How to Make Sure Young People Never Get Drug Counseling

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How to Make Sure Young People Never Get Drug Counseling

By Robert Schwebel 01/07/16

Tell them they are powerless, tell them you trust them but conduct drug tests, be an alarmist and other effective ways to get your kids to avoid getting help.

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How to Make Sure Young People Never Get Drug Counseling
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Because so many young people have been mandated into drug treatment, counselors and counseling agencies have taken client participation for granted. They now face the challenge of trying to make their services more appealing to clients, an effort that they have not had much experience in. One exception has been The Seven Challenges program, created 25 years ago by Dr. Robert Schwebel as a way of engaging young people in a discussion about their relationship with drugs so as to empower them to consider self-directed change in their patterns of substance use. His methods are in contrast to the majority of programs that continue to use coercion and enforced abstinence as strategic pillars. Here, Dr. Schwebel begins by lightheartedly depicting the folly of the current dominant treatment models before discussing how to design a treatment program that could engage young people in ways that promote hope and optimism…Richard Juman, PsyD

How can communities and counseling centers keep adolescents from seeking counseling on drug issues?

There are so many great ways to do this and be sure that young people never get an opportunity to talk honestly about their drug use with an adult who cares. Experts in the field of drug treatment have already figured out most of them. You don’t have to do them all. Just a few will suffice. Here’s a sample. (Don’t cheat and skip ahead to alternatives.)

  • Be sure to have a judgmental attitude.
  • Be highly critical of youth for using drugs. 
  • Be simplistic.
  • Explain their drug use as a moral failure, bad judgment, ignorance of the dangers, or the inability of a weak-willed person to resist peer influence. (They can’t say NO.)
  • Be an alarmist. Don’t discriminate in evaluating drug use. Consider all drug use highly dangerous.
  • If youth ask for counseling, never let them come right in. Set an appointment in the future, possibly weeks away.
  • If youth come for counseling, make sure the setting is kind of cold and institutional. 
  • Greet young clients with mountains of paperwork, including numerous questionnaires and assessment tools before you have done anything to build up a comfort level or a positive relationship. 
  • If you can, make sure they know you’ll go out of your way to contact their parents for permission.
  • Be sure to use a system of medical diagnosis and find one that fits so you can get paid for your services. Ideally, youth and the parents who send them realize that this diagnosis will become part of their permanent medical file and follow them for life.
  • If the youth is involved with the court, establish a direct pipeline with information passing back-and-forth. Always tell the probation officer and judge about their drug use.
  • Tell young people that they’re powerless over drugs. (Adolescents love to be told that they are powerless.)
  • Make sure you let them know, right off, that they have a disease and can never drink or use drugs for the rest of their lives.
  • Let them know there is only one way to succeed in drug counseling—and that is through immediate abstinence. Their success will be measured in this way.
  • Talk about building a trusting relationship, but then conduct drug tests.
  • Let them know that you expect them to quit—right here, right now—or perhaps sprinkle in a few “motivational sessions” before you establish this goal. (This applies even if they are not convinced they have a drug problem; not sure what it takes to give up drugs; have no idea what needs they have been satisfying through their drug use; and no idea about coping without drugs.) 
  • Make sure regulatory bodies and/or insurance companies stipulate abstinence as the primary goal, and that the regulators and payers also state that treatment goals must be developed in collaboration with client agreement. (When you succeed with this oxymoron, please tell us how you worked this magic.)
  • Bombard adolescents with information about all the harm from drugs. Maybe have old people come and tell their story. Pull an intervention. Everyone likes being pushed into a corner, especially adolescents. If for some strange reason they push back and won’t quit on your timing and your terms, accuse these “resistant clients” of being in denial.
  • Be clear that you are trying to make them do it your way. Be argumentative. Teens like to have their lives controlled by others. They don’t want to try to figure things out themselves. Anyway, they use drugs and therefore, by definition, are incapable of making good decisions. They need you to rescue them. Not that you disrespect them, or anything.
  • If young people want to set new limits on their drug use, argue against it. They will fail. Drug use is wrong. They must quit now.
  • If they won’t quit now, don’t worry about sending them away as treatment failures. Lots of people have already called them failures, so it won’t hurt. 
  • Let their failure fit your theory: “You just have to reach rock bottom. You haven’t hit it yet. You’ll come back later when your life is really terrible. Then you’ll play ball.”
  • When youth have finally been bullied into saying that they will be abstinent, be sure to believe them when they announce that they’re going to quit. They will have been treated so respectfully that, of course, they wouldn’t lie to you.
  • If they do lie, remember all drug users are liars. Not your fault.
  • Make sure you call it drug treatment because all conversations will be about drugs. No one will be especially interested in what’s going on in the rest of their lives. Why would that matter?
  • Make sure you don’t ask them what they like about drugs (because according to your theory that would be encouraging them to use; triggering them; enabling them, etc.). It is better they remain in ignorance of their own motivation. That way, they can make decisions about quitting drugs without even considering what they will be giving up.
  • When youth are blindsided by whatever motivates their drug use (for example, can’t fall asleep at night) and have a relapse, the setback will reinforce and confirm that they are failures and must admit their powerlessness over drugs.
  • Offer to serve a diverse population, but make no special effort to hire people of color or people from diverse backgrounds.
  • Put up a shingle in front of your office and expect youth to crash through the door because of their positive views of what drug counselors do.

Follow This Advice...Or Else

Follow the advice above—even a few items from the list—and I guarantee you success in keeping young people away.

On the other hand, if you are concerned about the well-being of young people who are using drugs, you can do the opposite.

Attracting Young People To Counseling

How about giving young people a warm greeting and a readily accessible place where they can talk to an adult who will listen to their point of view and won’t pass judgments and won’t try to control them? Make it a comfortable setting. Be curious and interested in understanding them. Eliminate barriers of paperwork and various assessments. Encourage them to talk about what they like about drugs and about everything else in their lives. Validate their reasons for using drugs. Counter excessive self-blame by helping them put their drug use in context of the circumstances of their lives, which includes pointing out injustices and ways that they have been harmed. Help them gain self-understanding about the needs they are satisfying or attempting to satisfy with drugs. 

Build a relationship of mutual respect and trust. Let courts or schools drug test if they wish, but not counselors. You’re not trying to catch youth in a game of cat and mouse. You’re there to support them in looking at their lives; becoming aware of their options, expanding their options and making their own decisions. Inspire them with hope and optimism. 

Advocate for youth. Challenge systems that limit services or stigmatize them. Create space for supportive talks without a medical record (file). Work cooperatively with the courts, but maintain a counselor identity: Challenge the courts to understand the importance of confidentiality – not just for clients, but also for the sake of public safety. Fight against racial disparity.

When you do all the right things, you still have an uphill battle; more like a mountain to climb. You have to undo all the negative expectations that youth have of “drug treatment.” Go to young people in schools and communities. Keep going. Go again. Then, again and again. Introduce yourself in person and with all forms of creative outreach. Talk informally and make presentations. Sell yourself as something different. And most important: Be different.

Robert Schwebel, Ph.D., is a clinical psychologist who wrote and developed The Seven Challenges® Program for adolescents and young adults, an evidence-based program now widely used across the United States, and in Germany and Canada. Over the years, Robert wrote several books including Saying No Is Not Enough; and Who’s on Top, Who’s on Bottom: How Couples Can Learn to Share Power. He is regularly called for comments and interviews, and has appeared on Oprah, The Today Show, The CBS Early Show, CNN interviews and various other national media.

Website: www.sevenchallenges.com

email: [email protected]

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Robert Schwebel, Ph.D., is a clinical psychologist who wrote and developed The Seven Challenges® Program for adolescents and young adults, an evidence-based program now widely used across the United States, and in Germany and Canada. Over the years, Robert wrote several books including Saying No Is Not Enough and Who’s on Top, Who’s on Bottom: How Couples Can Learn to Share Power. He is regularly called for comments and interviews, and has appeared on Oprah, The Today Show, The CBS Early Show, CNN interviews, and more.

Disqus comments