Earlier this month a few of us attended a Lunch ‘n’ Learn event at CASAColumbia with Maia Szalavitz, a neuroscience journalist who covers health, science and public policy. She discussed the theme of her book, Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006), an exposé of the “tough love� business.

The talk prompted us to revisit and share what we at The Partnership at Drugfree.org know about boot camps and wilderness programs for troubled and/or addicted teens.

First, it is important to note that boot camps and wilderness programs are not included among the levels of care defined by the American Society of Addiction Medicine. Although you may have heard success stories or read about the benefits of boot camps, we strongly suggest you look very carefully into any boot camp or wilderness program before sending your teen for substance abuse treatment.

According to a government report, these programs are not subjected to federal oversight, and there have been thousands of reports of neglect and abuse at privately owned and operated boot camps and wilderness programs for troubled youth.

Ms. Szalavitz explained that a person with the disease of addiction is already in a lot of pain. To get better, that person doesn’t need more pain and abuse, but rather a kind and supportive approach to treatment. One that’s comprehensive, respectfully addressing the individual’s physical, emotional and social issues. One that makes the person feel better.

We suggest that if you are seriously considering a boot camp or wilderness program, you check with the Better Business Bureau for any complaints against the program. You should also call the program and ask a lot of questions, including:

1) What specific substance abuse and mental health licensing and accreditation does the program have? (If the providers are not licensed, do NOT send your child to the program.)
2) Has a child in the care of the program ever died, and if so, why?
3) What specific training (particularly survival skills training for outdoor programs) do the counselors have?
4) Have there have been any complaints of abuse or neglect at the camp?
5) Can you put me in touch with a few families that have a child who have completed the program so that I can hear about their experience?
6) Who is responsible for medical care? (It should be a licensed medical doctor.)

Remember, addiction is a serious health issue and requires appropriate treatment by licensed professionals so that addicted persons can learn how to manage drug and alcohol problems, how to handle relapse and how to live a life free of drugs and alcohol.

For more questions to ask programs when looking for treatment for your child, here are some helpful resources:

• Time To Get Help’s Questions to Ask Checklist at TimeToGetHelp.Drugfree.org

• Maia Szalavitz’s list of important questions to ask, especially if considering a boot camp or wilderness program for your child.

To find the best assistance option for your child with an alcohol or drug problem, see our Treatment e-book.

To connect with other parents about your child’s drug and alcohol problem, join our online support community at TimeToGetHelp.drugfree.org.

To speak to a trained specialist, call our toll-free helpline at 1-855-DRUGFREE (1-855-378-4373).

Have you sent or considered sending your child to a boot camp or wilderness program? Comment below to share your thoughts or experiences.

When someone – including a teenager – gets treatment for alcohol and substance abuse, it is standard practice to identify some of the reasons why they started using and the benefits they feel they get from these substances.   This helps them reduce shame and best identify their triggers and areas to focus on. Among the research, most reasons for using alcohol fall into a few broad categories such as mood or personality enhancement, social reasons, and coping reasons. Reviewing personal motivations for using alcohol is often an “ah-ha� experience for the person seeking help but it needs to be handled with care as there is the potential in such a discussion to make alcohol use seem more appealing.

Nowhere is this concern greater than when attempting to prevent alcohol use in teens as many parents have a justified fear that such a discussion will promote alcohol use in kids who may not have otherwise been aware of the potential short-term “benefits� of alcohol. This fear has often caused parents and caregivers to avoid the topic, focus only on the consequences of drinking or minimize the reasons why people drink – especially with younger children. While reinforcing the consequences of underage drinking is always recommended, understanding teen’s motivations can also be useful to parents as a point for both prevention and early intervention of teenage drinking. Below are a few tips on using teen motivations to intervene and connect with your children.

A useful strategy is to ask teens about what they “expect� to get from drinking. Along with perceived risk, your teen’s alcohol use can be predicted by the expectation that one will feel a certain way when they drink. These expectations are reinforced by the media and by your teen’s peers. Expectations are essentially motivating (I want to relax and I will drink because I expect that it will help me relax). The first step is to identify what your teens think about drinking’s benefits or what drinking may give them. If you can identify the reasons they think people drink (or they drink), it is a point of intervention.

Tailor Your Strategy: Based on the motivations or expectations your teen mentions reports there are several options to continue the conversation.

1.  Identify myths about the effects of alcohol: Teens may think that alcohol will help them achieve a particular outcome when in fact the opposite is true in the research. For example, if a teen says he drinks to relax, you can counter that alcohol only has temporary relaxing qualities (and only in moderation) and drinking actually reduces sleep quality which then causes stress. When teens understand that alcohol in fact may not actually give them what they want – they might think twice about drinking for a specific reason.

2. Once you have identified your child’s reason for drinking, encourage him or her to find other activities that will achieve the same outcome without alcohol. This is called “counter conditioning.� So using the above example you can identify other ways that are significantly more effective than alcohol in helping them relax (e.g. exercise, music, yoga). This is important because you will be teaching your teen a valuable coping skill that might prevent them from developing problems later on in life.

3. Lastly, point out that much of the “effect� they get from alcohol is simply based on what they expect they will get when they drink. This is especially effective for the “I want to have fun� motivation. My favorite way to talk about this is to discuss the numerous experiments done on placebo alcohol – yes – that’s right, studies where there was fake beer or tonic water alone and people thought it was actual alcohol. Individuals in these studies reported everything from being more social/sexual to being more confident to even having memory loss. In other words – you get what you expect. So simply being primed and thinking positively will give you what you need without the alcohol. These results are not unique to alcohol either – the placebo effect whether it be through fake surgery or a pill is extremely powerful. Studies even show that people who receive placebos have actual changes in their brain chemistry based simply on the expectation that they are getting what they need to achieve their goals. More importantly, some studies also reveal that people taking a placebo attribute their changes to themselves and not an external substance.

What I have found when I discuss alcohol motivations with teens is that they appreciate hearing a more rounded view of drinking. Teens are smart – they understand that people drink for a reason and if we ignore the reasons for drinking we are going to lose credibility with our teens. Discussions about expectancies and motivation typically also bring up much broader discussions of internal vs. external control. When I was working with college students who were referred to me for binge or excessive drinking – I would ask them to “pretend� they were drunk the next time they went to a party. It was a powerful experience for them to just hold a tonic water and pretend that it was a real drink. It helped them recognize the internal power they have over their actions and to feel more confident and secure. When teens begin to realize that they are in control of their actions they can begin to master the world around them to achieve their goals without a pill or drink.

Related Links:
What Got Me into Treatment? Drug Intervention
Teens Only Listen to One Person…Themselves:  How a Child’s Own Reasons for Change Lead to the Most Success
How to Prepare for a Drug Intervention with Your Teenager