescent’s environment, and may be involved in the origin of the adolescent’s substance use problem. In some cases teens may have been coerced into treatment and thus will have certain motivational barriers which will complicate or slow treatment. Identifying these early can greatly help treatment progress.
These are some components of adolescent treatment in rehab centers:
- Education: It is common for adolescents to have an incomplete picture of the nature of substance use disorders and treatment centers. Treatment will involve furthering their understanding of what treatment is, and what it is for. They will be taught about chemical dependency, expectations, and more.
- Scheduled activities: Many adolescents may not know what to do with their time outside of using drugs or alcohol. For this reason, adolescent treatment involves scheduling school, chores, homework, and recreational activities for the teen in question. In outpatient programs, treatment professionals would probably work with families to help with scheduling and taking part in activities.
- Group therapy: Teen substance abuse is often affected by peer influence. With group therapy, the idea is that teens can build the strength needed to override peer pressures and can learn to draw on positive peer strength. As well, peers can positively influence each other through stories, interactions, and feedback.
- Client contracts: Counselors sometimes create contracts to be signed by their adolescent clients. In these contracts there will be goals around specific target behaviors as well as commitments to being substance-free. The contract will outline rewards for positive behaviors and consequences if it is not followed.
- Schooling: Some, if not most programs require some classroom time to be incorporated in the treatment of adolescents. In residential programs this could be at the treatment facility or in local public schools, according to a SAMHSA Treatment Improvement Protocol.
- Vocational training: Some level of career planning and education about different career possibilities is common in adolescent treatment.
Behavioral and Psychosocial Interventions for Adolescents with Substance Use Disorders
There are a variety of more specific therapeutic approaches used by counselors in adolescent treatment. These interventions are favored over pharmacotherapy and often prove to be effective in treating substance use disorders in adolescents, according to the US National Library of Medicine.
These are the approaches:
- Family-based interventions: Counselors will analyze and identify problem behaviors within the family, especially things that may contribute to the adolescent’s substance use disorder. Parents are taught monitoring skills, behavioral management to improve their adolescent’s behavior, and strategies to improve overall family functioning to improve and sustain treatment outcomes.
- Behavioral therapy approaches: A system of rewards will be created to promote positive behaviors in which the adolescent will receive rewards for activities that promote abstinence while reward is withheld when drug use or other behaviors occur. Urine tests are often used here to determine drug use and properly offer or withhold rewards.
- Cognitive-behavioral therapy: Increase motivation to increase engagement in treatment. Discover patterns of substance use, skill deficits, and attitudes that will be targets of treatment intervention. Work on enhancing coping strategies for the individual to deal with cravings and anger. Strengthen problem solving and communication.
Mental Health and Adolescents
There is a substantial prevalence of mental health disorders among the adolescent population, and up to one in five is affected by a diagnosable disorder. The warning signs can be subtle, and are sometimes looked over or rolled into the expected signs of ‘teenage angst’. Adolescent mental health disorders can harm a child’s relationships, school performance, and can in some cases lead to suicide.
According to the Office of Adolescent Health, common warning signs of teenage mental health problems include:
- Persistent irritability
- Social withdrawal
- Major changes in sleep patterns and/or appetite.
Adolescence is a particularly important time for mental health, as well, as most mental health problems have their onset in adolescence. A report from the National Adolescent Health Information Center shows that half of lifetime mental health disorders start by age 14, while 75 percent start by age 24.
The same report shows that the most common mental health disorders among adolescents are:
- Anxiety disorders
- Attention-deficit/hyperactivity disorder
- Substance use disorder
The mental health of young people is important for their development and their futures. Youth with poor mental health are more likely to engage in risky health behaviors such as substance abuse and self harm.
Mental Health Treatments for Adolescents
Rehab centers offering adolescent treatment for mental health disorders has an age-specific approach. Treatment addresses the specific issues facing adolescents as well as their relative emotional and biological development. Some medication treatments that are provided to adults are not provided to teenagers, or at least not in the same dosage. According to the National Center for Children in Poverty, suicide is the third leading cause of death in adolescents and young adults. This fact underscores the need for adequate mental health treatment for adolescents.
Treatment for adolescents at rehab centers depends on their specific circumstances and what mental health disorder they are diagnosed with. The US National Library of Medicine outlined some of the more common disorders and the appropriate adolescent treatment:
- Conduct Disorder: behavioral interventions, family-based therapy.
- ADHD/ADD: pharmacotherapy with psychostimulants
- Bipolar Disorder: pharmacotherapy with mood stabilizers
- Depression: adolescents with severe depression will likely receive both psychotherapy and pharmacotherapy while with those with mild symptoms will be offered a trial with psychotherapy alone
- Anxiety Disorders: cognitive-behavioral therapies, sometimes combined with medications
How Many Adolescents are getting the Treatment They Need?
According to the National Adolescent Health Information Center, most youth with significant emotional distress do not receive mental health services. Another study found that only 10% of children and adolescents with symptoms of mental health problems received any type of evaluation or other mental health service. In addition, disparities by ethnicity, income, and geography are noted in the receipt of mental health treatment by youth. At the same time, a measure by the NSDUH found that 21.3% of youth aged 12-17 received some form of mental health treatment.