The challenges of treating teens

Below is Odyssey House President Dr. Peter Provet's response to an article posted on TIME.com questioning the effectiveness of adolescent drug treatment (see "Does Teen Drug Rehab Cure Addiction or Create It?" June 16, 2010). Read his response and let us know what you think in the comments.

Maia Szalavitz presents a provocative criticism of adolescent drug treatment in America and questions admissions policies that lump teens together regardless of individual circumstances. This is an anathema to good treatment, which should always start with a careful assessment of the severity substance abuse has and its impact on the teen’s behavior at school, at home, and among his or her peer group. Teens should ideally be surrounded by those who are at similar levels of disturbance, whether in outpatient or residential treatment.

If Szalavitz had expanded her article to include interviews with adolescent treatment providers, she would have found most agree that 12-Step programs are not ideally suited for teens. Messages of powerlessness are too easily interpreted by adolescents as passivity, which is a disincentive to adolescent drive, and because their religious and spiritual identities are just forming, they are typically too immature for the 12-Steps’ adamant calling.

Family therapy must be the crux of adolescent drug treatment and in a large therapeutic community (TC) such as Odyssey House, we have developed programs that combine family and individual therapy with group treatment. Group work is important however – if not critical – because of its constructive impact on teens’ success, as positive peer pressure replaces negative peer demands. Teens who follow the rules, pursue their education, behave respectfully towards others and authority figures, and subscribe to an accepted social and moral set of principles are placed in positions of authority and emulated by the group.

In sum, quality improvement pertaining to adolescent drug treatment incorporating group work must continue. So let’s not throw the baby out with the bathwater.