If you’re a parent looking for a substance abuse treatment program for your teen, most likely you’re in crisis mode, without a lot to go on.

Only 10 percent of the estimated 1.4 million adolescents who need treatment receive it, according to a September 2004 article in the Archives of Pediatric & Adolescent Medicine. When they do, it often isn't targeted to their developmental needs. The fact that adolescents have different triggers than adults for drug and alcohol use may not be addressed in treatment. And programs too often fail to integrate two key ingredients: families and social services.

But there are plenty of good programs out there, even though few provide enough long-term data to help you make an educated decision. So when starting your search, ask these questions:

What is the program’s success rate? How many teens actually finish?
This answer may be hard to come by since few programs track how their adolescent clients fare after treatment. So be aware that an overly inflated success rate may be a sign to question further, warns Thomas Freese, director of training at the Integrated Substance Abuse Programs at the University of California Los Angeles.

How long is the program? How successfully does it keep teens engaged and enrolled?
Many experts flatly state that any program shorter than 90 days isn't worth the money or time because it takes that long to begin to see a change in behavior. Randolph Muck, lead public advisor of the federal Center for Substance Abuse Treatment, isn't so sure it’s quite that simple.

“What's really important is not whether it's 30 days or 90 days,” he says, “but to make a connection. I did a focus group (last) August with 30 youths who had all been in treatment more than once,” he says. “The thing that succeeded in their last recovery was that they got engaged with a person who helped teach them to practice the skills they'd learned to reintegrate into the community.”

The question for many is what defines a successful life. “It's not just the absence of drugs,” says William Manov, administrator of Santa Cruz (Calif.) County's Alcohol and Drug Program. “You need something better than drugs, something to replace drugs. So a probation officer will look at getting a kid into a soccer league, getting him guitar lessons, finding him a job in an auto body shop.”

Does the program address gender and culture?
Programs fail when they neglect to consider their community. A few years ago, Santa Cruz administrators planned to use a hefty grant from the Robert Wood Johnson Foundation to create a “natural helping” program that featured one-on-one mentoring similar to the Big Brother/Big Sister model. They had their sights set on the Latino community, but when they approached its members, they were quickly set straight — the families told the county they would never send their children off with strangers. Instead, the money was used to develop a family-strengthening program, “Cara y Corazon,” loosely translated as “Face and Heart.” It’s attracted hundreds of families.

By contrast, authorities in Dayton, Ohio, a primarily black city, used the same grant money to set up the very kind of mentoring program that Santa Cruz had first envisioned. This time it was welcomed with open arms, with its natural helpers largely drawn from churches, the heart of the community.

Is family a big part of the program?
Every good substance abuse treatment model starts with a strong family component, including therapy, to work to change to the home environment.

CASASTART, developed by Columbia University and now operating in 72 schools in 16 states, has had significant success in combining these elements. One of its national prevention programs, run by the Mi Casa Resource Center for Women in Denver, focuses on “the usual suspects” among the predominantly Latino 8- to 13-year-olds who have been identified as at risk because of family problems, substance abuse in the home and school behavior issues.

“We let them know up front that we're going to get involved in every aspect of your life,” explains Brigid McRaith, director of the program. That means a classroom tutor, anger management classes, family meetings, after-school programs four days a week, weekend excursions to college campuses and rock-climbing adventures.

As she speaks, a high school senior has dropped by her office, asking for help to complete his college applications. The youngest of six children, he is the first in his family to graduate from high school.

He was in elementary school when he entered the program six years ago. His parents, both addicted to alcohol and drugs, constantly moved the family from one place to another.

The program addressed his particular needs: arranged counseling, provided anger management workshops, along with boxing classes; found him an adult mentor, and perhaps most important, met regularly with his parents, finally persuading them to stay in one place.

“To me, the piece about the family is key,” says McRaith. “If we're not in the home, we don't understand what's happening. We're just looking at it from the outside.”

(Richard Scheinin is a reporter for The San Jose Mercury News.)
 

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