Adolescence is an important period of individual growth and development in which people go through remarkable physical, psychological, social, and biological changes as they near adulthood. These changes take place concurrently without the knowledge of the individuals undergoing the changes.
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The changes as well as the psychosocial factors revolving around the adolescents make them a unique group, especially regarding substance abuse and treatment of substance abuse problems. This paper is a critical analysis of the factors affecting the treatment of adolescents with substance abuse problems.
Counselors and health care providers who work with adolescents with substance abuse problems ought to have a good comprehension of the biological and sociopsychological processes that adolescents go through (Susman & Rogol, 2004).
For instance, adolescents have an elevated need for instant rewards, augmented risk taking, mood regulation problems, and heightened production of Adenosine Triphosphate. All these changes affect the adolescents’ predisposition to abuse substances. Clinicians who offer treatment for substance abuse should conduct studies to establish the link between developmental factors and the success of treatment options.
It is also important to note that there are different groups of adolescents (Winters, 2012). For instance, young adolescents aged thirteen are significantly different from those aged eighteen in their predisposition to substance abuse and their psychological maturity. Clinicians and adolescent treatment providers should take these variations into consideration and make the essential modifications.
For example, while the treatment provider ought to take a firm and direct approach with an early adolescent, a more relaxed approach of being an objective sounding board works best for older adolescents.
Knowledge about the patient’s cultural beliefs, and how the patient’s culture views substance use and abstinence are important when designing a treatment plan (Turner & Lloyd, 2003). Viewing substance abuse from the patient’s cultural standpoint enables the treatment provider to understand some reasons that compel the patient’s substance problem.
The clinician ought to try to establish whether the patient’s family are first or second generation migrants. Treatment intervention targeting an adolescent from a migrant family is likely to be more effective if the clinician is well informed about the cultural beliefs of the client and his close relatives.
The need to incorporate cultural consideration in treatment stems from the idea that substance abuse does not happen in a vacuum (Turner & Lloyd, 2003). Cultural principles and beliefs concerning the use of alcohol and illicit drugs vary from one culture to the next.
These differences in beliefs can have substantial effects on the effectiveness of a treatment plan. For instance, certain cultures perceive therapy as an invasion of a person’s private life. In contrast, some people from different cultures may need the inclusion of the extended family during family counseling sessions.
In addition, programs that cater for non-English speaking patients ought to provide treatment services in the language of the patients. Besides solving language barriers, cultural customs such as special holidays of certain communities should be incorporated into the treatment setting. It is essential to improve the levels of cultural sensitivity in the treatment program.
Gender and gender-connected dynamics not only play a significant role in the extent to which a person is predisposed to substance abuse, but also the way they respond to certain approaches. Adolescent treatment approaches that take the patient’s gender into consideration are more likely to be effective than those that group boys and girls together.
Teenage females, for instance, require more focus regarding family related problems than their male counterparts. Girls get affected more by family instability than boys. According to a study by Tapert, Brown, Baratta and Brown, female teenage substance abuse cases are often related to extreme parental neglect and sexual molestation or physical mistreatment (2004).
Female adolescents often need more specialized treatment and specialization in certain services. For instance, pregnant or parenting adolescents may have different psychological and physical demands than the ordinary adolescent. Professional mediation in cases of domestic abuse or sexual molestation may also be necessary for girls.
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A coexistence of disorders often refers to the existence of a psychiatric malady alongside substance abuse disorder. Adolescents with substance abuse problems are often more predisposed to psychiatric disorders than adolescents without such problems (Winters, 2012). The psychiatric disorders often linked to substance abuse include Attention Deficit Hyperactivity Disorder (ADHD), anxiety disorders, conduct and oppositional disorders, and affective disorders.
The conduct and oppositional disorders during childhood often lead to substance abuse during adolescence. In addition, the co-occurrence of more than one psychiatric malady elevates a person’s predisposition to substance abuse as an adolescent. Comprehensive examination ought to be conducted on patients to find out if they have any psychiatric disorder besides substance abuse.
If left untreated, co-occurring disorders can inhibit treatment of substance abuse and can increase the chances of the patient relapsing. Identification of these coexisting disorders and their proper treatment aid in safeguarding against such relapses and hindrances to treatment. To cure adolescents with co-occurring disorders effectively, clinicians ought to design programs together with psychiatrists and facilitate cross-training of their members of staff.
Instability in the family setting characterized by poor parenting, family conflict, domestic violence and poor bonding among family members often elevates an adolescent’s predisposition to substance abuse (Winters, 2012). A closely knit and properly functioning family can protect an adolescent from engaging in substance use and abuse. When parents fail in their role of appropriately disciplining their children for misconduct, either by being overly permissive or excessively strict, they form the foundations of substance abuse.
A family’s genetic history and history of substance abuse can also provide a bearing on the background of the adolescent’s substance abuse. Adolescents whose parents possess substance abuse disorders are more likely to acquire substance abuse disorders than adolescents whose parents do not abuse substances (Rhee et al., 2003).
Establishing the family history concerning substance abuse can offer a clue to the possible role played by genetic components in contributing towards the disorder.
It is also important to assess the risk of relapse posed by the family setting. Parents and siblings who are users and overly permissive parents increase the risk of relapse. All family members should take part in therapy sessions and stages of treatment. The family in this situation comprises grandparents, older siblings, foster parents or any relations who have a role in the adolescent’s life.
Social and Community Factors
Social factors such as school, peer pressure and the community in which the adolescents live and interact can affect their exposure, indulgence and abuse of substances. Comprehending the role played by these factors in the adolescent’s substance abuse disorder can enable a clinician to identify the areas that require intervention for effective treatment and recovery. Outlined below are some of the social factors.
Keeping the company of peers who are involved in crime and abuse substances increases an adolescent’s predisposition to substance abuse (Winters, 2012). These groups of peers provide substances to the members. The need to belong to these groups sees many teenagers involve themselves in substance abuse. Peer influence also increases the likelihood of relapse and is a major impediment to successful recovery.
The socioeconomic class of adolescents contributes to their predisposition to substance abuse in several ways. More financial muscle means that alcohol and illicit substances are affordable and accessible. The environment also dictates the tolerance towards substance abuse.
Some neighborhoods are more tolerant of substance abuse than others. In most of the neighborhoods where substance abuse is tolerated, positive role models that can mentor adolescents are often few or non-existent. In designing a treatment plan, the treatment provider needs to assess the environment in which the adolescent lives and the role that the environment plays in influencing the adolescent’s conduct. The provider can also try to be a positive role model for the adolescent.
Substance abuse presents a unique problem for adolescents who are in an already confusing stage in their development. Treatment regimens designed for adolescents need to be unique and should take into consideration their unique needs and the factors addressed in this paper.
Treatment providers should perform assessments of the adolescents’ background, family, friends, medical history as well as their social environment to understand the causes of abuse and the risk of relapse. An adolescent’s effective treatment plan is unique to the individual.
Rhee, H., Hewitt, K., Young, E., Corley, P., Crowley, T. J., & Stallings, C. (2003). Genetic and environmental influences on substance initiation, use, and problem use in adolescents. Archives of General Psychiatry, 60(12), 1256-1264.
Susman, E. J., & Rogol, A. (2004). Puberty and psychological development. In R. M. Lerner& L. Steinberg (Eds.), Handbook of adolescent psychology (2nd ed., pp. 15-44). Hoboken, NJ: John Wiley & Sons, Inc.
Tapert, S. F., Brown, G. G., Baratta, M. V., Brown, S. A. (2004). fMRI BOLD response to alcohol stimuli in alcohol dependent young women. Addictive Behaviors, 29(1), 33-50.
Turner, R. J. & Lloyd, D. A. (2003). Cumulative adversity and substance dependence in young adults: Racial/ethnic contrasts, Addiction, 98(3), 305-315.
Winters, K. (2012). Adolescent substance abuse: New frontiers in assessment. New York, NY: Routledge.