A young-adult treatment approach with visual appeal

An ever-present clinical challenge in working with young adults involves the likelihood that they won't progress simply by listening to recovery messages in a traditional lecture format. A cornerstone of the Young Adults Program at Pavillon in Mill Spring, N.C., uses evidence-based “node-link mapping” to present material more visually and to force a closer patient-clinician collaboration.

For those uninitated to the process, Pavillon director of clinical services Brian Coon likens node-link mapping to flowcharting, though he considers that comparison an oversimplification. Tested primarily with cognitively compromised individuals with cocaine dependence, the technique involves writing down the concepts and thoughts that will be discussed in a therapy session and displaying the alternative paths and actions that a patient can take that are related to the concept.

Coon says the Pavillon Young Adults Program uses node-link mapping (which it refers to simply as “mapping” in its program descriptions) in both individual and group therapy sessions. He adds that young adults take very well to its visual approach. In addition, he says that the clinician working with this technique becomes a “coach/consultant rather than an inquisitor.”

Coon adds, “Instead of just engaging in talk therapy, this forces the counselor and the patient to get collaborative, and solution-oriented.”

Mapping scenario

In one typical mapping exercise, a patient might write a word such as “depression” or “family stress” at the center of the page, circle it, and then draw lines off the circle and write related concepts at the end of each line. These might describe characteristics of the problem, such as the times during which it tends to surface or when it doesn't.

Another exercise could involve mapping a comparison of sustained abstinence and relapse, looking visually at the different factors that could contribute to each.

“By using mapping, the patient is encoding a skill,” says Coon. “The person is learning mapping as a process. That has a direct payoff.” Patients ultimately will bring to their counselors a visual depiction of another problem they have been encountering.

Writing in Addiction Professional in 2012, leaders with the recovery academy program for high school students at Fairbanks in Indianapolis cited node-link mapping as a foundational approach of their work with youths.

Pavillon's Young Adults Program generally works with individuals ages 18 and 26. Their developmental stage often makes traditional didactic approaches to therapy impractical for them, Coon says.