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Ask A Therapist: If My Teen is Using Drugs or Alcohol, Do They Need Rehab?

I just found out my teen is using drugs and alcohol. I’m so scared for them. What do I do?  How do I help them? Should I consider rehab centers, residential treatment, or family therapy? When is the right time to explore treatment plans? 

If you’re asking yourself these questions about teen treatment, Kevin Randall, clinical director at Fulshear Treatment to Transition, has some answers about substance use in teens and teen drug rehab. To start, he advises: 

“The first step is sitting down and having a conversation with your teen to understand what’s going on. A lot of times, we want to focus on the symptom, but there has to be an understanding of what’s driving the behavior.” 

Ask questions like how much they’re using, smoking, or drinking, how frequently, and where they’re getting the substances. Those answers will help you determine the scope of substance abuse and potential risks. But, more importantly, Randall recommends finding out what the need is for substance or drug abuse. He explains: 

“A lot of times what we find is that the substance use is really a way to deal with distress.” 

Your teen might not feel like they can talk about things, or they may be keeping to themselves because they feel like things are really bad in their life. So, they may resort to self-medication. Randall adds: 

“They hold it all in and don’t believe they have anybody with whom they can talk. Teen substance abuse is a way of dealing with the distress that comes from day-to-day life without the use of connections or other people.”  

5 Tips to Address Your Teen’s Substance Use Before Considering a Rehab Center 

It’s natural to be scared if you discover your teen is using drugs or alcohol. You might be thinking about whether you’re dealing with drug or alcohol addiction and may want to understand if detox is necessary. But, instead of getting into a power struggle, it’s important to check your emotions.  

As much as you have real fears around the issue, your teen is scared, too. They may be fearful that they’re in trouble, or they may be afraid of addressing an underlying problem that’s driving them to use. Randall points out that your teen may be thinking, ‘I’m busted, and my life is over.’

Come together in a conversation that’s about understanding your loved one more than it is about trying to put a stop to the behavior immediately. Randall expands: 

“You obviously don’t want your child to continue the drug use, but you also want to really understand what’s going on before you begin to address the behavior.” 

Here are five things you can do to broach the topic of drug or alcohol use with your teen when it first comes to your attention: 

  1. Approach it with curiosity. It might seem easy to do, but it’s natural to shift from curiosity to problem-solving as soon as you hear something you don’t like. If, for example, your kid hates high school, you may start prescribing solutions or stating judgments like ‘You like school, what are you talking about?’ Instead, ask questions like ‘What’s going on at school that’s difficult for you?’ Randall explains that when we stop being curious, we start telling our child what we know or what we think we know. Ultimately, that can lead to them shutting down because they don’t feel understood or heard. If, for example, your teen tells you that they’ve started using drugs or drinking because they need to be connected with friends, instead of stating what you’ve observed or feel like you know, ask them to tell you more about why they’re feeling that way. Randall recommends saying something like, ‘Help me understand a little bit more about your friends and what’s been going on that I don’t understand,’ and then let your child continue to talk. 
  1. Listen — really listen. “I know that sounds easy, and it’s kind of obvious,” says Randall. “But what happens is, as soon as emotion gets involved, we stop listening as parents.” Your child might get angry about the root issue they’re dealing with, or they may feel that there’s an issue in the guardian-child relationship and become critical. As family members, this can cause us to shut down. Randall recommends pushing past that – keep listening and reflecting on back what they’re saying. 
  1. Empathize with and validate what they’re experiencing. Randall recognizes that validating something you disagree with can be challenging. Let your teen know if you saw things the way they see things, then you’d be in distress or feel hurt, too. You don’t need to condone the coping mechanism, but you can empathize and validate the thing that drove them to it. Randall adds, “Show them that you can relate to each other on a really human level.” It’s important that they feel heard and understood, as they’ll be more receptive to your advice if they feel like it’s coming from a place of understanding than a place of judgment.  
  1. Consult and coregulate the emotional experience. A lot of times, teens and young adults don’t want their parents to consult with them. But after you’ve had these conversations and you’re attuned to their experience, you should suggest ideas for addressing the problem. Randall suggests saying, “Hey, I’ve got a couple of ideas of some things that we could maybe try a little bit differently. Are you interested in hearing them?” Your child might say no. If they do, let them know that when they’re interested, you’d be happy to share those ideas when they’re ready. 
  1. Correct the behavior by setting concrete boundaries. Consider what the natural and logical consequences of their behavior should be and remain consistent in enforcing them. For example, if a child is of driving age, restricting car use could be a natural and logical consequence of drug and alcohol use, as a parent may not be able to trust them not to drive under the influence. Randall explains, “When you do that corrective teaching, and you put those boundaries in place if they continue to break those boundaries, there’s a point where they may reach the limit and the power structure shifts to the teen.”  

You have to first be able to understand what’s going on and then attempt to set boundaries and consistently follow through before looking at other measures like teen rehab and treatment programs.  

When to Consider Treatment Centers or a Treatment Program for Teens 

If you’ve taken the steps above and the issue persists, you’ll likely need to explore treatment options such as rehab or addiction treatment. Randall recommends that teen rehab be a consequence of consistently breaking boundaries, and, as a parent, you need to hold your child accountable. “Once the limits that your family sets are met, then it’s time for a treatment center,” he states. 

As your teen breaks boundaries, their privileges should decrease to put pressure on them to get substance abuse treatment. By reducing their level of privileges, you’re making it no longer easy for them to continue to use drugs or alcohol. They’ll come to terms with the fact that they have to do a treatment plan to regain the same level of support and privileges they had before. 

“Position a rehab program as an opportunity for them to get that support for alcohol or drug treatment and get those privileges back,” Randall suggests. 

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Embark Behavioral Health

Embark Behavioral Health is a leading network of outpatient centers and residential programs offering premier mental health treatment for preteens, teens, and young adults. Dedicated to its big mission of reversing the trends of teen and young adult anxiety, depression, and suicide by 2028, Embark offers a robust continuum of care with different levels of service and programming; has a deep legacy of over 25 years serving youths; works with families to adjust treatment in real time to improve results; treats the entire family using an evidence-supported approach; and offers the highest levels of quality care and safety standards. For more information about Embark or its treatment programs, including virtual services, intensive outpatient programs (IOPs), therapeutic day treatment programs, also known as partial hospitalization programs (PHPs), residential treatment, and outdoor therapy, visit embarkbh.com.