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If your son or daughter has begun to get involved with drugs, alcohol, or other substances, it can be the most frightening and confusing experience of your parenting life. The child you once knew has grown unrecognizable, your own home doesn’t feel safe anymore, and nothing you say or do seems to have any impact. With substance abuse on the rise throughout the country, thousands of families have suffered this same struggle; you are not alone. Today we are going to explore options families have for managing a teen with addiction issues. This is a two-part article with this article focusing on inpatient rehabilitation and wilderness therapy programs. The second article will focus on ranch therapy and nurturing or therapeutic boarding schools.

Addiction in Teens

Before we address the options for this special population, let’s first look at addiction in teenagers. The first thing parents should keep in mind is that addiction is a chronic illness just like other diseases, such as asthma, diabetes, and, depression. Addiction in teens can be very difficult to identify and define, much less diagnose and treat. 

In March, we posted a two-part article on teens and substance abuse that discussed how to identify substance use and abuse, and steps to take to start the discussion with teens about suspected substance use. Check out those articles for background info on teens and addiction.

We should also remind parents that teens turn to drugs in order to help them cope with some of the most challenging years of their lives. These stressors can range from living in a stressful and unstable home environment, to social pressures, to academic challenges, to traumatic events.

Addiction is a progressive illness and many teens are at the beginning stages of addiction when their behavior is discovered. Most parents are hyper-aware of the peer pressure that teens face regarding drugs, so many parents are on the lookout for substance use. This is good news because the earlier the behavior is caught and addressed, the easier it is to manage.

What is traditional rehab?

Traditional rehabilitation facilities offer shorter stays, between 30-90 days in length, and focus entirely on treating addiction. Most of them use a medical model, meaning they emphasize getting their clients clean and sober through therapy and medications, providing them with a few simple tools, and then directing them to further outpatient or community support after they leave the program. Inpatient programs involve full-time care and are thus very expensive, with the average cost averaging about $20K a month. Most health insurance plans will cover at least some of the cost if a medical need for rehab is demonstrated. 

The major pro of these programs is that the teen receives a lot of therapy and opportunities to model improved behaviors. As a registered nurse, I can tell you that any rehab program only works if the patient has buy-in and is committed to making changes, which many teens are not. Also, most of these programs do not involve the parents as much as they should. Teen addiction is rooted in family dynamics and inpatient programs do not thoroughly address, and thus heal this dynamic. These programs may send updates to the parents, but this is not the same as actively involving the parents and holding parents accountable for their possible role in the teen’s addiction. 

Another issue with inpatient rehab is that if your teen is college-bound, their high school record is going to demonstrate a gap for the time the student was in rehab. The student may need to repeat a semester or even a grade. This is going to need to be explained on college applications.

What is wilderness therapy?

Following the migration of the Outward Bound program from Europe to the United States in the 1950s, several programs throughout the country began to incorporate the principles of wilderness therapy and outdoor education. According to an article by Stacy B. Shaw that appeared in the Spring 2003 edition of UCLA’s Undergraduate Psychology Journal, the “noticeable emotional and psychological benefits” experienced by Outward Bound clients prompted the development of formal wilderness therapies designed to meet the specific needs of at-risk clinical populations.

Today, hundreds of wilderness experiences are available, with dozens of programs offering therapeutic treatments for individuals such as adolescent substance abusers and teens with behavioral disorders. These programs offer enlightened, innovative, and research-based approaches to help young people who are struggling with behavioral challenges, emotional issues, or substance abuse.

The student is removed from their troubling environment that was conducive to their unhealthy behaviors. The best wilderness therapy programs are accredited, offer highly trained staff, and place a priority on student safety. These are not boot-camp programs that work kids to the bone, deprive them of food and water, etc. Most of these programs have been shut down and no longer exist.

Wilderness programs focus on personal and social responsibility. So instead of yet another adult in the teen’s life using authority to impose their views on the student, wilderness therapy focuses on the impact of the teen’s behavior. For example, let’s say a student is assigned to gather firewood to cook the evening meal and the student refuses. The student’s lack of action means that the entire group is faced with eating a cold dinner as opposed to a hot meal. This impacts the teen greatly because his or her behavior impacts their peers, which is more meaningful to a teen than how their behavior impacts an adult, which they don’t care so much about.

In their attempts to discover and describe the reasons behind the successes of therapeutic wilderness programs, many researchers and experts have noted that the programs feature the development of intense interpersonal relationships, the opportunity to overcome significant emotional and physical challenges, and the encouragement to gain a greater understanding of oneself and one’s place in the world.

Working together in settings that are free of the myriad distractions of today’s stimulation-intensive world allows considerable growth to occur in relatively short periods of time. And because wilderness therapists work so closely and so intensely with the teens, they are able to make significant accomplishments together.

In wilderness therapy, the student learns self-reliance, the value of effective communication, and how to engage in teamwork. The teen engages in individual therapy with an assigned therapist, group therapy with other students, and family therapy with the teen’s parents. 

As a registered nurse, the reason I feel wilderness therapy is so effective, and I’ve seen this in my educational consulting practice with many clients, is that the therapy addresses the family dynamic in detail. The parents learn how to communicate with and manage their teen in an effective manner, and the teen learns the value of having a supportive family. I’ve seen many times how this therapy repairs the parent-child dynamic. When this dynamic is healed, the student tends to get back on track and move forward with their goals.

The timeframe that the student attends wilderness therapy averages 8 to 10 weeks with a monthly cost of roughly $15K. The cost includes everything, such as clothing, gear/equipment, toiletries, and food. Some health insurance companies will reimburse families for the medical cost, which is the therapy the student receives, but not the tuition cost. Many programs offer financing and payment plans.

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