Teens and Drugs: Helping Parents Chill Out - Page 2

By Barry Lessin 04/03/13

A teen's drug use can cause parents to make bad decisions that damage their child. By tapping into what harm reduction and skilled parenting share, therapists can help parents to truly help.

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A side-door way that can encourage dialogue is to ask a child to explore their peers’ drinking and drug use. That can be less threatening than discussing their own use; it also gives both parent and teen a shared context and reality check. Examining the consequences of their friends’ use enables kids to begin making judgments about their own use, possible consequences and safe boundaries.

3. Small positive steps

Change may be desired, but it is also frightening and can sometimes feel overwhelming. Most people tend to resist changing all at once, and indeed research shows that change occurs in predictable stages. Family problems usually take some time to develop and some time to resolve.

Exasperated by their lack of success making changes, parents frequently tell me, “We’ve tried everything! Nothing works!” Sometimes the problem is that their approach is too confrontational to succeed. But often the problem is that their expectations of the speed and size of the desired change are unrealistic.

Small steps leading to small improvements in behavior—the experience of success—can give everyone some confidence and hope, which drives the process forward. Even a high-achieving child’s self-esteem is vulnerable, so it’s important to voice appreciation and encouragement for any positive change he makes.

4. No need to “hit bottom”

Some parents are under the influence of  “tough love” as the only approach. When they come to my office, seemingly at a breaking point, they begin by saying, “Everyone tells us that we should kick our kid out. Maybe that’s the only way she’ll get her act together.”

Tough love has been popularized, to a degree that should trouble every addiction therapist, as the only solution to the problem of drug use. Traditional support groups and counselors have steeped us all in the “evils” of “enabling”—for the reasonable goal of creating healthier boundaries. We’re told that by directly confronting kids—and not backing down from our demands that they stop using—we can protect ourselves from encouraging further misbehavior or at least from being further manipulated. “Enabler” is a badge of shame, potentially dumping humiliation on parents who may already feel like failures.

The notion that everyone with a serious drug or alcohol problem has to “hit bottom” before he is ready (sufficiently desperate, miserable, injured, etc.) is a myth with the potential to do great harm. Research shows that most people enter treatment or make positive changes in their substance use without hitting bottom. It not only can encourage parents to abandon a struggling teen but can also offer a rationalization to erase their own guilt or grief. In the absence of violence or abuse in the home, kicking a child out of a family could potentially be disastrous.

Parents don’t need to reinvent themselves as parents to become more confident when drugs enter the family circle.

With parents who are seriously considering taking this step, a therapist needs to first ascertain that the home is a safe place for the child and then make an effort to “talk the parents down.” This requires presenting an alternative that makes sense and holds out hope to them. The harm reduction approach can accomplish this. Meeting people “where they’re at” and making small positive steps are realistic strategies to replace tough love and its assumption about the need to “hit bottom.”

Compassion and flexibility

When confronted with drug use that’s worrisome, parents will frequently jump to a zero-tolerance approach, often accompanied by “lockdown” mode—grounding, no cell phone, no online access—in an attempt to eliminate all risk. Recently a teenager, in his own wisdom, said to me, “If my parents think these punishments will stop me from getting high, they’re wrong!” Indeed, we can’t prevent a child from using drugs if she is determined to, and that fact, combined with zero tolerance’s zero flexibility, keeps anxiety high, often locking everyone into a destructive cycle. Tough love can then seem the only way out.

Harm reduction often succeeds where tough love fails in part because people respond favorably to compassion and flexibility—characteristics also essential to effective parenting. Tough love can damage or even destroy a child’s life-sustaining connection to the only people who truly care about him.

Certainly compassion can be sorely tested when parents feel angry, hurt and raw in response to their child’s destructive opposition. But kids generally do better throughout life when parents lead with a gentle but balanced hand, staying engaged while allowing independence. As therapists, we must encourage parents to remember their child’s strengths—and that he is much more than just a drug user.

Education and self-empowerment

Harm reduction emphasizes providing unbiased information based on established science and research.

Teens want information given with honesty and the faith that they can make up their own minds. They prefer to learn from their friends, but whether they admit it or not, therapists’ and parents’ wisdom resonates with them because they appreciate that adults have already faced the same difficult issues.

Prohibition approaches to substance use have been proven to almost always be failures. Evidence-based therapies informed by harm reduction encourage parents to learn about the range of options open to them (there is no “one and only way”) based on their teen’s unique situation.

A child in a family that I recently saw told me, after his mother had explored various options, “I’m so relieved my mom understands me better.” With a more flexible approach, he was more willing to try to improve family relationships, even offering her more realistic restrictions for himself.

Parents know their kids the best. A therapist’s challenge is to collaborate with clients and to empower them to regain confidence. I support them to use their instincts to inform the difficult decisions they must make to establish healthy boundaries that will balance their family’s (and their own!) needs while always providing a safety net for their struggling child. 

Barry Lessin is a licensed psychologist, certified advanced alcohol and drug counselor, and addiction treatment consultant in private practice in suburban Philadelphia working with adolescents, young adults and their families. He is clinical advisor to the public health advocacy group Broken No More and its associated bereavement group, Grief Recovery After a Substance Passing (GRASP).

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Barry Lessin is a Licensed Psychologist with a private practice in Philadelphia and almost 40 years of work as a clinician, administrator, educator, researcher and drug policy reformer. Find Barry on Linkedin or Twitter.