By Jeff Foote, Carrie Wilkens and Nicole Kosanke

“My son is using drugs and it’s wrecking our family. I’ve tried to talk to him, but he just gets mad and then we just stop talking. What should I do?â€�

We often receive this kind of call here at Center for Motivation & Change (CMC). It’s a terrible call because of the anguish involved. It’s also a wonderful call, because we have the tools needed to help. A call like this provides our CMC clinicians the opportunity to invite the family member to learn about CRAFT.

Community Reinforcement and Family Training, or CRAFT, is an approach for families who have a loved one struggling with substances but who is not really interested in making changes or getting help. CRAFT is about learning a different method to communicate with and support your loved one. It’s about taking care of yourself, while also learning how to interact with your loved one in a way that increases the likelihood of making a real change.

The old method – either help them, or help yourself by distancing yourself from them – was never a choice you should have to make. CRAFT teaches you a series of strategies such as:

• Understanding how to communicate positively (even when things aren’t going so well)
• Using positive reinforcement to focus on what is working, while allowing for the bad stuff they are doing to impact them
• Taking real steps and developing real awareness of what it means to take care of yourself, not as an afterthought, but as a priority for the whole family

Parents have been told a number of things that are neither helpful nor practical: “Let them hit bottom, they have to figure it out for themselves�; “There’s nothing you can do, helping them is enabling their use and means you are ‘co-dependent.’� These “tough love� messages are often excruciating for many parents.

The good news? You can help your loved one without taking those steps. CRAFT works to change your interactions with your loved one so that sober behavior is more rewarding to them than continued alcohol and drug use.

CRAFT is “menu-driven.� This means that different components and procedures are selected from the CRAFT “menu� based on the family’s particular needs. Where the treatment starts depends on the substance user’s behavior, severity and openness to change. It also depends on your emotional state, experience and history as a family.

CRAFT research (and our clinical experience) has demonstrated that by learning skills and understanding what motivates your child, positive change can occur. Evidence shows that positive outcomes occur at a much higher rate with the CRAFT approach than with other, more well-known approaches, such as either the 12-Step Anon programs or Intervention approaches.

Why? Probably because CRAFT is positive, aimed at encouraging healthy, constructive changes, and is focused on helping your child develop or re-develop a life. In addition, CRAFT is a behavioral approach, interested in changing behaviors (theirs and yours), not just talking about them. And as we mentioned, it is geared toward improving your life as well. Research studies repeatedly find that family members feel much better throughout the CRAFT process, whether or not their loved one ultimately gets into treatment. Best of all, using the CRAFT approach, the substance user in the family seeks treatment at a rate of about 65-75%, 2-3 times higher than interventions or Anon approaches.

CRAFT works. It may require work, practice, stumbles, practice and more practice. But CRAFT also teaches you that “you can help.�

Perhaps most importantly, the skills, strategies and insight you gain through CRAFT are built for the long haul: what you will learn now will remain applicable beyond your current situation; it’s not just useful when “trying to get him to say yes to treatment.� Saying yes matters, but what matters more are the changes you can make in your family, because these changes are the ones that provide the fuel for lasting change, not just for putting out the immediate fire.

The Center for Motivation & Change is a unique, NYC-based private group practice of dedicated clinicians and researchers providing non-ideological, evidence-based, effective treatment of addictive disorders and other compulsive behaviors. CMC’s treatment approach is informed by a strong commitment to both the humanity and the science of change, providing a unique, compelling, and inspiring environment in which to begin the process of change. Staffed by a group of experienced psychologists, CMC takes pride in their collective record of clinical research and administrative experience but most of all are driven by an optimism about people’s capacity to change and a commitment to the science of change.

 Learn more about CMC and read about our unique and effective approach to treating addictive disorders, and meet CMC’s directorial staff and clinical staff. To find more resources for families, please see our Parent’s 20 Minute Guide, and our Family Blog.  And to find out more about CRAFT, see our CRAFT Family Services page.

Forty percent of the calls that we receive on the Parent Helpline are from despairing moms and dads looking for a sensible answers to help them deal with their teenagers’ and young adults’ drug abuse and dependencies. By the time parents find their way to us, the “conversationâ€� with their teen hasn’t worked, the abstinence contract has been broken, and they have heard all about “tough love,â€� “letting them hit bottomâ€� and “enablingâ€� — with enough gratuitous advice and ideological claptrap about how to “fixâ€� the problem, that their heads are reeling.

Yet, their loved one’s drug problem continues to worsen, family difficulties deteriorate along with increased school failures and dropout, drunk and drugged driving, delinquency, and early pregnancy becoming all too common. And, while we all agree that there are no easy answers, the conventional wisdom, stubbornly insists on telling parents that emotional detachment is the holy grail of family recovery, the magic ingredient that they have missed out on – that as parents of addicts, to truly help their children, and in order to retain their own personal, physical, emotional and spiritual health, they must love their drug addicted child enough to let them suffer so that they can get better. Some parents, desperate for answers, try this with mixed results, but most parents that we talk to tell us that they wish that there had been another way.

But, finding another way isn’t always that simple. The treatment and recovery landscape can be described as being dominated by a singular approach that proposes that “denial� must first be broken before the afflicted individual can find the road to recovery.

But through the hundreds of phone calls we receive from parents who have been there, we have come to understand a few things about this. That is that:

• Active positive family involvement as opposed to detachment works better
• Motivational styles in reaching loved ones are more effective than confrontational styles
• Parents feel better about themselves when they encourage vs. confront
• Parents like motivational approaches better than confrontational ones
• Positive reinforcement works

It is for this reason, we are proud to announce a very special Intervene blog collaboration with The Center for Motivation and Change (CMC) to provide Intervene’s readers with an ongoing series of professionally written articles proposing alternatives to the traditional approach of dealing with a loved one’s addictive problems.

The cornerstone of CMC’s treatment approach is motivational, helping each client find a path toward change they can truly embrace. By providing the structure and tools to pursue that path, and through the use of respectful, flexible, evidence-based approaches, CMC addresses a range of issues to help each individual clear the often difficult obstacles to effective, life-enhancing, and long-lasting change.

Be on the lookout for CMC’s first post on Intervene – “The CRAFT Approach: Encouraging Healthy, Constructive, Positive Changes for Your Family� – coming soon!

What’s it like being the parent of an addict? I’m not talking about the day-to-day experience with a crisis and drama around every corner. I mean what is it like inside the mind of a parent who has gone from discovery (of a child’s drug use) to recovery (from a drug addiction)? As I take stock of my current emotional state – examining all of the emotions I have felt over the last 10 years – I wonder: Am I normal? Am I a survivor? Am I crazy? Maybe I’m just a composite of these experiences and it’s simply who I am now.

***

After reflecting on the last 10 years, here is my emotional inventory:

Hurt: Hurt is one of the emotions that never fully dissipates. Usually I am able to put the hurt aside and shield myself. Occasionally, however, it jumps out at me. I have never hurt like I had while suffering through my son’s active addiction. For me, it is a hurt that even overshadows the death of a loved one. I spent a long time with this emotion. For many years I couldn’t separate the disease in my son from my son himself. His addiction was a personal affront and I held onto very deeply. The pain from this emotion took me to places I wish I never would have seen. This was the hardest to reconcile within myself. Hurt was the most destructive emotion for me and it drove my life.

Anger: Anger was my defense mechanism against the hurt. Anger moved me to do things that I am not proud of: scream and curse at my son, scream and curse at my wonderful wife — in fact, at times, I attacked anyone who was within reach. For the most part, my anger wasn’t physical. Rather, I sliced people to bits with words. But one day my anger drove me to my lowest point in life — I struck my son in anger. My son taught me a lesson, however. Even though he was high and addicted, he did not strike back. His respect for me at that time was greater than my respect for him. Of this, I am ashamed. “You have a right to be angry,” he would say. I have heard those words before. But they are empty. Anger comes with the territory. Our response to life with anger is something we must find a way to live with, while not destroying ourselves.

Suspicion: I always thought of myself as a trusting person. My whole philosophy in life was that I was too lazy to distrust somebody. After all, trusting is easy. To distrust, on the other hand, requires a tremendous amount of work and energy. Yet, suspicion makes distrust easier. You begin to see the evil in a person. It is easy to forget that the symptoms of a disease can mask the reality of a situation. It is easy to allow suspicion to drive your life and behaviors. I’m not talking about the things the parent of an addict must do to protect themselves and the addict. I talking about learning to see evil in a person, when evil is not the intent. This outlook leads to negative consequences for all involved.

Contempt: Contempt is the culmination of hurt, anger and suspicion. Contempt is a terrible thing for parents to hold against their own children. Contempt can easily slide to a place where there is no caring. I felt once that I was entering that place. I can’t go there; it is a one way door. Thankfully, I did not go through that passage. It is a bad, bad place.

Joy: Joy is that emotion we all want. When I think of joy the picture of Snoopy dancing on top of his doghouse comes to mind. Joy comes from many places -– but it is immediate and temporary. However joy is a fix that I craved. I’d twist reality in order to experience that feeling. Too often my desire for joy allowed me to ignore realities to the detriment of myself and my son.

Hope: Hope was the most dangerous of positive emotions. Hope set me up for terrible lows. I misunderstood hope for most of the time that my son was using. It was an emotion that I transferred to others. My hope was based upon the actions — or lack thereof — by others. I would pass out hope to people like business cards at a conference. I placed my hope in the hands of rehabs, meetings, counselors…anyone. I allowed others to both build up my hope and pull it out from underneath me. Yet, hope is an emotion that must be internalized; it isn’t a wish. Hope is an awareness of life and the tender nature of what impacted me. Where there is life there is hope; it was only after I understood that simple phrase that I understood what hope really was, rather than what I wanted it to be.

Happiness: Happiness is so much more than joy. Joy is fleeting, happiness is an internal state of being. Happiness can be found in all things. Happiness can be obvious: the birth of wonderful grandchildren; the sound of, “Papa come here.” But happiness can be born of heartache and pain, like the happiness I feel to have known my father for 27 years of my life. Happiness isn’t the smile or grin you see on my face, it is the feeling inside. The smile is simply a physical response.

Appreciation: Appreciation is the dominant feeling I have today. Appreciation isn’t a “thank you,” but rather, it is a recognition of what “is.” Appreciation is taking it all in-the good, the bad and the ugly. The simple process of writing this post is a process of appreciation for me. The horrible emotions and actions I described above are just as valuable in shaping my well being as the wonderful feelings I experience today while my son is in recovery. Appreciation ALLOWS me to learn from what I have experienced over these past 10 years. If I choose not to learn then what has been the worth of a decade of my life? I wish that I had never experienced any of this and that my son had never been an addict. If there was a time machine I’d be on it right now to change it all, but that can’t happen. Ignoring the bad and only recognizing the good discounts my life and make me less than. I want to be the best I can be. In order to do so, I must learn from my terrible mistakes.

Love: Love is so much more than what we whisper at night before falling asleep. Love is a life preserver in a storm; it is a foundation that holds you up; it is something that makes you better than what you can be alone. I learned more about love in the last 10 years than I had learned all my life before. Love comes not just from those whom are close to you, but also from those who have enough in their life that they wish to share. All you have to do is ACCEPT it.

***

As the parent of an addict, I have learned that we are not perfect. In fact, we shouldn’t even strive for perfection. Trying to be perfect causes terrible control issues (speaking from experience here). It’s a hard lesson, but we all must do what we are capable of doing at any one time. Self assessment and learning isn’t something we do, it is a process we work through.

I wish that I could live the rest of my life experiencing only the positive emotions. But I know that hurt, anger and suspicion will at some time again enter my life. That’s the way life is. Yet after experiencing the extreme emotions brought about by parenting an addict – and acknowledging them — I believe that I will be better able to cope with any negative feelings that arise.

Have any of you have experienced these same emotions? If you have, it is worth the reflection to examine what being the parent of an addict has done for you as much as it has done to you.

Maybe I’m normal, or maybe not. But no matter, quoting an old wise philosopher, Popeye the Sailor Man:

“I yam wot I yam. And that’s all wot I yam……”

We’re thrilled to share the following video featuring Dr. John Sharp, a renowned psychiatrist, bestselling author and faculty member at both the Harvard Medical School and the David Geffen School of Medicine at UCLA.

In this video, shot by Clio award-winning director Lori Hoeft, Sharp discusses the genetics of addiction, the developing teen brain and the importance of early intervention.

Sharp encourages parents to take action early. “Your role is critical,� he says. “You can influence the behavior of your loved one. You want to continuously let him or her know how much you care and what your support can mean.�

Learn more about the teen brain and the steps you can take if you think or know your child is drinking or using drugs. For guidance, call our Toll-Free Parent Helpline at 1-855-DRUGFREE (1-855-378-4373) or visit Time To Get Help.

Want to hear more from Dr. John Sharp? Keep an eye out for his feature article on Join Together, coming out this summer.

Earlier this month, The Partnership at Drugfree.org was alerted that Urban Outfitters, the national retail store popular with teens, is selling pint glasses, flasks and shot glasses made to look like prescription pill bottles. These products make light of prescription drug misuse and abuse, a dangerous behavior that is responsible for more deaths in the United States each year than heroin and cocaine combined.

In fact, medicine abuse has increased 33 percent over the past five years with one in four teens having misused or abused a prescription drug in their lifetime. Combined with alcohol, the misuse and abuse of prescription medications can be especially risky, making the Urban Outfitter merchandise even more disturbing.

Prescription drug abuse is no joke- it affects real people like Aaron, Mark, Chelsea, and their family and friends. Please join our fight in having Urban Outfitters remove these products from their shelves and website immediately.

Over the course of this past month, we have been working tirelessly to bring attention to this effort and have received an overwhelming amount of support from families, friends, government officials, strategic partners and the media. In fact,  we have collected nearly 4,000 signatures on our petition to stop Urban Outfitters from selling these items, surpassing our original goal of 500.

Gil Kerlikowske, Director of the Office of National Drug Control Policy; Congressman Hal Rogers (KY); Attorney General Jack Conway (KY); David Sheff, New York Times bestselling author; and Melissa Gilbert, The Partnership at Drugfree.org Celebrity Champion and actress, have joined our effort and sent letters or social media posts to the Urban Outfitters CEO to demand the items be removed. Hundreds of tweets have been sent to @UrbanOutfitters with similar demands. The culmination of these actions has generated significant media coverage from news outlets including ABC News, Associated Press, The Huffington Post, UPI and more. Together, we are making a real difference.

Despite all these actions, however, we still haven’t received a response from Urban Outfitters.

Tongue-in-cheek products that normalize and promote prescription drug abuse only serve to reinforce the misperception about the dangers associated with abusing medicine and put more teens at risk.

Please ask Urban Outfitters to remove these tasteless products from their stores now. Feel free to use the information above to help make your point.

Sign this Facebook Causes petition:
http://www.causes.com/drugfreeurbanoutfitters

You can also send an e-mail to:
Richard A. Hayne; CEO & Chairman
richard.hayne@urbanout.com

Write a letter:
Urban Outfitters, Inc.
5000 South Broad St
Philadelphia, PA 19112-1495

Join me and take action today!

What do you think about Urban Outfitter’s sale of these items? I’d love to hear from you, the Intervene community.

The other day a friend said to me, “It seems as if all the people I knew in high school who used drugs were the ones who had trouble coping with their feelings.”

As a person in recovery from alcohol and drug addiction, I agree with her observation.

I had a great amount of anxiety as a child and as a teenager. My parents were often angry at each other. We frequently ate dinner in silence and, although we didn’t acknowledge it, the tension was high. I didn’t understand how to sort out my anxiety and my feelings became too much to bear. Just thinking about it 25 years later (14 in recovery) brings knots to my stomach.

I didn’t want to be at home with my family. As a result I started going out every night at an early age, even on weeknights, just to get away.

At 14 years old, when I had my first drink, the anxiety went away — albeit temporarily — and I thought I had finally found the answer to my problem. After that, all I wanted to do was drink again.

Now, with children of my own and being in recovery and knowing what I know about drugs and alcohol, I think a lot about the concept of coping.

I often see parents using distraction as a method to calm down their children. But what are we really telling our kids if each time they are upset about something we say, “Oh, let’s go over here, and let’s look at this really fun book!� Or “Here let’s see what’s in the fridge?� This method prevents children from learning how to experience emotions appropriately. We’re setting them up for a lifetime of bottled-up emotions; we’re teaching them to cover up their feelings, rather than to express themselves. My mother’s idea of comforting herself was through shopping and sweets. Naturally, my brother and I picked up similar habits. And believe me, I thoroughly enjoyed the shopping, chocolate and Coca-Cola.

I didn’t have a safe place to express myself and never learned how to process feelings. When I felt bad and anxious it was so painful and so overwhelming.

In early recovery when I no longer had drugs and alcohol to cover my feelings,  it was very difficult to deal with my feelings of sadness and despair. I became very depressed; I would cry endlessly. I didn’t have the ability to get passed my pain and release my emotions.

With the help of the 12 steps, therapy and meditation I have learned how to cope better. Today, when I get sad about something, my reaction is appropriate to the situation at hand.

Nevertheless, parents today never want to see their children sad. We fear that they won’t be able to handle adversity. I fall into that trap even though I consider myself to be a pretty conscious mother. Recently, my 4 year old had a playdate with a young girl who subsequently made her cry twice in the little time she was at our house. My instinct was to ban the girl from our home, and I hoped that my daughter would never want to play with her again at school. I was adamant about it. I didn’t want anyone to hurt my little girl.

But then I thought, “Wait a minute, is this the right way to go?�

I recently watched a video called the Opiate Effect. It is a short film about the Oxycodone problem in Vermont. In the film, Dr. Bob Bick (Director of Mental Health and Substance Abuse Services at the Howard Center) says, “If we encourage young people to think, to THINK and FEEL from the earliest age as opposed to believing that we can think for them or feel for them, we will be in a much better position…for young people to make decisions which ultimately will affect the rest of their lives.�

Thinking and feeling for myself was something I did not know how to do until several years into my recovery. Thinking, but foremost FEELING for themselves is something I deeply would like my children to learn. And if I just step out of the way, not necessarily interfering but instead simply giving them gentle guidance along the way, I’m hoping it will be achieved.

So, I’m taking a different approach. If my daughter is angry or sad, I ask her what is going on and try to get her to talk about it. Sometimes I’ll just hold her without saying anything and let her cry until she is done. I never try to distract her with TV, food or shopping like I see so many others do, and like my own parents did.

To me it is clear that teenagers who have learned to cover up their feelings with video games or shopping or food will more easily say yes when someone offers them a joint at a party. And if they are predisposed, and have a lot of unresolved or pent-up emotions and the joint offers them relief, then they will likely want to do it again. And then who knows what will happen.

As they say, I am trying to just take it one step at a time and one day at a time encourage my two little girls to figure out life, thinking and feeling on their own, and hopefully it will make a difference.   Of course, I am just a parent in recovery. I am not an expert nor a PhD, and these are just my observations.

I would really like to hear from parents who have had or currently have children who are suffering from drug and alcohol abuse issues and hear what they have to say on this topic. Does any of this matter? Please comment below and let me know what you did or didn’t do.

When it comes to addiction treatment, too often there is a disconnect between what people with an addiction need — and what they get. Combine that with the stigma, desperation and fear that accompany the disease of addiction, time and again, present seemingly insurmountable odds for the addicted person to overcome. In this, the final installment in a four-part series of my Q&A with award-winning journalist Maia Szalavitz, Ms. Szalavitz weighs in on “Addiction Treatment: How Can We Make Things Better?�

JERRY OTERO: Most of the media stories about addiction are often tied to something sensational, like a celebrity death. What will motivate journalists to pay more attention to this issue and, in turn, create more awareness and education among their readers/viewers? What kinds of stories would you like to see?

MAIA SZALAVITZ: Hard to say how to get more attention to this (if I knew how, I’d do it!), but I would like to see reporters who cover this area question their own ingrained beliefs and not just assume that traditional treatment is the only way to recovery, that police are any kind of experts on the effects of drugs, that treatment providers are impartial experts (use academic sources who know the data; you wouldn’t go to a pharmaceutical company for unbiased perspective on its own products) or that current policies are the most effective way to deal with problem.

JERRY OTERO: What’s your biggest wish for change in the addictions field?

MAIA SZALAVITZ: That addiction be seen as a health problem and truly treated that way, with evidence-based treatment in which the traditional harsh approach would be as unacceptable as it would be for doctors to treat cancer patients as immoral malingerers.

JERRY OTERO: Anything parents can do to bring about this change?

MAIA SZALAVITZ: Advocate for evidence-based treatment and policy change that recognizes that addiction problems cannot be solved by the criminal justice system and treat people with addiction with compassion.

This concludes our Q&A with Maia Szalavitz. I want to thank Ms. Szalavitz for sharing her insights with our readers, and for weighing in on topics that are important for parents and other caregivers.

Are you a parent or caregiver of a teen or young adult struggling with a substance abuse problem? Please visit the online community at The Partnership at Drugfree.org’s Time To Get Help.

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com . Find her on Twitter at @maiasz. She is co-author of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010), The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

Opioids (heroin and prescription pain relievers) are powerful drugs that act on specific receptors in the brain that are important in regulating pain. While prescription opioids can be highly beneficial if used as prescribed, as a class of drug, they have a high potential for abuse. In fact, the National Institute on Drug Abuse estimated that 1.9 million people in the U.S. were addicted to prescription opioid pain relievers in 2010 and 359,000 were addicted to heroin.

Medication-assisted treatment for opiate dependence generally refers to the use of the medications buprenorphine, methadone or naltrexone to treat opiate dependence, in combination with counseling and recovery support services.  

In this, Part 3 of a 4-part series of my Q&A with award winning journalist Maia Szalavitz, Ms. Szalavitz shares her views on the dominance and effectiveness of traditional AA/12 Step based rehab programs, as well as the changes she has seen in the addiction field with a special emphasis on medication-assisted treatment for those struggling with opioid dependency.

JERRY OTERO: What’s been the biggest change in the addictions and treatment field since your book, Recovery Options  publication in 2000? What are the implications for teenagers?

MAIA SZALAVITZ: The biggest change is the widespread use of buprenorphine for opioid addiction treatment and the acceptance of the need for maintenance medication in some cases by abstinence-focused providers like Hazelden.  There has also been a decline in harsh and confrontational treatment, but unfortunately, some is still out there.

I wish there had been more changes though:  it’s still hard to get care that doesn’t present the idea that the 12-steps are the best way and that really meets people’s needs.

Teen treatment is unfortunately still very problematic, particularly in programs that sell themselves as “troubled teen� programs, i.e., emotional growth boarding schools, boot camps, therapeutic boarding schools, behavior modification programs and wilderness programs.  None of these have any controlled evidence supporting their effectiveness for addictions or other teen drug problems and yet lots of teens with drug problems are sent to them.  These programs tend to use tough, harsh tactics that are known to be harmful.

JERRY OTERO: What are your thoughts on medicated-assisted treatment (such as methadone, suboxone, vivitrol) for patients with opioid addictions? What are things parents should know about this treatment for their older teens/young adults?

MAIA SZALAVITZ: For opioid addiction, medication-assisted treatment is the safest and best option, the one most likely to preserve life and health.  It’s trickiest to determine when it should be used with young people:  obviously, it’s preferable not to have to be on lifelong maintenance of anything, whether blood pressure medication or buprenorphine.  So, young people should be aiming for abstinence at first, but maintenance should not be ruled out or seen as failure and parents should not pressure kids who are doing well on maintenance to come off, simply because they feel that drug-free is better.

Stay tuned next week for Part lV of our Q&A “How Can We Makes Things Better?�

To learn more about prescription medicine abuse, please visit The Partnership at Drugfree.org’s The Medicine Abuse Project.

And look for The Partnership at Drugfree.org’s free Medication-Assisted Treatment e-book coming out next month.

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com. Find her on Twitter at @maiasz. She is co-author of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010), The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

Recognizing that your child needs substance abuse treatment can be emotional and overwhelming; and you may feel that your child’s addiction has taken over your family’s life. Here, we present Part 2 of a 4-part series of my Q & A with award-winning journalist, Maia Szalvitz. Today, Ms. Szalavitz shares some advice on how parents can find the right addiction treatment for their teens and young adults — and what they should avoid.

JERRY OTERO: What do parents need to know about the differences between girls and boys when dealing with substance abuse issues?

MAIA SZALAVITZ: Mainly that everyone has individual needs and some of them relate to gender, like the fact that girls may be more likely to be depressed or that they may feel uncomfortable discussing issues of sexuality in mixed gender groups.  Mostly, it’s critical for everyone to be thoroughly evaluated before treatment is sought so that an independent assessment of these needs can be done by someone who doesn’t have a particular treatment in mind.  Note:  independent assessment should be done by a psychiatrist or psychologist, not an educational consultant who refers people to residential care.

JERRY OTERO: What should parents be cautious of when looking for the right treatment for their child? What about programs that “whip kids into shape?” And, is there a difference between boot camps and wilderness programs?

MAIA SZALAVITZ: Any treatment that wants to cut off or control communication between parent and child (outside of obvious abusive parents) for longer than a week or two should be viewed with extreme skepticism.  There is no therapeutic reason for this: love and support from family help treatment, they do not hinder it.

Any program that tells parents to expect bizarre complaints or reports of abuse and ignore them should be avoided.  A program that goes on about children being manipulative liars is not safe because health complaints will be ignored and this can and has been deadly.

Programs that require 12-step work for teens— admissions of addiction and powerlessness— are not the best; programs which suggest and support them are fine.

Programs that use physical punishment or restraint or isolation should be avoided; you can’t whip someone with heart disease into a cure, nor can you do this with addiction.

Wilderness programs are different from boot camps in that the harsh treatment takes place in the woods or wilds rather than in a more military style but both have had serious abuses and there is no evidence supporting the idea that they are better than safer alternatives.  If a child likes the woods, a voluntary Outward Bound program may be healing, but forcing someone into camping and hiking isn’t addiction treatment.  If a child goes to a wilderness camp for normal teens, he also will be believed when he has a health complaint — but in “troubled teen� programs the complaints are dismissed so callously that it has lead to dozens of deaths.  They’re also either unregulated or not well regulated.

JERRY OTERO: Thank you so much, for your insights, Maia.

Readers, for more information about adolescent and young-adult alcohol and other drug abuse treatment and how to find the most appropriate care for your child and family, download The Partnership at Drugfree.org’s Treatment e-book. This e-book will provide helpful and realistic information and advice to aid you in steering your child — and your family — toward recovery. Here, you will learn what alcohol and drug abuse treatment is, how to find the right type of treatment for your child, how to pay for treatment and the importance of taking care of yourself and your family.

Stay tuned next week for Part III of our Q&A“Changes in the Field, including Medication-Assisted Treatement�

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com . Find her on Twitter at @maiasz. She is co-author of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010), The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

Maia Szalavitz is an award-winning journalist who covers the addiction field, health, science and public policy. She is co-author (with leading child trauma expert Bruce D. Perry, MD, PhD) of Born for Love: Why Empathy is Essential — and Endangered, (Morrow, 2010) and the author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006).

I recently had the opportunity to speak with Ms. Szalavitz about her work. Following is the first in a four-part series. Here, Ms. Szalavitz shares her insights into how parents can better deal with their teens’ and young adults’ drug and alcohol abuse problems.

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JERRY OTERO: In your latest book, Born for Love: Why Empathy Is Essential — and Endangered ,you explore empathy’s startling importance in human evolution and its significance for our children and our society. Why is empathy essential, and how can parents help to instill it in their children? Are there any lessons here to learn for parents who are struggling to make sense of their teenagers and young adult children’s drug abuse issues?

MAIA SZALAVITZ: Empathy is critical for having a happy, healthy life because it affects all of our relationships and our health — physical and mental — to an enormous degree is determined by our ability to form strong bonds with others.  The best way to teach empathy is to behave kindly:  as one expert put it, empathy can’t be taught, but it can be caught.  However, kids need to learn to understand their own feelings well before they can understand those of others:  good ways of helping them learn this are reading to them and asking them explicit questions about their own and other people’s thoughts and feelings in various situations.

Empathy is also important for preventing and treating drug problems.  In terms of prevention, schools with warm atmospheres where kids feel part of a community have less drug use and less bullying, for one.

Also, part of the reason I got interested in the subject was that I saw how unkind so many counselors and treatment programs were to people with addictions.  And there are all kinds of people out there advocating that being cruel is the only way to help.  The data just doesn’t support that — empathetic treatment is the most effective.  And harsh treatment drives people away from seeking help.

JERRY OTERO:  “Kind Love� vs. “Tough Love�, what’s a parent to do about a teenager’s or young adult’s substance use?

MAIA SZALAVITZ: There is no evidence that “tough love� does anything useful.  Of course, you shouldn’t buy drugs for your children or do things that will help them use easily and if they are a danger to you or your other children, you may have to have them live elsewhere — but don’t put a child on the street with the aim of helping him stop using.  It might do that — but it also might make a temporary problem into a permanent one by entrenching the street lifestyle and putting the child at greater risk for overdose, suicide and disease.  If you need to cut a child out of your life, in other words, do it to protect yourself or others, not to help them.  There’s no evidence that it does help and all of the evidence on treatment and intervention shows that kind, supportive, gradual approaches are more effective than abrupt, harsh, confrontational ones.

This goes back to empathy:  if you want to help your child quit, you need to understand why they use and help them find other ways of getting those needs met.  If the child believes you are on their side and will not place them in an awful place they can’t escape and want them to feel good, not control them, you will be much more successful in motivating change.  It’s a lot easier for a kid to say yes to treatment if he knows his parents will back him up if it’s not right for him; a trial of antidepressants is much more easily done if the teen sees this as a way for her to feel better, not a way for her to be made compliant.

Check back next week for Part 2 of our Q&A, “Finding Treatment for Your Teen.�

Maia Szalavitz is a health writer at TIME.com and writes about addiction-related issues for The Fix.com . Find her on Twitter at @maiasz.  In addition to the books mentioned above, Ms. Szalavitz previously co-authored The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook: What Traumatized Children Can Teach Us About Loss, Love and Healing (Basic, 2007), and Recovery Options: The Complete Guide: How You and Your Loved Ones Can Understand and Treat Alcohol and Other Drug Problems (John S. Wiley, 2000).