Teenagers resist substance abuse treatment for a variety of reasons, but one critical factor is the fact that teenagers are going through important cognitive, physical, and emotional changes.
What causes teens to resist substance abuse treatment, and how can you get them the help they need? This article will examine these questions in further detail, covering the following topics:
- Reasons for resistance
- Program that can help
- Intervention options
Explore the Reasons for Resistance
Teenagers resist substance abuse treatment for a variety of reasons, but one critical factor is the fact that teenagers are going through important cognitive, physical, and emotional changes. They are beginning to form identities separate from their parents and are figuring out how to develop independent social relationships. During these years, it is natural for teens to move from complete dependence to a more independent lifestyle. But for most young people, this process also involves a great deal of turmoil and rebellion.4
Other reasons for resistance include:3,5,6,7
- Fear of treatment: Many people with substance use disorders fear the unknown, particularly not knowing what will happen during treatment. You can help ease your teen’s anxiety by ensuring them that professional treatment strives to keep them safe and as comfortable as possible. You can also research what actual programs involve to demystify the process.
- Privacy concerns: Teens are sometimes worried that everyone will know they’re in treatment, and they feel shame about that. They may also be concerned that they won’t be able to get into the college they want if a university finds out they went to rehab. Assure your teen that federal privacy laws (HIPAA) prevent medical experts from disclosing information about their substance abuse treatment to others except in cases where your teen may be a danger to themselves or others.
- A lack of social support: Sometimes, kids think they’ll have to go through the whole process alone, or that they might lose friends because of it. Be sure to let your adolescent or teenager know that family, loved ones, and good friends will stand by and offer loving support as they go through treatment.
- Rebellion against authority: Some teens simply rebel against any authority figure who is trying to exert some influence in their life. For kids who fit this description, you might consider having a respectful, compassionate intervention.
- A lack of authority by the parents: In certain cases, parents do not exhibit the appropriate authority necessary to direct their teen to treatment. If this is true for you, do not back down on your decision to seek treatment—it could literally save their life.
Try a Program Designed to Help
Cognitive behavioral therapy (CBT) is one of the more beneficial forms of therapy for adolescents who have engaged in treatment as the result of the CRAFT intervention.
Some programs have been created to work with families whose teens struggle with substance abuse and need treatment. One such program is Community Reinforcement and Family Training, or CRAFT, which is a family engagement approach designed to help parents or other loved ones engage significant others in drug or alcohol treatment who are resistant to do so. Research has found that this approach may offer a viable strategy for initiating treatment with resistant drug-abusing teenagers.3
Cognitive behavioral therapy (CBT) is one of the more beneficial forms of therapy for adolescents who have engaged in treatment as the result of the CRAFT intervention. It is a well-researched and supported intervention for adolescents that helps them significantly reduce their substance use behaviors and increase abstinence rates.3
Other tips to pave the way for successful substance abuse treatment for your teenager include:6,7
- Avoiding aggressive, confrontational interactions: This approach to coercing teens into treatment rarely works.
- Focusing on your teen’s strengths: Rather than overly focusing on your teen’s shortcomings, identify and emphasize their strengths, qualities, and resilience. Remind them that these factors will help them get through treatment.
- Finding a program that is geared toward helping teens recover from drug and alcohol abuse.
Consider an Intervention
An intervention refers to an attempt made by a family member or friend to help someone who is addicted to drugs or alcohol get into treatment, particularly if they are resistant to the idea. The first step to take is to contact a qualified substance abuse professional who can help walk the family through the process. An intervention provides support not only for the teenager abusing drugs or alcohol, but for the entire family.7,8
The 2 main types of interventions are:8
- Confrontational or surprise interventions: More popular in previous decades, this type of intervention typically involved unexpected confrontations after which the teen would be whisked away by a transporter—usually in the middle of the night or early morning— and taken to a treatment program. These types of interventions are no longer recommended, since being forced out of one’s home and to a treatment center far away is traumatizing in and of itself.
- Invitational interventions: This form is much preferred for today’s intervention because it is respectful and dignified for the adolescent. It focuses on the teenager’s personal strengths and history of resilience to remind them that they can make positive choices and be successful at good things.
Something most families don’t think about is how to actually get their child from the intervention to the treatment facility. Experienced and reputable interventionists can facilitate this transition smoothly with protocols that fill this need without re-traumatizing the teen.7,9 These types of program emphasize your child’s dignity and self-worth, which helps reduce the risk of trauma and increases the likelihood that your teen will agree to treatment. It also reduces the risk of physical and verbal aggression from your teen.
Examples of steps for a respectful intervention transport program might include:7,8,9
- Trained transporters who are familiar with your adolescent’s history, substance abuse patterns, and mental health concerns meet with you and other family members to help prepare you for the transport process.
- The transporters coach you on how to talk to your teen about the process of seeking treatment, as well as what the transport entails.
- You will be asked to write a letter to your teenager identifying their strengths and preparing them for the process. In the letter, you should mention that you will stand firm on your decision for them to seek treatment, as well as emphasize your unconditional love for them.
- When the transporters meet your child, they will listen to your teen’s story with genuine curiosity and concern about their life. They will help them pack clothing and supplies for residential or inpatient treatment, guiding them through the preparation process.
- Your teenager will be allowed to make certain choices about the trip. For instance, the transporter will ask them what snacks they would like to bring, which movie options they prefer during the trip, and other safe choices.
- The transporters stay with your teenager until they reach their final destination at the treatment center.
Though it can be stressful when your teen refuses to get help for their substance abuse, there are people and programs ready to help you and your family. Reach out to one of them today.
- National Institute on Drug Abuse. (2017). Help Children and Teens Stay Drug-Free.
- National Institute on Drug Abuse. (2015). Brain in Progress: Why Teens Can’t Always Resist Temptation.
- Waldron, H., Kern-Jones, S., Turner, C.W., Peterson, T.R., & Ozechowski, T.J. (2007). Engaging Resistant Adolescents in Drug Abuse Treatment. Journal of Substance Abuse Treatment, 32(2), 133–142.
- Taddeo, D., Egedy, M., & Frappier, J.Y. (2008). Adherence to Treatment in Adolescents. Pediatrics & Child Health, 13(1), 19–24.
- Rapp, R., Xu, J., Carr, C., Lane, D., Wang, J., & Carlson, R. (2006). Treatment Barriers Identified by Substance Abusers Assessed at a Centralized Intake Unit. Journal of Substance Abuse Treatment, 30(3), 227–235.
- National Institute on Drug Abuse. (2016). What to Do If Your Teen or Young Adult Has a Problem with Drugs.
- Heather R. Hayes & Associates. (2017). Respectful Adolescent Transports: Principles and Dynamics.
- Heather R. Hayes & Associates. (2016). The Facts on Interventions.
- Substance Abuse and Mental Health Services Administration. (2014). A Treatment Improvement Protocol: Trauma-Informed Care in Behavioral Health Services.