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Texting, Tweeting and Robo-tripping:
Substance use disorder treatment
for the teen of the 21st
century
David R. Selden, LICSW
Director, SOAP
Health and Education Services, Inc.
Key Issues
• Short attention span
• Tweet, Text and You
Tube
• Co-occurring
disorders
• Family systems
The Ten Key Elements for Effective
Treatment of Adolescent Substance Abuse
Community based,
substance abuse focused
Individualized
treatment
Self Help/12 Step
Opportunities
From: SAMHSA
Evaluate Outcomes
Engage & Retain
Continuity of Care
School Liaison
Gender & Culture
Qualified Staff
Assessment at
Beginning
Program Foundation Elements
Co-occurring disorder/CCISC
Co-occurring disorder/CCISC
Harm Reduction
Harm Reduction
Needs of teens & Young adults
Erikson's stages
TAY
Needs of teens & Young adults
Erikson's stages
TAY
Motivational
Enhancement
Therapy
Motivational
Enhancement
Therapy
Relapse
Prevention
Relapse
Prevention
Family WorkFamily Work Group TreatmentGroup Treatment
Milieu Therapy
Milieu Therapy
Case ManagementCase Management
Self HelpSelf Help
The Needs of Teens & Young Adults
• Erikson’s Stages
– Ages 5-12: Industry vs. inferiority
– Adolescence: Identity vs. confusion
– Young adulthood: Intimacy vs. isolation
The Needs of Teens & Young Adults
• Transitional Age
Youth
– Engage
– Tailor services and supports
– Personal choice and social
responsibility
– Safety-net of support
– Enhance competencies to achieve
greater self-sufficiency and
confidence
– Outcome focus
– Involve young people, parents, and
other community partners
From: Transition to Independence Program,
Rusty Clark
Relapse Prevention
• The Stages of
Relapse
–Emotional
–Mental
–Physical
Relapse Prevention
“If you are not
working on
your recovery,
you are
working on a
relapse”.
Harm Reduction
• The continuum of risk
• Abstinence is final
step
• Any change is positive
• Not everyone may
attain sobriety
• Goal= reduce harm of
habits as much as
possible
Motivational Enhancement
• Express empathy
• Develop discrepancy
• Roll with resistance
• Support self-efficacy
Group Treatment
• Provide positive peer support
• Reduce sense of isolation
• Learn to cope by allowing them to
see how others deal with similar
problems
• Provide useful information
• Offer positive family-like
experiences
• Opportunity to learn or re-learn the
social skills they need to cope with
every-day life instead of resorting to
substance abuse
• Instill hope
From: Substance Abuse Treatment: Group Therapy.
TIP41. US Dept of Health and Human Services
Co-occurring Disorders
• Comprehensive,
Continuous,
Integrated System of
Care (CCISC)
• Kenneth Minkoff, MD
• www.kenminkoff.com
Co-occurring Disorders/CCISC
1. Dual diagnosis is an
expectation, not an
exception
2. Empathic, hopeful,
integrated and continuing
relationships
3. Treatment must be
individualized and
structured
Co-occurring Disorders/CCISC
4. Balance case
management and clinical
care
5. Each disorder is
“primary”
6. “Disease and recovery”
model
1.Match to phase of
recovery and stage of
change
7. No one correct approach
Milieu Treatment
• Multi-disciplinary team
• Individualized interactions and
understanding of the
emotional conflicts that are
activated in such human
interactions
• Examination of client/client,
client/staff and staff/staff
interactions
Family Work
• Being Family Focused
– Family involvement
– Family-focused
treatment
– Family driven
– Broad definition of
family
– Empowering parents
– Family voice
• Ensuring ongoing
family involvement
– Family/parent support
– Family/parent
counseling
– Family team
– Family preservation
– Sibling services
– Family/marriage
educationFrom: SAMHSA: Designing a Recovery-Oriented Care
Model for Adolescents and Transition Age Youth with
Substance Use or Co-occurring Mental Health Disorders
Case Management
• Planning
• Linkage
• Advocacy
• Support
• Monitoring
• Assessment
• Outreach
Self Help
• Counters feelings of
isolation, powerlessness,
alienation
• Reciprocal helping
exchange
• Support sense of self-
efficacy
• Provides resource to
meet like-minded peers
• Provides sobriety focused
activities
SOAP
• A two week intensive after-school
program designed to meet the
specific needs of teens and young
adults. SOAP provides a safe place
for teens and young adults to spend
their after school hours where they
can learn and develop skills to
support recovery from substance
use disorders.
SOAP Class Rooms
SOAP Class Rooms
SOAP Gym
SOAP Activity Room
SOAP Music Room
Monday Tuesday Wednesday Thursday Friday
2:00-2:30 PM StaffMeeting StaffMeeting StaffMeeting StaffMeeting StaffMeeting
2:30-3:30 PM Individual and
Intake Mtgs
Individual and
Intake Mtgs
Individual and
Intake Mtgs
Individual and
Intake Mtgs
Individual and
Intake Mtgs
3:30-3:45PM Check-In Check-In Check-In Check-In Check-In
3:45-4:15 PM Personal Assessment Life Skills Personal Assessment Life Skills Personal Assessment
4:15-4:25PM Break Break Break Break Break
4:25-4:55PM Substance Use
Education
Therapy Group Activities Therapy Group Activities
4:55-5:05 PM Break Break Break Break Break
5:05-5:35PM Sobriety
Planning/ Using
the Steps
Relapse Prevention Family Group Relapse Prevention Weekend Planning
5:35-5:50 PM Wrap-up Wrap-up Wrap-up Wrap-up Wrap-up
Weekly Schedule
Web Sites
Mouse Party:
http: //learn.genetics.utah.edu/content/addiction/drugs/mouse.html
Intoximeter:
http: //www.intox.com/wheel/drinkwheel.asp
SAMHSA Report:
http://www.chestnut.org/LI/downloads/SAMHSA_Recovery_Report_on_
Adolescents_and_Transitional_Age_Youth.pdf

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21st Century Teens

  • 1. Texting, Tweeting and Robo-tripping: Substance use disorder treatment for the teen of the 21st century David R. Selden, LICSW Director, SOAP Health and Education Services, Inc.
  • 2. Key Issues • Short attention span • Tweet, Text and You Tube • Co-occurring disorders • Family systems
  • 3. The Ten Key Elements for Effective Treatment of Adolescent Substance Abuse Community based, substance abuse focused Individualized treatment Self Help/12 Step Opportunities From: SAMHSA Evaluate Outcomes Engage & Retain Continuity of Care School Liaison Gender & Culture Qualified Staff Assessment at Beginning
  • 4. Program Foundation Elements Co-occurring disorder/CCISC Co-occurring disorder/CCISC Harm Reduction Harm Reduction Needs of teens & Young adults Erikson's stages TAY Needs of teens & Young adults Erikson's stages TAY Motivational Enhancement Therapy Motivational Enhancement Therapy Relapse Prevention Relapse Prevention Family WorkFamily Work Group TreatmentGroup Treatment Milieu Therapy Milieu Therapy Case ManagementCase Management Self HelpSelf Help
  • 5. The Needs of Teens & Young Adults • Erikson’s Stages – Ages 5-12: Industry vs. inferiority – Adolescence: Identity vs. confusion – Young adulthood: Intimacy vs. isolation
  • 6. The Needs of Teens & Young Adults • Transitional Age Youth – Engage – Tailor services and supports – Personal choice and social responsibility – Safety-net of support – Enhance competencies to achieve greater self-sufficiency and confidence – Outcome focus – Involve young people, parents, and other community partners From: Transition to Independence Program, Rusty Clark
  • 7. Relapse Prevention • The Stages of Relapse –Emotional –Mental –Physical
  • 8. Relapse Prevention “If you are not working on your recovery, you are working on a relapse”.
  • 9. Harm Reduction • The continuum of risk • Abstinence is final step • Any change is positive • Not everyone may attain sobriety • Goal= reduce harm of habits as much as possible
  • 10. Motivational Enhancement • Express empathy • Develop discrepancy • Roll with resistance • Support self-efficacy
  • 11. Group Treatment • Provide positive peer support • Reduce sense of isolation • Learn to cope by allowing them to see how others deal with similar problems • Provide useful information • Offer positive family-like experiences • Opportunity to learn or re-learn the social skills they need to cope with every-day life instead of resorting to substance abuse • Instill hope From: Substance Abuse Treatment: Group Therapy. TIP41. US Dept of Health and Human Services
  • 12. Co-occurring Disorders • Comprehensive, Continuous, Integrated System of Care (CCISC) • Kenneth Minkoff, MD • www.kenminkoff.com
  • 13. Co-occurring Disorders/CCISC 1. Dual diagnosis is an expectation, not an exception 2. Empathic, hopeful, integrated and continuing relationships 3. Treatment must be individualized and structured
  • 14. Co-occurring Disorders/CCISC 4. Balance case management and clinical care 5. Each disorder is “primary” 6. “Disease and recovery” model 1.Match to phase of recovery and stage of change 7. No one correct approach
  • 15. Milieu Treatment • Multi-disciplinary team • Individualized interactions and understanding of the emotional conflicts that are activated in such human interactions • Examination of client/client, client/staff and staff/staff interactions
  • 16. Family Work • Being Family Focused – Family involvement – Family-focused treatment – Family driven – Broad definition of family – Empowering parents – Family voice • Ensuring ongoing family involvement – Family/parent support – Family/parent counseling – Family team – Family preservation – Sibling services – Family/marriage educationFrom: SAMHSA: Designing a Recovery-Oriented Care Model for Adolescents and Transition Age Youth with Substance Use or Co-occurring Mental Health Disorders
  • 17. Case Management • Planning • Linkage • Advocacy • Support • Monitoring • Assessment • Outreach
  • 18. Self Help • Counters feelings of isolation, powerlessness, alienation • Reciprocal helping exchange • Support sense of self- efficacy • Provides resource to meet like-minded peers • Provides sobriety focused activities
  • 19. SOAP • A two week intensive after-school program designed to meet the specific needs of teens and young adults. SOAP provides a safe place for teens and young adults to spend their after school hours where they can learn and develop skills to support recovery from substance use disorders.
  • 25. Monday Tuesday Wednesday Thursday Friday 2:00-2:30 PM StaffMeeting StaffMeeting StaffMeeting StaffMeeting StaffMeeting 2:30-3:30 PM Individual and Intake Mtgs Individual and Intake Mtgs Individual and Intake Mtgs Individual and Intake Mtgs Individual and Intake Mtgs 3:30-3:45PM Check-In Check-In Check-In Check-In Check-In 3:45-4:15 PM Personal Assessment Life Skills Personal Assessment Life Skills Personal Assessment 4:15-4:25PM Break Break Break Break Break 4:25-4:55PM Substance Use Education Therapy Group Activities Therapy Group Activities 4:55-5:05 PM Break Break Break Break Break 5:05-5:35PM Sobriety Planning/ Using the Steps Relapse Prevention Family Group Relapse Prevention Weekend Planning 5:35-5:50 PM Wrap-up Wrap-up Wrap-up Wrap-up Wrap-up Weekly Schedule
  • 26. Web Sites Mouse Party: http: //learn.genetics.utah.edu/content/addiction/drugs/mouse.html Intoximeter: http: //www.intox.com/wheel/drinkwheel.asp SAMHSA Report: http://www.chestnut.org/LI/downloads/SAMHSA_Recovery_Report_on_ Adolescents_and_Transitional_Age_Youth.pdf

Editor's Notes

  1. Who Is Eligible? All of the following criteria are necessary for admission: Individual is between the ages of 13 and 21 and has a DSM-IV diagnosis of substance abuse-related disorder; The individual demonstrates a pattern of drug and/or alcohol use that has resulted in significant impairment of interpersonal, occupational, and/or educational functioning; The individual's condition requires coordinated, comprehensive, multi-disciplinary, and multi-modal treatment; The individual is able to function in a community-based environment. There is, however, impairment in social, medical, family or work functioning; The individual's living situation and support system are supportive of his or her recovery efforts; and The individual is sufficiently motivated to be compliant with treatment at this level of care.