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Treatment

Components of an Effective Teen Residential Treatment Program

Regardless of whether your teen has come forward about struggling with drug use, or you have convinced them that you’re all going to need help to get through this as a family, finding the right teen residential treatment program is a critically important and difficult process.

Private treatment facilities are relatively unregulated, and there are no strict standards set in place for these facilities nor the programs they espouse. Parents are required to do their own research and rely on other qualifications and accreditations to ensure that their teen is in the right hands, and that is no easy task.

The FTC asks that all parents go through a step-by-step process when identifying and vetting potential teen residential treatment programs, beginning with a thorough online search, proof for claims regarding qualifications and state- or nationwide accreditations, and a site visit. Here’s what some of the things you should pay attention to when looking for the right teen residential treatment program.

Accredited Program and Trained Staff

While there are no federal standards or guidelines for residential treatment programs and outpatient treatment programs, multiple non-profit organizations provide several regulations and accreditation options for addiction treatment facilities, outpatient facilities, and behavioral health programs. Teen treatment programs offering academic curriculums should also be accredited to offer these educational programs and adhere to the standards set by relevant national and international organizations.

These include organizations such as The Joint Commission and the Western Association of Schools and Colleges. When reviewing a facility’s staff and clinical director, consider giving each member their own individual search. The Federation of State Medical Boards website, for example, lets you search whether a medical professional in the team has the board certifications they claim to have through DocInfo.org.

The Internet will be invaluable for learning as much as you can about the people running the show and their reputation in each given field. Any teen residential treatment program should have at least one accredited and trained child and adolescent psychiatrist, as well as multiple medical doctors and nurses. These treatment programs, particularly ones specializing in addiction and co-occurring mental health issues, are equipped to handle certain medical emergencies, from the aftermath of a self-harm episode to a serious physical withdrawal.

Reliance on Evidence-Based Treatments

Dual diagnosis and mental health treatment are evolving research fields, but certain treatments have a larger body of evidence to support them than others. Most treatment programs will rely on a combination of specific pharmacology and targeted psychotherapy, particularly:

Alternative therapies and treatments may also be offered and play a role in the treatment process, yet would not typically take center stage, including equine and pet therapy, acupuncture, and more. You can learn more about what therapies are most often recommended for teens struggling with drug use and co-occurring mental health issues through resources such as the American Psychological Association and the National Alliance on Mental Illness.

Long-Term Ongoing Support

Another important predictor for the quality of a program’s treatment process is its emphasis on long-term and ongoing support, even after treatment. Addiction is not wholly addressed within a 1–3-month period, and it can take months or years for a teen to remain reliably sober and learn to cope with co-occurring mental health issues.

Look for programs that offer and encourage extended care, as well as ongoing support, family therapy, referrals to other therapists for ongoing care, and access to community resources so teens can continue to seek help after the treatment period has ended. Programs that focus on promoting sustainable positive change in teen behavior and health, and offer realistic outcomes, are preferred.

Skills Training and Specialized Care

Teen treatment programs often cover care for many complex and varied conditions, with circumstances including a history of trauma, victimization, and more. These treatment programs must be tailored to each teen, based on their respective circumstances and risk factors, symptoms, and more, on a case-by-case basis.

This means programs must often work together with local specialists or include a staff of trained psychiatrists and doctors with experience in these special or unique circumstances to create an environment and treatment program conducive to each teen. Programs that include staff with multiple specialists are recommended.

School and Tutoring Services

Outpatient programs and residential (inpatient) programs might offer various academic programs to help teens enroll in treatment, keep up with their classmates and continue studying. An acknowledged accreditation body must usually accredit these programs.

Questions for Parents to Ask

When determining which of your options is the best fit for your teen helps prepare a few questions.

  1. What sort of accreditations does your program have?

While no federal regulations are surrounding residential and outpatient treatment programs, accreditation programs are the next best for setting an industry standard.

  1. What kind of qualifications does the staff have?

These treatment facilities work with children dealing with many serious mental and physical health crises, so having multiple licensed and experienced medical professionals on-board is important.

  1. What is the site like?

Is it spacious and private? Does it have homely accommodations for each teen in the program?

  1. What is your reputation like?

A program’s online reputation can be a great source of information. Be sure to go over multiple different local forums and groups for a big-picture impression.

  1. Do you provide an academic curriculum?

Teens are usually still in school when they are enrolled in a treatment program, and to this end, many residential treatment programs offer day schools.

  1. How thoroughly vetted are your staff?

Find out what sort of background checks the facility runs on its staff and how thorough these checks are.

  1. Can I keep in contact with my teen?

Some programs heavily restrict or forbid contact with the outside world, including parents. Find out what the rules and limitations are around having contact with your teen during the treatment process.

  1. How will my child’s needs be assessed and reassessed?

Most programs utilize rigorous psychiatric evaluations to determine a teen’s needed level of care and an appropriate treatment program. These evaluations may need to be performed multiple times throughout the program, depending on a teen’s progress.

Finding the right teen residential treatment program will be a multistep process. Understandably, you would want the best possible care for your child, and taking every measure to ensure you make the right choice is worth the time spent on working through the options available to you.

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Treatment

How to Choose the Right Teen Treatment Program

Choosing the right teen treatment program for your child can be very difficult. We are often torn between doing the right thing and wanting the easiest and most comfortable path for our teens. Still, sometimes, specialized or intensive care is the only appropriate measure for ensuring that your child gets the treatment they need.

Furthermore, mental disorders come in all shapes and sizes, with a dramatically vast array of associated problems and symptoms. The offer for teen treatment programs is beginning to mirror the complexity with which mental health issues can manifest. It would help if you were as informed as possible when making this choice.

Different Teen Treatment Program Types

Teen treatment programs are focused on providing a flexible treatment plan to match your teen’s needs. To that end, most treatment facilities offer multiple programs depending on:

    • The severity of the disorder.
    • The level of danger a teen might pose for themselves or others.
    • And the appropriate level of care that their specific condition calls for.

Some cases are best treated without much upheaval from everyday life through an outpatient program that focuses on remote monitoring and support, for example. Other issues require a much more rigorous intervention and can involve housing a teen in a residential treatment facility for several weeks or months.

It is always best to consult a professional and get a firsthand recommendation for what kind of treatment your teen might need, depending on their diagnosis and symptoms. We will go over some of the most common and basic teen treatment program types you are likely to encounter.

Inpatient vs. Outpatient Treatment

Mental health treatment programs are most often differentiated by being either an inpatient or outpatient program. Inpatient or residential treatment programs require a teen to live inside the facility throughout the treatment process, always caring for professionals and living alongside other teens.

On the other hand, outpatient programs are less intensive and focus on providing greater flexibility, allowing a teen to live at home and go to school or work while visiting the outpatient center on a scheduled basis, usually once or twice a week. Outpatient programs are also typically more affordable.

The pros and cons of both serve to skew inpatient programs as more favorable for teens with conditions that require long-term professional care and oversight, especially if their parents are typically at work throughout the week. In contrast, outpatient programs are often more appropriate for teens with moderate symptoms who do not need a more structured residential program.

Inpatient programs are typically set in either a clinical or residential property, where teens are given individualized routines to address symptoms and group-based activities to promote healthy social relationships. Sometimes, inpatient programs serve to take a teen out of a stressful or troubling environment, such as in addiction or trauma cases, where specific triggers could lead to relapses and should be avoided in the early months of treatment.

In other cases, a professional might decide that a teen’s family dynamic could be antithetic to their treatment process, and situating them in an inpatient program while addressing family strife through therapy would be far better for the teen’s recovery than an outpatient program that doesn’t serve to address the stressors at home.

Partial Hospitalization Programs (PHP)

When teens need a treatment program that transitions them from an inpatient setting into outpatient treatment or need a step up from outpatient treatment before requiring 24-hour care, some professionals might recommend a partial hospitalization program (PHP). This is often a short-term program aimed at providing care for teens who have a hard time at school or work because of their condition but are not a danger to themselves or others.

Partial hospitalization is also usually specialized towards teens with co-occurring disorders. Teens are expected to visit the facility during a partial hospitalization program, much like an outpatient program, but for multiple hours a day, often three to five days a week.

Extended Care Treatment

Mental health and addiction treatment programs are usually designed to be the first significant step in a teen’s path towards a better life quality. They are not the A-to-Z of recovery – instead, teens are expected to take what they have learned and experienced and, with the help of their friends and family, leverage this knowledge to cope with future problems, seek help during stressful times, and adhere to a long-term treatment plan that works for them.

But in some cases, the first steps of a teen’s treatment last longer than a few weeks, and extended care is needed. Some facilities provide comprehensive care programs that last several months, helping teens ease out of a residential setting, preparing them for the challenges they will have to overcome in addition to their symptoms and personal difficulties.

Extended care programs usually coordinate with a teen’s school, community, friends, and family to ensure a transition into a healthy and informed support system while helping the teen find their role in life and take on greater responsibilities. Teens will continue to take classes and study on the same level as their classmates while in an extended inpatient care program. These programs often coordinate with educators to adapt the teen’s curriculum into their daily schedule.

Specialty Clinics

Certain mental disorders require specialized care due to the nature of the illness. Obsessive-compulsive disorder (OCD), trauma disorders, and eating disorders may require specific or additional features to accommodate better teens with a dangerous or complicated condition that is more likely to lead to self-harm or might otherwise not be fully addressed in an environment that isn’t necessarily equipped with the staff and tools to help these teens.

For example, eating disorders carry the highest risk of death among all mental illnesses. They require a program tailored to a teen’s mental and physical needs, including access to emergency care, nutritional expertise, and physical therapy. Specialty clinics can address such disorders and help teens who might otherwise not get the help they need.

Teens with Mental Disorders Require Professional Help

The treatment process for any teen differs significantly depending on their circumstances and conditions. When choosing a treatment provider, it is essential to consider professional advice and choose based on your teen’s individual needs above all else. There are many different options out there, but often just a handful that is right for your child.

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Treatment

How Does Teen Addiction Treatment Work?

Addiction treatment usually involves several different therapies and modalities, but the vast majority of facilities have moved away from the traditional “one-size-fits-all” model and towards an individualized approach. Teen addiction treatment programs tend to place great importance on understanding the circumstances surrounding a teen’s addiction. Because most teens are not long-term users, and because adolescents differ from adults in behavior, thorough assessment and careful consideration of teen-specific treatment options is important.

The physical effects of drug use manifest differently in teens who have only been using drugs for a few months or years versus adults who have been struggling with addiction for decades. Teens who use drugs also tend to be struggling with a co-occurring mental health condition that may have tied into their addiction, further complicating treatment. However, while every teen’s treatment is unique, there are several elements that remain common between cases.

Understanding Addiction

Treating an addiction requires a holistic approach that determines how a person’s biopsychosocial profile feeds into their drug use, and how both short-term and long-term support will be necessary to help a teen remain drug free. This means:

    • Looking at a teen’s family history.
    • Taking into context previous instances of drug use and/or addiction.
    • Taking into account potential risk factors at home and/or at school.
    • Working with parents and educators to better understand how the addiction began, and how to treat it.

Substance-use disorders are distinct from behavioral addictions and refer specifically to disorders caused by and characterized by the repeated and compulsive use of addictive substances despite clear and recurring negative consequences, as defined by both the APA and the DSM-5. Addiction begins in the brain, and in the context of substance use, it is at least partially tied to a drug’s “addictiveness”.

Some drugs are addictive, and some aren’t, which is understood to be tied to how certain substances interact with pathways in the brain related to pleasure, motivation, and decision-making. Different drugs affect the brain via different drug mechanisms, many of which rely on the release or amplification of dopamine, one of many neurotransmitters responsible for reinforcing behavior.

What Does Teen Addiction Treatment Entail?

Treating an addiction often begins with abstinence, cutting into how recurring use reinforces a drug’s effects on the brain. Treatment providers work with teens and their parents to identify contributing factors, such as triggering events, recurring stressors or diagnosed mental health conditions.

From there, they work on providing patient-specific therapy (and medication, if needed) to combat these issues and provide teens with more constructive coping mechanisms. In cases where repeated relapses or a history of issues may make outpatient treatment difficult, teens and their parents can opt to seek more intensive care.

At this next level of care in residential or inpatient treatment, teens learn how to:

    • Better cope with elements in their life that might drive them to use again.
    • Seek support from peers and adults.
    • Foster behavior that can help them avoid relapsing while continuing their treatment outside of the program in the long-term.

Some teens do well with individual therapy, while others might respond better in a group. Experiential therapy techniques, and therapy aimed at helping teens hone interpersonal skills to combat feelings of isolation, can also have a positive effect on their overall mental state and likelihood of relapse.

Other important elements that are taken into consideration include helping a teen get through their schoolwork, promoting physical wellness via healthier habits (from better sleep and more exercise to a better understanding of diet), and more.

Some research also indicates that teens are less sensitive to withdrawal symptoms, and less likely to relapse because of drug-induced withdrawal problems. If they do relapse, many treatment programs work to help teens preempt and understand that relapsing can be part of treating addiction, as it helps identify a trigger point or stressor that should be avoided or further addressed in therapy.

Differences Between Adult and Teen Addiction Treatment

Teen addiction treatment differs insofar that addiction may present itself differently in teens than it does in adults. In many cases, treating adolescent cases of substance abuse requires not only an approach that focuses on reducing harmful compulsive use, but also identifies the factors contributing to the behavior such as high risk mental health issues, childhood trauma, and victimization.

Diagnostic criteria may differ for teens as well, as research points out teens may require a different or developmentally bound definition of hazardous use and have very individualized and non-standardized definitions of cravings. An individualized assessment is necessary in every case to differentiate between mild use and a substance abuse disorder and determine whether treatment required would entail an outpatient program or something more intensive.

Types of Teen Addiction Treatment Programs

Addiction treatment is generally split between inpatient and outpatient treatment. More distinctions are applied based on factors such as the focus of the treatment, length of the program, and more. A few examples of different types of treatment programs include:

Co-Ed and Gender-Specific Programs

Some teen addiction treatment programs allow teens of all genders to enroll, while gender-specific programs are tailored to each gender.

LGBTQ+ Programs

Non-conforming gender identities and sexual minorities experience a host of unique issues which can exacerbate or affect their substance use disorder. Treatment programs that cater to LGBTQ+ teens specifically may be more effective for them.

Residential/Inpatient, Intensive Outpatient or Outpatient Programs

Residential (inpatient) and outpatient programs utilize different levels of care to cater to teens requiring different kinds of treatment. Outpatient treatment will involve less contact with treatment providers but allows teens stay with their family and continue to go to school, while residential treatment offers a more intensive experience, particularly if teens are a danger to themselves or those around them.

Partial Hospitalization Programs (PHP)

Partial hospitalization is a treatment type that is a step down from inpatient care but provides a more intensive care than most other outpatient programs. Teens are instructed to visit the outpatient facility on a more regular basis and follow a strict schedule.

Extended Care Programs

An extended care program serves an alternative for when teens require inpatient treatment for longer than the standard duration of roughly 30-60 days. Extended care programs are usually a minimum of three months.

Addiction vs. Dual Diagnosis Treatment Programs

Addiction treatment and dual diagnosis treatment (a diagnosis of both substance use disorder and a co-occurring mental disorder) are two distinct types of care. While both programs require a holistic approach, facilities that cater to cases of dual diagnosis more heavily rely on trained psychiatric staff members to provide critical mental healthcare.

The Importance of a Strong Support Network

Both in and out of treatment, teens must rely on a strong support network. Friends and family, especially family, play a role in helping a teen stay accountable and continue to work on their mental and physical health after treatment.

As adolescents are usually in daily contact with their parents or guardians, one of the most important protective factors against relapse is a strong, positive relationship between teens and their family. Teen addiction treatment can provide a recovery toolset to combat addiction, but it’s the continuum of care and support that plays the greater, long-term role.

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Addiction Alcohol Alcoholism Treatment

Alcohol Abuse and Sexual Assault: Is There a Link?

Alcohol abuse is a common problem on many college campuses today, but even more frightening is the realization of just how much heavy drinking is tied to the incidence of sexual assault. A new poll from the Washington Post and the Kaiser Family Foundation showed new evidence of that link, finding that heavy drinking is a significant factor in predicting sexual assault during the college years.

Women More Likely to be Victims

Women that drink more than they should are twice as likely to be the victims of sexual assault as women who never or rarely drink, the poll found. Alcohol was also a factor for the men that were responsible for the assaults. The poll included 1,053 current and recent college students that were living on or near their college campus.

According to this survey, one in five women reported being sexually assaulted during college. More than half of those women – 14 percent – said they were assaulted while incapacitated. Most students that experienced unwanted sexual contact during this time admitted to drinking alcohol shortly before the incident, according to interviews conducted with many of the students that had responded to the poll.

Other Dangers of Alcohol Abuse

Despite the association between alcohol consumption and sexual assault, college students in the poll saw drinking alcohol as the bigger problem of the two. Nearly 40 percent of the students surveyed said that when they drink alcohol in social situations, they sometimes or often drink more than they should. Only three in 10 said that happens rarely, while another three in 10 said it never happens or they don’t drink at all.

Sexual assault is not the only danger associated with excessive drinking during the college years. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), other consequences of college drinking include:

  • Unintentional injury (affects nearly 600,000 students annually)
  • Other types of assault (occurs in around 696,000 students annually)
  • Academic problems (affects around one-fourth of all students annually)
  • Unsafe sex (occurs with approximately 400,000 students each year)
  • Drunk driving (more than 4.8 million students drive under the influence annually)
  • Death (affects around 1,825 students annually)

The College Drinking Problem

College students that drink abusively are also more likely to develop a substance abuse disorder. According to a survey by the NIAAA, 19 percent of college students met the criteria for an alcohol abuse disorder. However, only five percent of those students had sought help for their substance abused within the past year.

Drinking alcohol is not a normal rite of passage during the college years. It is a dangerous practice that can turn into a dependency within a relatively short period of time. If you or someone you know is struggling with substance abuse, help is available. Contact Visions Adolescent Treatment Centers today at 866-889-3665 to learn more about your treatment options.

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Addiction Adolescence Alcohol Alcoholism Bullying Communication Depression Family Feelings Mental Health Prevention School Substance Abuse Treatment

Risk Factors for Substance Abuse for Teens


While there is no way to definitively predict which teens might develop a substance abuse disorder, there are a number of risk factors that considerably increase the likelihood an abuse problem will occur. By understanding these risk factors, parents and others involved in a child’s life can employ effective protective actions to minimize the risk. Below are a few of the common factors that raise the chances substance abuse could become a problem by the time a child becomes a teenager.

Genetics
Family history of substance abuse is one of the biggest risk factors for children develop a substance abuse disorder by the time they hit the teen years. Prenatal exposure to alcohol may also make a person more vulnerable to substance abuse later in life.

Environment
Children that are around substance use, either by parents, friends or members of their community, may regard drugs and alcohol as a normal part of life. They may not recognize the dangers of using these substances, which puts them at increased risk of addiction.

Behavior
Children who are impulsive or aggressive in the early years of life may also be more likely to abuse drugs and alcohol. Aggressive behavior could lead to anti-social tendencies, while impulsivity is an individual risk factor that involves the inability to set limits on one’s behavior.

Mental Health
The connection between a substance abuse disorder and a mental illness is very high. In some cases, the person may use substances to cope with the painful symptoms of the mental illness. Other times, regular substance use may trigger the symptoms of a mental disorder.

Family Life
Children with parents that abuse drugs or alcohol are more likely to use the substances themselves. In addition, a home life that is stressful due to conflict or other difficult situations can also make a teen more likely to use substances as a way of dealing with the stress.

Social Life
Children that do not socialize well with their peers are more likely to turn to drugs and alcohol to cope with their loneliness. By the same token, teens who choose friends that use are more likely to use themselves as well.

Academics
Struggles in school, whether academically or socially, can also lead to substance abuse. The earlier the school problems begin, the more likely it is that substance abuse will become an obstacle over time.

At Visions Adolescent Treatment Centers, we have seen teens turn to drugs and alcohol for a wide range of reasons. While prevention should always be the primary focus in keeping this age group safe and healthy, sometimes prevention efforts are simply not enough to keep a potential addiction at bay. The good news is there are also effective methods of treating substance abuse that help teens move away from their abusive behaviors and into a healthier, sober way of life. To learn more about our treatment programs, contact Visions Adolescent Treatment Centers at 866-889-3665.

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Mental Health Recovery Treatment

ROOTS: A 10-Week Re-Entry Program

ROOTS is a 10-week re-entry program geared to assist adolescents with transitions. The creation of individualized treatment plans benefit all variants of treatment needs.

ROOTS, Our Los Angeles outpatient program supports teens reintegrating into the home environment after long-term treatment and/or therapeutic boarding schools. Our curriculum addresses family dynamics, renewed relationships, as well as re-established boundaries and redefined roles. The treatment modalities we apply garner the cultivation of healthy change and encourage internal growth.

If more intensive reintegration is required, we also offer our 1-year Intensive Outpatient Treatment program. This IOP track includes:

  • 1 year of clinical support;
  • Primary Care Phase (Months 1 to 2);
  • Continuing Care Phase (Months 3 to 6);
  • Aftercare Planning (Months 7 to 12);
  • Individual and Family sessions;
  • Group sessions;
  • Parent support groups, and;
  • Drug testing

We also offer the first gender-specific extended care program, where clients can live in a therapeutically supported sober living environment during their reintegration. NeXT, which is the 1st licensed adolescent extended care facility is for teens 15-18 years of age. The program requires:

  • Parental involvement
  • A 90-day minimum length of stay
  • Day staff supervision and transportation
  • 24-hour crisis intervention

Also works in synchrony with:

  • Therapists
  • Therapeutic resources, and
  • Local educational environments

The staff at extended care facilitates an environment of respect and dignity while cultivating a sense of family and emotional safety for the clients.

Regardless of which track your adolescent and family take, Visions encourages healthy change, and an ability to adopt a more sustainable lifestyle. By supporting healthy peer interactions, implementing self-regulatory awareness, and nurturing one’s own ability for self-care, teens learn to thrive without perpetuation of dysregulatory and self-destructive behaviors.

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Mental Health Recovery Trauma Treatment

In Recovery, We Lean In to Let Go

Being in recovery from mental illness, substance abuse, alcoholism, eating disorders, behavioral issues, et cetera, require that we lean into some things that make us uncomfortable. Let me tell you, “leaning in” isn’t easy. Our brains like pleasure and revile pain. In fact, finding ourselves in rehab tells us that our habitual patterns of trying to put an elementary salve on a gushing wound weren’t working very well. It means that drinking, drugging, stealing or lying our way out of our feelings doesn’t work — at least not permanently. Frankly, none of these “solutions” ever work. Not in the long or short term.

By suggesting that we lean into our difficulties instead of leaning away, I am asking for you to embrace your courage. I am also asking you to trust in your exemplary clinical team, your support team, and in your own ability to do this difficult work while you are in treatment and beyond. Positive thinking or praying for it all to magically go away are both examples of temporary, feel-good actions that don’t provide a long-term solution. It’s wise to also recognize that the recovery process often requires legitimate, clinically supported psychological care.

Recovery is about change. It’s about shifting perspectives and learning how to redefine and revise old paradigms in order to create healthy ones. When we face our old thought patterns and old ideals, we offer ourselves the opportunity to let go. We often find ourselves able to walk through our issues not around them, recognizing that while they are present, ready and willing to make us miserable, we don’t have to take the bait. When we begin to look at our issues with some awareness and compassion, their negative influence has a chance to dissipate.

Our ability to recognize the negative for what it is allows us to invite the positive experiences and influences into our lives. In our recent blog, “How do You Stay Motivated,” I quoted Dr. Rick Hanson, Ph.D., who addresses this very thing: “The remedy is not to suppress negative experiences; when they happen, they happen. Rather, it is to foster positive experiences – and in particular, take them in so they become a permanent part of you.”

Negative experiences do not have to own us; in fact, they can be part of the landscape without being part of our foundations.  This is emblematic of recovery.

The process of recovery is not something you have to do alone. In fact, you can’t. There are support groups, clinicians, treatment facilities, therapists, et cetera, as available resources to you. Yes, there are things you may have to face and work through, but coming to an understanding that you don’t have to ride through that storm alone is a welcome relief.

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Adolescence Dual Diagnosis Mental Health Recovery School Treatment

The Benefits of Blending School and Treatment

(Photo credit: theirhistory)

There is tremendous value in combining school and treatment. Many clients come to us having fallen off-track in their education as a result of substance abuse and mental health issues. There may also be undiagnosed learning disabilities that need to be addressed. Falling grades and school pressure can create another layer of stress and panic for a teen. When an adolescent comes to treatment, it is our responsibility to provide them with both treatment and educational support that fosters an environment of safety and encouragement around learning and healing. At the same time, providing school and treatment simultaneously allows us to notice where an adolescent needs extra support so we can provide that client with adequate educational and clinical support.

 

I looked to Daniel Dewey, our Residential Director of Education, and Joseph Rogers, our Educational Coordinator at our Outpatient Day School for some insight and perspective, particularly since they each see both sides of the education/treatment pendulum. Daniel sees our clients from their initial point of treatment, while Joseph spends time with our clients during their aftercare process. Both of them promote and create foundational pieces to add to the bedrock of an adolescent’s recovery; they invite curiosity about learning, provide support during times of difficulty, and provide individualized methods of teaching to facilitate and nurture a healthy outlook on education.

 

Daniel gave me some wonderful insight when he said, “School is important for treatment success; when a resident can stay on track (or in many cases gets back on track) they will have a stronger foundation for their aftercare. School can be a big stressor, so if school can work with treatment, we feel residents will be better equipped to leave Visions and follow their academic path. Additionally, doing well in school tends to be a source of self-esteem for adolescents.  We want our clients to feel good about learning. Many of our clients come into treatment hopeless. It is our goal to help them see the intrinsic value in education and to guide them toward a meaningful life.”

 

Joseph gave us similar insights, which also help identify the continuum that occurs with school and treatment. He said,  “The practical piece of joining treatment and education is having the benefit of rolling enrollment – clients can enroll at any time, increasing their opportunities of getting back on track. Additionally, students may not be emotionally able or prepared to go back into a normalized educational setting. Having them in a setting that is therapeutically structured for their safety gives them the chance to practice their new behaviors before they go back to their regular school, and because we have clinicians on staff, we can react to and notice a change in behavior quickly and effectively.”

 

We understand the importance of creating a therapeutically alive and nourishing environment for our clients and their families. Placing school in the treatment arena allows us to support our clients at optimum levels, and it provides a multi-level aspect to the healing process. School and Treatment from the residential and outpatient perspective is a necessary stone in the path to wellness. It is beneficial to the adolescent, building confidence and self-esteem, and it is advantageous for parents to see their children simultaneously succeed in their education and in their substance abuse and mental health treatment.

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Mental Health Personality Disorder Recovery Therapy Treatment

Do I Have Narcissistic Personality Disorder?

We’ve all done it: called the arrogant, self-righteous, unsympathetic person we know a

Narcissus (oil on canvas) (Photo credit: Wikipedia)

“narcissist” and we may have even felt pretty confident that they are most certainly suffering from a Narcissistic Personality Disorder.  It’s a buzzword for the selfish and self-indulgent people we have difficulty with. We may even be right on occasion. I know I have, much to my chagrin. We never really want our laymen’s assessment to be true, do we?

 

While it’s true that someone can have narcissistic tendencies, to receive a diagnosis for Narcissistic Personality Disorder, you have to meet some significant traits and they have to have been present for some time. Because of this, adolescents aren’t typically diagnosed with this particular personality disorder because their brains are changing so rapidly. However, if an adolescent presents with the traits of Narcissistic Personality Disorder, they have to be actively present for at least a year.  I do think it’s important to remember that Narcissistic Personality Disorder is diagnosed as a result of it being a long-standing, enduring behavior.

 

It’s not common for someone with any personality disorder to seek help. Often times, one ends up in treatment or in a therapist’s office for something else and it’s determined then. Rather than trying to diagnose someone who is innately selfish, ensure that you have firm boundaries and limits around this difficult person.

 

I asked Noelle Rodriguez to give me some clinical insight on Narcissistic Personality Disorder:

 

“A narcissist is only interested in what reflects on them. All she/he experiences is a reflection of self, denial of profound feelings and grandiose fantasy as a shield from unworthiness caused by not feeling truly loved by their parent. A narcissist attacks separateness in everyone with whom he must have a relationship; either they fit into his ego-supporting mold or they are excluded from his life.

Narcissistic rage and aggression is based on fear. His entitlement and absolute control over others must go unchallenged.”

Noelle went on to expand on part of the child’s development that may contribute to Narcissistic Personality Disorder and where parental neglect or denial is a factor, “The child’s natural growth sets off a parental alarm: he or she is blamed for their emerging individuality as if it were a crime. He is made to feel that there is something wrong with such development.”

 

According the DSM-V, Narcissistic Personality Disorder is described thusly:

 

  • A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
  • Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  • Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
  • Requires excessive admiration.
  • Has a sense of entitlement (i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations).
  • Is interpersonally exploitative (i.e., takes advantage of others to achieve his or her own ends).
  • Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
  • Is often envious of others or believes that others are envious of him or her.
  • Shows arrogant, haughty behaviors or attitudes.”

For more information about personality disorders, please speak to a therapist, or medical professional skilled in working within this genre of mental illness.

 

 

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Bipolar Disorder Dialectical Behavioral Therapy (DBT) Mental Health Recovery Therapy Treatment

A Brief Overview of DBT – Dialectical Behavioral Therapy

In this brief overview of Dialectical Behavioral Therapy (DBT), we are illustrating the efficacy of  DBT for the treatment of patients with suicidal behavior, bipolar disorder, and borderline personality disorder. DBT has been shown to reduce severe dysfunctional behaviors in clients. DBT uses validation has a tool to the client accept unpleasant thoughts and feelings rather than react to them in a dysfunctional way.  Simply put, dialectical means that two ideas can be true at the same time. Validation is the action of telling someone that what they see, feel, think or experience is real, logical and understandable. It’s important to remember that validation is non-judgmental and doesn’t mean you agree or even approve of the behavior you are validating.

 

Over the last year, Visions has effectively trained the staff to be DBT informed. We hold regular DBT skills groups at our residential and outpatient facilities. We have adopted and incorporated DBT skills into our day-to-day interactions with clients and are finding it to be incredibly beneficial.

 

I took some time to speak to Jesse Engdahl, MA, RRW, about his observations and experience with running the DBT skills group. He said, “We are happily surprised that it’s (DBT) become a community within a community. It’s set itself apart through the kids’ commitment to not only use the skills but in their support of each other. There is a high level of trust. We have kids coming into IOP who’ve felt marginalized and who hadn’t felt a broader amount of support, but find their place in DBT.”

 

The emphasis on validation in DBT is profound. Someone suffering from borderline personality disorder often has a movie playing in their heads and when the validity of that “movie” is denied, it can create a waterfall of dysregulation which can include anxiety, depression, anger, and fear. Taking a counter-intuitive stance and validating one’s reality is has been shown to be particularly efficacious. It deescalates the anxiety, and it teaches the client to self-regulate.

 

Joseph Rogers, MDiv-Candidate and DBT skills group facilitator and mindfulness teacher succinctly illustrates the value of our DBT groups, “Our DBT skills group gives our clients the confidence that they have the ability to meet their difficulties with skills that can be found within themselves and their capabilities.  By utilizing daily skills diary cards and reporting on their results, clients are able to see where they are being effective and can acknowledge the positive outcomes they are responsible for through their actions.  DBT has the ability to move clients out of their diagnosis toward a confidence in their personhood.”