Use multiple strategies to help young adults launch

Experts say that as the term “failure to launch” has gained prominence, and as treatment programs closely examine the needs of the 18-to-34-year-old age group, many are coming to realize the multilayered nature of launch issues among young adults. Dynamics often include substance use problems to a large degree, but even more basic issues such as budgeting money and other essential life skills also come into play.

“The millennial generation is facing an unprecedented level of financial insecurity with not only one of the most challenging job markets in recent history but also an extremely complex and fast-moving social life,” says Paul Auchterlonie, CEO of Decision Point, an Arizona treatment center that offers a specialized failure to launch program. “While most young people can effectively navigate these difficulties and find a way to enter independent adulthood, many others will fall by the wayside and find themselves stagnating without a sense of purpose or passion.”

While failure to launch by definition involves a lack of independence and resiliency, Auchterlonie says the issue should not be boiled down to a lack of motivation. Societal factors such as the extension of adolescence, parental enabling behaviors and a greater acceptance of drug experimentation can all play into an existence that is not self-reliant.

For example, the number of high school and college graduates living at home with their parents continues to increase steadily, now at 36%. Throw in full-blown behavioral health disorders and “launching” can be virtually impossible for some individuals, Auchterlonie says.

And unfortunately, the overlap between failure to launch and substance use problems has become extremely common, with the two often going hand-in-hand.

“Our young adult population has been impacted harshly by the increased use of dangerous narcotic pills and heroin, benzodiazepines, stimulants and more potent forms of cannabinoids in recent years,” says Christopher Yadron, director of Rosecrance Lakeview, a facility scheduled to open in Chicago in June that will specifically focus on treatment and support of these individuals through outpatient counseling coupled with recovery housing. “This age segment of the population uses illicit substances more often than any other age group in the United States.”

Linked with the prescription opioid epidemic, heroin use has more than doubled among the 18-to-25 group in the last decade. Yadron says the use of substances is disrupting healthy attachment in relationships and is depriving young people of the opportunity to develop the skills necessary to transition from adolescence to healthy independence and autonomy as adults.

“Whether succumbing to substance misuse and losing the ability to focus and work effectively or self-medicating to overcome underlying mental health problems such as depression and anxiety, where you find failure to launch you often find substance use disorder,” Auchterlonie says. “The ability to develop the skills and mentality in order to complete an education, attain meaningful work, maintain relationships and live independently are key to treating the condition.”

Address underlying issues

In order for treatment to be effective for the young adult, it is important to address any trauma and mental health disorders, assist with identity achievement and functional relationship building, and provide educational and career counseling services.

“Addiction within this age group significantly impacts development,” Yadron adds. “Helping them create a healthy sense of personal identity and competency to successfully transition into adulthood is key.”

Because many young adults began using during an earlier stage of adolescence, developmental concerns and identity issues—including gender and sexuality—also need to be addressed in treatment, he adds.

“Patients come to us feeling that they lack the direction or ability to move forward in education or working life,” Auchterlonie says. “We believe that, at its core, this perceived inability to engage with life on one’s own terms is due to a general lack of emotional maturity needed to face one’s responsibility to self and the idea that we must find, access, and hone our unique gifts.”

Decision Point uses what it calls an Emotional Maturity & Motivation Model designed to help young people develop the mentality needed to successfully gain momentum. Life skills work is also used to instill positive, healthy behaviors and thinking. It also teaches important yet overlooked abilities, such as shopping for healthy foods and the fundamentals of financial literacy.

“There is no one-size-fits-all approach,” says Jerry Halverson, MD, medical director of Rogers Behavioral Healthcare's FOCUS program for adults ages 18 to 30, based in Wisconsin. “But the staging of the treatment is a crucially important aspect to successful treatment, as there are situations where you can't even approach one issue—like a mood disorder—until you have a better handle on another disorder—like a daily opioid habit.”

Some co-occurring disorders can feed into each other and make diagnosis and treatment more difficult, Halverson says. Because of this, it is often best to take a broad diagnostic approach that is both sensitive and specific to the age group in order to be sure that everything has been detected. That will lead to better overall treatment planning, he says.

Treatment guidance

Based on the comments from these leaders in young-adult treatment, here is some overall guidance on sound practices at various treatment stages:

Conduct assessments and evaluations. First determine emotional, psychological, learning/cognitive, substance abuse/dependence, psychiatric, family and trauma issues affecting each individual, says Auchterlonie. Assess educational and life plan skills and interests.

Engage the family in a plan. Because addiction is a disease that affects the whole family, patients do poorly in treatment and recovery when family members are excluded, says Percy Menzies, president of Assisted Recovery Centers of America.

“The family has had to bear the brunt of the addictive behavior, which quite often involves lying, cheating, and stealing,” he says. “Family members can feel like hostages in their own homes, and the dynamic shattered by the addiction has to be healed.”

This is helpful for parents, too, who often can enable their child’s behavior without even knowing it.

“Parents need assistance with detaching while also remaining supportive,” Yadron says.

The end goal should be independence after treatment, Auchterlonie says, adding that it’s critical for family members to be involved because unresolved family issues appear as a common theme for individuals affected by failure to launch. Honest communication facilitated by professionals becomes essential with young adults.

“Effective treatment combined with long-term recovery housing can allow young adults to stay connected to their families without remaining in a state of dependency,” adds Yadron.

Stop treating the symptoms alone. Determine whether the young adult’s substance use constitutes abuse or dependence, while also addressing potential trauma and the other emotional/psychological issues that are driving the individual’s negative cycle of behaviors and thinking, Auchterlonie says.

He advises not only to provide patients with education and career planning services, but also to get to know them, spend time understanding what they’re passionate about, and help them experience and nurture those interests and talents. In essence, it is about helping them get excited and have fun.

“This whole concept of a healthy lifestyle and recovery and figuring out where you want to go in life, nothing is going to happen without being able to laugh at yourself and figuring out what healthy activities are fun for you,” says Auchterlonie. “Those are just as important to me as the clinical [element].”

Set a road map for recovery. Finally, develop a family support plan and ensure that the expectations going forward are detailed and supported, Auchterlionie says. Provide follow-up resources and continued support to the individual.

“These young adults are not only developing independence and separating from their families, but also trying to create healthy relationships with peers and other adults in the context of a healthy recovery culture,” says Yadron. “We need to provide them with long-term recovery interventions so that once abstinence is achieved, these young adults can gain the support necessary to achieve their educational or vocational goals and engage in a meaningful, healthy way out in the world.”

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