It wasn’t until the past 15-20 years that neuroscientists have had the technology they’ve needed to understand the inner workings of the brain – how it develops, how it’s harmed, what mental illness does to it, what addiction does to it, how it looks after substance abuse is stopped and addiction and/or mental illness are treated. One of the most profound findings in terms of treating addiction is learning about adolescent brain development and how substances affect the adolescent brain differently than they affect the brain of an adult. Not only that, but the adolescent brain does not even start wiring what’s known as the executive functioning part of the brain – areas in the cerebral cortex responsible for judgment, reasoning, logic, motivation, complicated thought processes and the brakes on the risk taking behaviors that originate in puberty – until ages 15-16. This wiring process typically lasts until age 22 for girls and 24 for boys. [See related post, Give Their Brain a Break | Underage Substance Abuse Prevention.]

As a result, it’s now understood that adolescent addiction must be treated differently than adult addiction. To help parents and treatment programs better understand what adolescent addiction treatment should entail, I am sharing the following Ten Important Questions to Ask a Treatment Program, from Treating Teens: A Guide to Adolescent Drug Programs, which is a publication of Drug Strategies.  Drug Strategies, created in 1993 with support from major foundations, is a nonprofit research institute based in Washington, D.C. Its mission is to identify and promote more effective approaches to substance abuse and to increase public understanding of current research on what works and what does not.

Treating teen addiction must be done differently than treating adult addiction. It’s because the teen brain is not the brain of an adult. Here are 10 Questions to Ask a Teen Addiction Treatment Program.
Credit: Image Use Purchased from iStock

Now, quoting from Treating Teens: A Guide to Adolescent Drug Programs here are 10 questions to ask a teen addiction treatment program:

1. How does your program address the needs of adolescents?

Most treatment programs are designed for adults, not adolescents. Although adolescent treatment capacity has recently begun to expand, relatively few teens can get help for substance abuse in programs that specifically address the unique challenges of adolescence. Experts agree that adolescent treatment cannot just be adult treatment modified for kids. The program should be developmentally appropriate for adolescents. It should also actively engage the family, which is the primary provider of financial support and the dominant force in the adolescent’s life. In addition, the program should address the many different contexts which shape the teen’s environment, such as school, healthcare, recreation, peer groups and where necessary, juvenile court and probation. For residential treatment programs, it is important to know how teens continue their education. Do they attend school in the local community, or does the program include regular onsite classes approved by the local school district with credits that can be transferred to the student’s home school? The nine key elements of effectiveness discussed in Treating Teens provide a framework for assessing how well a treatment program addresses the needs of adolescents.

2. What kind of assessment does the program conduct of the adolescent’s problems?

3. How often does the program review and update the treatment plan in light of the adolescent’s progress?

The treatment plan, which the program develops after initial comprehensive assessment of the adolescent and his family, provides a guide to recovery that is tailored to the adolescent’s specific needs. These needs will change as the adolescent progresses through the treatment process. Experts suggest that the treatment plan should be reviewed within the first thirty days, and again after sixty and ninety days. In addition, the plan should be reviewed in light of significant developments, such as urinalysis tests that show drug use. As the adolescent nears completion of treatment, the plan should be modified to include continued care and relapse prevention strategies. Follow-up after the teen leaves the program is also important in improving the likelihood that gains made in treatment will not be lost.

4. How is the family involved in the treatment process?

5. How do you engage adolescents so that they stay in treatment?

6. What are the qualifications of program staff and what kind of clinical supervision is provided?

7. Does the program offer separate single sex groups as well as male and female counselors for girls and boys?

8. How does the program follow up with the adolescent and provide continuing care after treatment is completed?

The period following treatment is vitally important in consolidating the gains made in treatment. Most adolescents relapse in the first three months after treatment. However, effective continuing care services substantially increase the teen’s chances of successful, sustained recovery. These services include relapse prevention training, follow-up plans and referrals to community resources. In addition, the program should schedule periodic check-ups with the adolescent at one month, three months and one year after completing treatment. Wherever possible, more frequent contact is preferable; both to monitor the teen’s progress and to make sure the teens and his or her family are receiving the necessary services in the community.

Most programs provide referrals to community resources, including Twelve Step meetings and group therapy, where available. Some programs offer continuing services, such as counseling and education, after the period of formal treatment is completed. Less frequently, programs develop a comprehensive continuing care plan while the teen is still in treatment so that the transition back into the community is as seamless as possible.

9. What evidence do you have that your program is effective?

10. What is the cost of the program?

The cost of drug treatment programs varies widely, depending on the program, its location and the type of care offered. Residential programs are generally the most expensive option, since they provide live-in facilities and around the clock supervision by trained counselors. For example, the rates charged by three of the programs described in this guide, Chestnut Health, Hazelden and Thunder Road, range from $500 to over $800 per day. Outpatient treatment is much less expensive, since the adolescent lives at home. For example, MDFT (Multidimensional Family Therapy), an outpatient program which is described in this guide, costs $164 per week. An intensive version of MDFT is more expensive ($384 per week) because of the additional services provided.

Health plans have not generally offered full coverage for substance abuse treatment, though recently enacted federal legislation requires group health insurance plans that cover addiction and/or mental illness to provide these benefits on par with benefits provided for other illnesses; while the law does not require insurance plans to offer addiction or mental health treatment, it does restrict group health insurance plans from setting higher co-payments or deductibles for these services in comparison to those charged for medical or surgical services.

Medicaid coverage for substance abuse treatment varies by state. Some states provide Medicaid coverage for a full range of treatment options, while others cover only inpatient detoxification. The recently passed Patient Protection and Affordable Care Act expands eligibility for Medicaid coverage and requires that newly eligible Medicaid recipients receive substance abuse and mental health services on par with medical services. For adolescents under the jurisdiction of the juvenile justice system, costs for participation in certain treatment programs are covered by the juvenile justice system.

To be clear, the above is quoted from Drug Strategies publication, Treating Teens, which was supported by a grant from the Robert Wood Johnson Foundation. “The guide is designed to help parents, teachers, judges, counselors and other concerned adults make better choices about teen substance abuse treatment.” T

Learn more about this 21^st century research and the adolescent brain and addiction

• The “Addiction” Documentary > Five Things to Know About Adolescent’ Brain Development and Use
• Advances in Adolescent Substance Abuse Treatment
• The Partnership at DrugFree.org, A Parent’s Guide to the Teen Brain
• How Teens Can Become Alcoholics Before Age 21

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Lisa Frederiksen

Author | Speaker | Consultant | Founder at BreakingTheCycles.com

Lisa Frederiksen is the author of hundreds of articles and 12 books, including her latest, "10th Anniversary Edition If You Loved Me, You'd Stop! What you really need to know when your loved one drinks too much,” and "Loved One In Treatment? Now What!” She is a national keynote speaker with over 30 years speaking experience, consultant and founder of BreakingTheCycles.com. Lisa has spent the last 19+ years studying and simplifying breakthrough research on the brain, substance use and other mental health disorders, secondhand drinking, toxic stress, trauma/ACEs and related topics.

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