With teens, accentuate the positive

It takes more than academic achievements to work successfully with teenagers struggling with drug or alcohol abuse. It takes the difficult-to-define “it factor.” That’s our theory at New Beginnings Adolescent Recovery Center, a 21-acre treatment center for teenagers in Opelousas, La. When we recruit therapists to join our team, we require academic and training qualifications, including master’s-level education and experience in working with substance abuse patients, but there’s more to it than that.

The truth is, there are a lot of talented therapists out there who are highly effective in working with the adult population, but that doesn’t necessarily mean they have the temperament to work with teenagers. And that’s the “it factor”—the ability to bond, connect, relate and get through to teens who are enduring a tough time in their already-tough adolescent years. It is hard to define, but each member of our team must possess it.

Not only do our therapists have the ability to connect with teenagers, but our nurses, recreational therapists and administrative staff also must display this. Everyone who works on campus needs to have the skills to interact effectively with teenagers. The importance of treatment for teenagers who have substance abuse issues cannot be overstated, both for current health concerns and future development. As the National Institute on Drug Abuse (NIDA) plainly states, “Drugs can have long-lasting effects on the developing brain and may interfere with family, positive peer relationships, and school performance. Most adults who develop a substance use disorder report having started drug use in adolescence or young adulthood, so it is important to identify and intervene in drug use early.”

Catch-22 of adolescence

Yet most adults forget what it’s like to be a teenager. It’s an incredibly difficult period. Teenagers are operating with a not yet fully developed brain, which causes them to be impulsive, make irrational decisions and participate in risky behavior. It’s a time in their lives when they desire independence, but feel stuck depending upon their parents and other authority figures. It’s a Catch-22.

Although we have been highly successful, we embrace a continuous quality improvement mindset. That’s why at New Beginnings we have created what we refer to as the “Lean Forward” initiative to improve motivation of teenagers in treatment. The program is rooted in creating a positive peer culture and environment. We have seen improvement in satisfaction scores by patients and family members, along with improved staff satisfaction over the work environment. The initiative has resulted in longer lengths of stay and fewer incidents among patients, and demonstrates a more effective way of motivating young people to embrace the recovery process.

This approach begins the minute a teenager first enters our program. These individuals have often felt like the black sheep in the family. Their self-esteem is low, and they frequently display frustration and anger. But when they arrive at New Beginnings, they are treated in a different manner by staff.

Lean Forward uses an acronym to summarize the main tenets of the initiative: REALISM, which represents respect, empathy, acceptance, love, information, support and motivation. From the moment a teenager steps onto the New Beginnings campus, negative labels and associations are gone.

See problems as opportunities

From the perspective of the staff at New Beginnings, there is no such thing as negative or bad behavior. We prefer to look upon these behaviors as therapeutic opportunities. Similarly, we reward and recognize positive and responsible behavior. Regardless of the behavior, the interaction stays positive, and each teenager is regarded as a special human being with tremendous potential.

There are numerous elements to the Lean Forward initiative, such as our “recovery bucks” component. When the teen displays positive behavior, he/she can earn recovery bucks (with their photo in the center) to make purchases at the campus store or cantina. This type of boost can make a difference, but so can small, less obvious gestures. Something as simple as encouraging words can have a remarkable impact on a teenager. Through the positivity of the program and support from the staff, the teens are better equipped for success.

Speaking of words, we have eliminated use of the word “consequences.” In my experience, when a teenager hears this word, he/she hears “punish.” We avoid telling a teenager, “There are consequences for your actions.” Instead, we use “outcome.” It may sound like a small detail, but “outcome” simply does not have the same negative connotation.

Parents frequently ask why their child may be turning to drugs or alcohol. My response is simple: They like the way it makes them feel. But that cries out for an answer to a deeper question: “Why don’t they like the way they feel in the first place?” That’s where New Beginnings places particular emphasis. We try to uncover the emotional feelings that are causing these young people to be less satisfied with life than they would like to be.

Because New Beginnings is an abstinence-based program, we embrace the 12-Step philosophy and also offer a variety of therapeutic techniques, including cognitive-behavioral therapy (CBT), Dialectical Behavior Therapy (DBT), rational emotive behavioral therapy and art therapy. Our experiential therapy includes an on-site ropes course that emphasizes teamwork.

The program’s music therapy also has demonstrated effectiveness. A recovering addict and successful singer/songwriter from Nashville will often visit to perform and talk with the teenagers about his challenges. Messages through music can be incredibly powerful for teens. At the end of these therapy sessions, patients sometimes share thoughts that they were uncomfortable sharing before. It is through the power of music that they become more open to share information that can help their growth and outlook.

Communicating hope

These positive impacts help us create success stories that we can share with new patients. We once had a young woman who came to the campus at age 17. She had a history of physical and sexual abuse, was addicted to alcohol and drugs, and dealt with her pain and anger by cutting herself. Initially she ran away from the campus, but eventually spent three months in the program. Upon completing our program, she went to a sober-living environment, where she continued her progress. Now, she is thriving—she’s employed, married, and recently gave birth to her first child. She returned to New Beginnings to share her story with the teenagers in treatment, and our entire group of boys and girls hung on every word she said.

Her story painted a picture of what it was like for her initially, what occurred during treatment, and what her life is like now. These moments are what bring our patients back to the life they deserve, and inspire them to think they too have potential within themselves.

These are special moments for our staff as well. When one of our patients comes back to tell his/her story, it’s a heartfelt reminder of why we’re in this profession. By starting with the staff, we ensure that the entire campus is infused with a positive energy, the “it factor.” This trickles down to the patients, which translates to higher success rates and more “new beginnings.”

Johnny Patout, LCSW, is CEO of New Beginnings Adolescent Recovery Center in Opelousas, La., and is a licensed clinical social worker with nearly 30 years of experience in the addiction treatment field. Patout is a recovering alcoholic and drug addict with more than 30 years of sobriety.