Don’t take away what you can’t replace

by Stars Training Academy   0 Comments

Integrating the services for traumatized youth who abuse substances isn’t always easy.

Working with traumatized youth and young adults who are abusing substances is as common as it is challenging. While these problems are frequently presented by the same young person, the treatment system (mental health + substance abuse) often responds with separate and different strategies. The National Child Traumatic Stress Network (NCTSN) states: “Despite the clear link between these two clinical areas, very few attempts have been made to integrate the services provided by each group, and each has developed different assessment protocols and treatment approaches”. Click Here to learn more.

So what might an integrated approach look like? It may start with the understanding the “self-medicating hypothesis” that recognizes the youth frequently cope with overwhelming distress and fear by using substances. Youth have learned to manage and adapt to toxic stress and emotional dysregulation by drinking, smoking, snorting and injecting. To be effective in helping youth reduce and eliminate these high risk behaviors requires providers to validate and respect these desperate survival methods, however harmful and misguided they may appear. The technique of reframing symptoms (such as substance abuse) as adaptations is key. Conversations guided by Motivational Interviewing approaches of asking about “what’s working/what’s not?” can create a safe space for youth to explore options.

Once a provider fully understands the function and purpose that the substance use serves, they can begin the essential work of teaching alternative coping strategies. Coaching youth on developing culturally attuned, practical ways that they can use to self-soothe and relax is central. This work of teaching skills that improve emotional identification, emotional expression and emotional modulation can take a long time and often occurs while a youth may be actively using. A traumatized youth may be highly resistant to setting aside something that provides at least short-term relief – without having acquired some tension- releasing, self-care tools that work for him or her.

What have you found to be helpful in working with traumatized and substance abusing youth?

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