Therapeutic Interventions

1. Disclose the family's history of substance abuse and/or special concerns about the child's use of illegal substances. (1, 2, 3)

2. Schedule time to communicate openly with the child

1. Assist the parents in outlining their concerns about substance usage in the family; gather background information about the child's social/emotional functioning, symptoms of chemical dependency, and behavior problems at home or school.

2. Ask the parents to disclose their own level of substance use and describe its effects on their daily functioning and relationship with the child.

3. Collaborate with the parents to enlist the assistance of a drug intervention specialist if necessary.

4. Stress the importance of maintaining open communication about the negative consequence of substance abuse. (4, 5)

3. Establish a zero tolerance policy for substance abuse. (6, 7)

4. Set reasonable limits for the child which encourage responsible behavior and appropriate independent functioning. (8, 9)

with the child about underage drinking and drug use; help the parents prepare for typical questions that might arise during a discussion (e.g., "How come you drink and I can't? How is marijuana harmful?").

5. Teach the parents effective communication techniques by role playing conversations using I-statements, active listening, not interrupting, and avoiding absolutes like "always" and "never."

6. Assign the parents to set a clear family rule of no drug use including tobacco, underage drinking, marijuana, ecstasy, or inhalants and to frequently communicate this standard to the child.

7. Assign the parents to brainstorm with the child the various ways to maintain a substance-free lifestyle (e.g., learning substance refusal strategies, connecting with a substance-free friendship group, learning about the harmful side effects of substance use, focusing on future goals and aspirations).

8. Emphasize to the parents the importance of extending freedoms to the child only after responsibility has been demonstrated (or assign the "Earning Privileges and Freedoms" activity from the Parenting Skills Homework Planner by Knapp).

9. Teach the parents to use enforceable statements (e.g.,

5. Remain firm and calm and use logical consequences when the child breaks the rules. (10, 11)

6. Monitor outside of school activities and require clear information detailing where, when, and with whom the child is involved. (12, 13)

"Feel free to go to the party as long as Justin's father assures me that he will be there to chaperone" versus "You're not going to that party until I know it will be chaperoned") and limited choices (e.g., "Would you rather do the dishes or drive your brother to soccer?" versus "Do you want to help me or not?") (See Parenting Teens with Love and Logic by Cline and Fay.)

10. Assign the parents to design several logical consequences to deal with chronic inappropriate behavior (e.g., child comes home intoxicated, child attends alcohol abuse classes and writes a paper about underage drinking).

11. Teach the parents to use delayed consequences (e.g., "This is a serious problem and I will need to do something about it. I will let you know when I decide what to do.") to address inappropriate child behavior when no consequence is immediately obvious and the misbehavior is extremely upsetting. (See Parenting Teens with Love and Logic by Cline and Fay).

12. Instruct the parents to require that the child inform them about the "where, when, and with whom" details of all activities.

13. Instruct the parents to remain firm yet compassionate when the child argues about the rules combining empathy (e.g., "I know that you desire an

Create a supportive, compassionate bond by giving the child daily affirmations and unconditional love. (14, 15)

Verbalize an accurate understanding of child and adolescence substance abuse education occurring in the child's school. (16)

Assist the child in listing the devastating effects of substance abuse upon personal behavior, relationships, health, and future goals. (17, 18)

10. Schedule a complete chemical dependence evaluation to unlimited curfew") with the rule or limit (e.g., "Right now your curfew is 11:30").

14. Assist the parents in creating a definition of unconditional love (e.g., complete and constant love given regardless of performance); brainstorm methods of sharing this nurturing form of love as an antidote to the child's temptation to use illegal substances.

15. Assign the parents to collaborate with the child to create a list of personal strengths that the child has; encourage them to refer often to the list especially when discouraged.

16. Assign the parents to contact their child's school to become informed about the substance abuse education programs being offered for students.

17 Council the parents to engage the child in a discussion about the devastating effect of substance abuse upon personal quality of life (e.g., loss of former friends, drop in grades, family problems, memory loss, legal problems).

18. Instruct the parents to explore the process of chemical dependency with the child by describing the initial exposure to mind-altering substances, the gradual process of dependency, the awareness of the negative effects of addiction and the difficult recovery process.

19. Strongly encourage counseling for any family members with determine treatment recommendations necessary to address any abuse of substances. (19, 20, 21)

11. Participate in an intervention in which family and other concerned relatives and friends confront the child's substance abuse and strongly advocate for appropriate treatment. (22, 23, 24)

12. Arrange for the child to attend group sessions focused on increasing self-esteem, expressing feelings and developing social skills addiction problems that may be contributing to the child's oppositional behavior, feelings of despair, and attempts to escape through chemical dependence.

20. Refer the parents to a certified substance abuse therapist who will evaluate the child's use of mind-altering substances.

21. Review the results of the substance abuse evaluation with the child and the parents and discuss treatment options (e.g., inpatient treatment, outpatient therapy, family therapy, Alcoholic's Anonymous); enlist a firm commitment to a course of treatment.

22. Explain the intervention process and goals with the parents and other close associates (e.g., drug-free friends, teachers, clergy, relatives, coaches) who will participate.

23. Role play how each person will present their concerns during the intervention and have a treatment facility available to work with the child immediately after the intervention.

24. Help the parents and other participants prepare for maintaining a loving, yet strong and determined, approach in the face of the child's anger and denial during the intervention.

25. Council the parents to arrange group counseling sessions for the child at school or a community agency that focus on building social skills, healthy and problem solving abilities. (25, 26)

13. Gain a deeper understanding of the child's self destructive behavior, its causes and treatment strategies. (27, 28)

14. Verbalize an increased recognition and encouragement of the child. (29, 30)

self-esteem, feelings expression, and refusal skills.

26. Assign the parents to enroll the child in a conflict management or assertiveness training program to develop interpersonal skills, appropriate assertiveness, and conflict-resolution abilities.

27. Direct the parents to informational resources offering interventions and treatments for preventing and treating adolescent chemical dependence (e.g., Partnership for a Drug-Free America, www.drugfreeamerica.org; Talking with Kids about Tough Issues, www.talkingwithkids .org; Teen Drug Use and Abuse Prevention, www.parentingteens .com).

28. Assign the parents to read and share with the child literature which describes adolescent substance abuse, it's causes and coping strategies (e.g., Street Wise Drug Prevention by Jalil or Field Guide to the American Teenager by DiPrisco).

29. Teach the parents to recognize and affirm the child daily by noticing personal attributes and verbalizing an awareness of activities that promote recovery.

30. Help the parents plan for reassuring the child about personal security and expressing awareness and empathy for the child's fears during the recovery process.

15. Verbalize support the child's renewing interest in former healthy activities and increased social interaction with a substance-free peer group. (31, 32)

16. Define the threats to the child's recovery and maintaining a substance-free lifestyle. (33, 34)

17. Involve the child in creating a plan for long-term abstinence from all mind-altering substances. (35)

31. Assign the parents to support the student in joining a drug free extracurricular group sponsored by school, a religious group, or the community.

32. Instruct the parents to assist the student in planning for an after school or weekend activity or to attend a school-sponsored function with a substance-free friend or group.

33. Assign the parents to brainstorm with the child the many factors that influenced the substance usage or addiction, list strategies that can combat these threats to recovery and discuss how to implement positive behaviors to prevent relapse.

34. Assign the parents to complete with the child the "Healthy Habits to Support Recovery" activity in the Parenting Skills Homework Planner (Knapp) to define positive behaviors and activities that can become antidotes to relapse.

35. Instruct the parents to sign and require that the child sign a joint commitment to maintain a substance-free lifestyle which includes long- and short-term recovery goals, support people, and the lifelong personal consequences of recovery versus dependency (or assign the "Our Commitment to a Substance-Free Life Style" activity in the Parenting Skills Homework Planner by Knapp).

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