Helping Youth Dealing with Substance Abuse while Preparing for Independent Living

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Helping Youth Dealing with Substance Abuse while
Preparing for Independent Living
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Whats our role with substance abusing youth
preparing for independent living?
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Substance Abuse Activity Overview

• Engaging youth moving toward mutual
  understanding regarding the perceived benefits
  youth experience by using drugs.
• Recognizing what contributes to and sustains
  substance abuse among foster care youth.
• Assessing and influencing change readiness for
  youth using alcohol and other drugs as they
  transition to independent living.
• Recognizing the dynamics of relapse and recovery
  for youth leaving care.

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Why do young people use drugs?
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Young people use drugs for the BENEFITS!!!
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BIO-PSYCHO-SOCIAL MODEL
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For your assigned area

• Describe 3 factors or conditions that would cause
  or contribute to substance abuse for youth in
  care preparing for independent living.
• Describe 3 ways that substance abuse impacts
  youth preparing for independent living.

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What would be some red flags or indicators of a
possible substance abuse problem in youth
preparing for independent living?
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Review COMMONLY ABUSED DRUGS CHART
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Substance abuse continuum

• Think about a youth whose substance abuse will be
  a barrier to successful independent living
  complete the SUBSTANCE ABUSE CONTINUUM SHEET.
• Place yourself on the continuum as if you were
  this youth.
• Place yourself on the continuum based on your
  assessment of the seriousness of this youths
  substance abuse .

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Whose problem is this anyway?

• How does this disparity in perception impact your
  relationship with this youth?
• Is the youth aware of the disparity in perception?

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Whose problem is this anyway?

• How can this information be used to achieve or
  increase mutual understanding with this youth
  regarding their substance abuse?

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• We can . . . .
• learn about and share with youth how they may
  use drugs to meet particular unmet needs.
• validate and understand mood states a youth is
  trying to achieve thru drugs numb, empowered,
  safe, etc..
• use understanding of benefits to join with and
  engage youth.

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We can . . . .

• use understanding of youths benefits from drugs
  to explore other methods for achieving the same
  benefits or mood state.
• build on youths strengths to increase emotional
  security and efficacy to explore alternatives to
  achieve benefits and desired mood states.
• explore impact of independent living, fears,
  aspirations, etc., on use of alcohol and other
  drugs.

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Ultimately it is up to the youth to decide
whether they have a problem with alcohol or other
drug use, and if they want to do something about
it.Our role is to influence the youths
perception of the concerns and benefits of
substance use as they move toward independent
living.
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Assessing and Influencing Change in High Risk
Youth Preparing for Independent Living

• Present Discomfort
• Emotional Security
• Efficacy
• Internalization of Responsibility
• Preferred Alternative Future

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Prochaskas Stages of Change

• Pre-contemplation no or vague awareness of
  problem with no intention of changing
• Contemplation aware of problem but need period
  of contemplation or thinking before they are
  willing to take action to change
• Preparation realization that the problems with
  using outweigh the benefits
• Action steps taken to change, such as treatment,
  AA, abstinence or cutting back
• Maintenance comfort with the change but must
  persist in sustaining the change possible relapse

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Key interview steps FRAMES

• F Feedback
• R Responsibility
• A Advise
• M Menu
• E Empathy
• S Self-Efficacy

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CASE EXAMPLE SKIT

• CASSIE

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How did the worker

• engage Cassie, establish safety and rapport using
  a strengths based, youth development
  approach?
• achieve mutual understanding regarding Cassies
  substance use?
• assess where Cassie was regarding each element of
  change? What was learned?
• assess where Cassie was regarding the stages of
  change? Where was she?
• use FRAMES of Motivational Interview?

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SUBSTANCE ABUSE TREATMENT A CONTINUUM OF CARE

• Mutual identification understanding regarding
  the seriousness of the problem
• 2. Learning about and selecting the best
  treatment facilitating entry into treatment as
  effective co-consumers and co-advocates of
  effective substance abuse services
• 3. Treatment to initiate the recovery process
• 4. Acknowledgement of issues and collaboration
  with other providers (MH, sexuality issues, PTSD,
  etc.)

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Successful treatment is rarely a single
intervention.

• Treatment must be seen as a continuum of care
  that seeks to initiate recovery by establishing a
  period of abstinence, sustained recovery and
  relapse prevention.

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Recovery is a process of moving to a higher level
of biological, social emotional functioning

• Recovery is process as opposed to an event.
• Unresolved depression and anxiety may be triggers
  for relapse if not attended to.
• Tightrope balance need to deal with them enough
  to maintain recovery process
• This is a high risk process so be vigilant .
• Be in close contact w/sub ab program to know what
  youth needs to deal with back at agency.

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Relapse and Recovery

• Relapse recovery issues are critical throughout
  foster care but especially during transition to
  independent living.
• Ensure that youths independent living community
  is not drug oriented.

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Relapse and Recovery

• Help youth create (new) social networks that
  support a drug free lifestyle.
• Aftercare must include tailored, collaborative
  case management services.
• Total abstinence may be unrealistic.
• Reduce triggers associated with use.

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Triggers can be anything from friends and a
video, to music and clothes, to something as
subtle as certain smells, or sitting in a
favorite chair.
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What would be some triggers associated with
substance use before and after youth leave foster
care and are living on their own?

• How can we help youth avoid these triggers?

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Substance Abuse Role Play

• Work in teams of 2.
• Complete the worksheet that describes a youth you
  are working with whose substance abuse is a
  barrier to successful transition to independent
  living.
• Exchange worksheets with your partner. You will
  play the worker for your youth your partner
  will use the worksheet to play the youth.
• Engage utilize the FRAMES approach to plan
  implement your role play influence youths
  change readiness.

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Summary

• Youth must be engaged in a process that moves
  toward mutual understanding regarding perceived
  benefits and consequences of substance abuse.
• Staff can explore with youth what biological,
  psychological social factors influence impact
  the youths use of substances.
• Staff can assess influence the youths
  readiness for change with regard to use of
  substances.
• Staff can use motivational interviewing to help
  youth explore their abuse of substances as they
  transition to independent living.
• Treatment is a continuum from engagement mutual
  understanding thru to relapse recovery .