So, you’re thinking of placing your kid in rehab? Or, maybe you’re thinking of getting a job in such a place, as a counselor, social worker, therapist, or whatever they’re being called these days. Do you know what it’s like being in rehab, or working in one? Have you visited a drug treatment facility, or heard stories from your neighbor who sent their kid to an out-of-state boarding school the previous summer, and later discharged just in time to begin senior year in high school. Are boarding schools the same thing as rehab? You wonder. A doctor outlines options: suggests therapy for a troubled teen, or an assessment at a nearby hospital, which boasts detox facilities and an intensive outpatient program, committing kids and their families to eight weeks of group and family therapy, ten hours a week, not counting the 12-step meetings that counselors will ask participants to attend on the weekends. A residential admission is the next level of care. It is the last resort as far as professional intervention is concerned—the last stop on the treatment ladder.
Do you want this? Need this? Does a kid getting referred to rehab even have a choice: Meaning, is a court presenting rehab as an alternative to incarceration? Or are the parents the mandating authority? Perhaps your kid’s best friend has called you up, or texted you anonymously, warning that he or she is drinking or smoking much more than you realize, or “experimenting” with some other, supposedly more hardcore drug—one that will really scare you. You notice the kid’s grades are going down, and that more time is being spent with sedentary, seemingly anti-social activities: marathon spells of video-gaming; the vague notion of “hanging out”. What happened to that kid that seemed vibrant a year or so before: polite, energetic, and gregarious. Is this normal adolescence? You worry. How long do you wait to see what happens?
Maybe this isn’t your story. Maybe you’re a parent who has struggled with your own substance use. Maybe you’re an addict, and it seems like your kid is following suit. You don’t know what to do, or even if, given your own history, you have the aptitude or even the right to speak your concerns. After all, did you listen to adults when you were a teen? So, your kid is staying out all hours, has joined a gang, become a dealer as well as a user. Involvement in the juvenile justice system seems imminent, if it hasn’t happened already. You’ve already had several phone calls from Child Protective Services; one or two home visits. You and a couple of county social workers are on a first name basis.
Maybe you’re a fledgling member of the mental health profession, and working with troubled kids seems like a good idea: a stepping stone to a career as a social worker, a teacher, or, if you’re really stupid, a psychotherapist. You’re a tweenie that’s looking for a job while in school. Or you’re a journeyman counselor that’s just completed requirements for certification as a drug and alcohol abuse counselor. An adolescent drug treatment program, attached, say, to a larger hospital, will offer steady employment, some modest benefits, if not a particularly competitive wage. You’re okay with that, maybe…for the time being. You want to reach young minds, work with those who may be more flexible in their ways, feel more hope than the adult addicts you’ve known. It will be less depressing, you think, working with kids.
Now that you’ve read the brochures and the websites of various programs, or taken tours of their sterile, hospital corridors and dorm-like accommodations, settle in for a first hand look at what happens in adolescent drug rehab programs, from the ground up, because that’s where I started. To do this properly, I have to go back in time to give some history, some context for what is happening today, especially in residential programs, for while some things have changed, others have not. Along the way, there are markers of change, nodal moments in my working life that in my opinion reflect trends in the business as a whole. If by the end of this text, the reader still wants to enter this field, or admit his or her child to a rehab like the ones I worked at, I’ll have no complaints. Just consider this the longest informed consent form in rehab history.