What to Expect in Teen Rehab

By Matianna Baldassari 04/20/18

Sometimes, for the young person, simply being removed from the environment where the dysfunction is occurring for a short while helps more than anything else.

Teenage girl and her family in therapy
Not always, but sometimes, teen rehab can lead to a success story.

There are benefits and challenges to sending a teenager to rehab, both for the parents and the teen. Being away from home and friends, disgruntled peers, feeling alienated and misunderstood by therapists and treatment center staff and a bevy of new rules can all create upheaval. For adolescents, whose emotions are already more volatile and unpredictable, it can be difficult to find the willingness to do the frequently taxing psychological work that’s part of treatment.

However, it can be a profound source of healing as well. A good treatment center gives teens a chance to reflect without the same old pressures of everyday life. Parents are able to work through issues in family therapy. Overall, there can be a reprieve from the conflict often inherent in struggling parent-teen relationships. Such a break can create a space for solace and healing. Sometimes, for the young person, simply being removed from the environment where the dysfunction is occurring for a short while helps more than anything else.

As a former therapist in teen rehab, I have an insider’s view. I no longer work at a teen treatment center and my goal is not to recruit clients. Rather, I am sharing what I have learned along the way in order to provide parents, loved ones, and young people with some insight into what adolescent addiction treatment is like.

One caveat: these examples are based on what you can expect at a reputable and ethical treatment center. Do a lot of research before deciding on a facility. Search the reviews on this site and others. Call and ask questions. Much has been written here and elsewhere about the troubled teen industry, which has created profit and heartbreak in equal measure.

Potential Benefits of Teen Rehab:

1) Removing Triggers

In adolescents, emotional dysregulation can cause things to go out of control fast. One of the benefits of residential treatment is that the triggers in the home or school environment are put on pause. When someone enters a new living environment, they are given permission to take a cleansing breath and start over. The change in living arrangements can instill the critical importance of sobriety and making positive life choices. The young person can also focus solely on healing and working through issues rather than being distracted by normal school and home pressures. In some cases, it works wonders.

2) Giving the Family a Short Break

Other family members also get a short break from the chaos of daily life when their loved one goes to rehab. Suddenly the unpredictability and volatility is replaced with a much-needed quietude. Such relative peace is often where the healing begins. A period of separation can create objectivity and as a parent, you may gain valuable perspective once there is physical distance between you and your child.

3) Open Minds and Faster Learning

The same character traits that make the teenage years wild and impulsive also mean adolescents have more of an open mind. They are not stuck in their ways like many adults, who have developed and reinforced “bad” habits over a lifetime. Moreover, many young people haven’t delved as deeply into problematic using or drinking because they haven’t been around the drugs or alcohol for that long. Since they have been doing it for less time, less damage has been done. In addition, young people learn better and more quickly. Some really shine when they are put in a new environment and given the proper time for guided introspection. Many have an innate capacity for self-reflection and deeply understand the importance of change, even if it takes a few weeks for them to get settled.

4) Structure and Success in Adolescence

Many adolescent treatment programs have a level-based structure system with rewards and consequences. The client progresses through tiers, or levels. Each tier has a specific set of rules. The rules at level 1 could include wearing specific clothes, such as a white t-shirt. At level 2 the client may be allowed to wear colored t-shirts. The rewards at level 4 could be leading a group session of peers with a topic of choice or having a longer outing with parents on the weekend.

The strict routine that the whole group follows provides structure as well. Most kids thrive on routine because they know what to expect and are less likely to feel out-of-control. Structure also helps them develop good habits that can be carried into home life.

5) Family Therapy and Structure

Family therapy may include instituting structure as well. The final sessions, prior to discharge, frequently include the family working on a schedule for when the teenager comes home. Also, developing and implementing a contract that outlines new rules, rewards, and consequences may be helpful in some cases. A therapist can help hash out these rules with you and your young person, acting as a mediator with the experience of what has worked for similar situations with other clients.

For example, cell phone use is often a point of contention between teenagers and their parents and consequently it’s typically high on the list of priorities when determining expectations and limits. By having a parent and a teen sign at the bottom of a final negotiated contract that includes cell phone usage, they are able to commit in a concrete way with little chance of confusion. The expectations are clear and family members are on the same page. When it comes to parenting, inconsistent enforcement of expectations and consequences combined with a lack of specific guidelines create a confusing and chaotic environment.

6) Multi-Family and Family-Only Groups

Many teen rehabs offer a group each week in which the families of different clients come together to learn and spend time with a therapist or clinical director as the group leader. For the clients and their families, multi-family group creates a space where meaningful time is spent together in a structured environment. As a result, everyone tends to be on good behavior due to the watchful gaze of other parents and peers. During the multi-family group process, there is often a psycho-educational portion during which families learn about new topics in recovery.

In addition, there is frequently a family-only process group, which is designed to give the parents an opportunity to check in and discuss challenges as well as victories with other parents and loved ones of the client. The families and clients can then come together to process the topics together and talk about how they relate to their family in particular and the client's drug or alcohol use in general. For example, in a Stages of Change multi-family group, parents may be asked to comment on how they have noticed a client’s readiness to change has progressed since coming to the facility. The goal of the group is to increase communication between family members in a monitored environment.

Not always, but sometimes, teen rehab can lead to a success story. The time spent and sacrificed while you and your child find help is an investment towards the well-being and health of your entire family. 30 to 90 days in an accredited facility is very short when compared to the rest of your life.

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Matianna Baldassari is a Licensed Marriage and Family Therapist (LMFT #93379) in private practice with Pacific MFT Network. Matti also has worked at teen treatment centers in the past, and she continues to work today at an adult treatment center as a primary therapist. She graduated from Pepperdine University with a Master’s degree in Clinical Psychology. Since starting her practice, Matti has developed a passion for working with people struggling with co-occurring disorders, substance abuse challenges, and mental health issues. She has written for the California Association of Marriage and Family Therapists (CAMFT) Los Angeles chapter’s newsletter, Voices, and the CAMFT state magazine, The Therapist. Matti also is certified as a Kundalini yoga instructor, and she has a black belt in Kung Jung Mu Sul (Korean Royal Court Martial Arts). The latter tends to surprise most people, but the former does not. In her spare time, Matti enjoys spending time with her husband, sitting at coffee shops, and exploring the intriguing mystery that makes up most of life as it unfolds around her. Find Matianna on LinkedIn.