Drug and Alcohol Abuse Counseling for

Children and Adolescents:

A Therapeutic Community Model

Gloria Aurora Champion

•Substance abuse should be considered a bio-psycho-social phenomenon

•Mental health, psychotherapy and counseling approaches are challenged by the difficulties inherent in the rehabilitation of substance abuse and substance dependencies.

•Children and adolescents constitute a very vulnerable part of our society.

•Drug use among these ages has been increasing.

•Erikson, E. has explained how adolescents go trough a critical moment of development characterized by an “Identity Crisis”.

•A family with a lack of organization and adequate structure founds inherent difficulties to promote a healthy body of psychological and social identifications.

•Adolescents have to take their identification sources from family models.

•In this process peer groups and gangs are a very powerful and attractive source of identifications, and many times through them they also found the first contact with drugs.

•The models of treatment for the individuals with the abuse and or dependency and his /her family should consider all aspects of this phenomenon.

•It is fundamental for the model of therapeutic community (TC) the inclusion and participation of the society with its different institutions, starting with the nuclear family, schools, youth and adult organizations and other important institutions related to mental health and counseling.

•The substance abuse experience should be considered as a “social phenomenon” instead of emphasizing the attention primarily to the “individual with the problem” in the first place and the “family with the problematic individual or as an agent of production of substance abuse problems” in the second place

•The model of TC emerges as an alternative in the treatment of mental health problems during the second half of the past century

•TC is an approach that understands the individual as part of different social groups, starting with the dyadic mother-baby within the family to social and institutional groups, and is to these groups to whom he/she owns the successful or unsuccessful obtained development.

•The concept of TC has implicit the understanding that “community” is a group of individuals in a particular system of relationships; this is a social therapeutic instrument for the participants

•Its very particular modality is a system that applies not just to the individuals that require the healing process or the treatment (clients or patients), but also for the individuals that form the groups that promote, organize and manage this system (professionals).

•To generate and maintain a social therapeutic environment is the main challenge of a TC.

•To reach this complex goal the interdisciplinary team must count with the necessary space for reflection, analysis and elaboration of the experience, actions with which the permanent healing of the group dynamic is promoted.

•Today TC exist in a very diverse variety or settings and are directed to different people’s needs, for example: severe emotional problems in children, adolescents or adults; substance abuse and dependency problems; special schools for children and adolescents; special units treatment in prisons to rehabilitate offenders; individuals with chronic mental illness.

•A TC pretends to offer a type of care that is based on establishing a supportive network of relationships.

•Their system of working is importantly based on some fundamental principles such as, democratic dialogue, social inclusion and establishing a safe environment

Each therapeutic community has its own needs and functions and its technical model is based in this needs. A typical model for a TC should be organized in different levels, for example:

1) Activities and programs to attend community needs,

2) Psychotherapeutic spaces,

3) Spaces for social and community development,

4) Integral physical health.

Under activities and programs that attend community needs a TC designed for the attention of children and adolescents with substance abuse issues, would need some of the next activities:

1. Team group for analysis and reflection about all kind of community issues; 2. Clinic reunions where goals and objectives for each one of the clients will be

revised and follow up; 3. Reunions for administrative planning; 4. Training in community model and other psychotherapeutic techniques.

Under psychotherapeutic spaces it is important to place:

• The psycho and physical diagnostic processes;

• Individual, group and family counseling interventions;

• Activities for social development like psychodrama or music therapy.

Under spaces for social and community development would be included the activities pertaining to living in the house or half day assistance, as well as the organization of other activities like sports, recreational and art activities, organization for cleaning and cooking, etc

Under integral physical health would be all needs of medical attention.

TC general philosophy specific for substance abuse problems is based in the principle of self-help.

Activities must be designed to help children and adolescents to rehabilitate from their substance abuse problems as well to learn how to behave in their own interests, as well as in the best interests of their families and their pairs.

•An effective TC for substance abuse must be designed considering the different phases of the process, starting with the induction or orientation where the individual will assimilate goals and learn rules, going through the stabilization of the rehabilitation and the final recovery with the reintegration to real life.

•During the first phase of the rehabilitation it is very important that the individual can establish positive bounds with peers and staff.

•Through the different therapeutic and community activities the client will be in contact with the need to stress his/her capacity for independent decision making, as well as the responsibility to self, family and the community

•A fundamental aspect of this context is the search and production of real opportunities through which the clients may assume an active participation in the government of the community, movement which is known as democratization.

•Al relationships must be consider as potentially therapeutic with the aim of actualized the beneficial effect of the relationships

•Traditional vertical relationships between professionals and clients must change to a more horizontal and democratic relationship

•TC in general emphasizes al methodologies that increase inter-individual and inter-group communication.

•It is possible to find some common characteristics in almost all TC even though they do not share the same ideology.

Among some of these characteristics are:

•Freedom to communicate at all levels of the institution.

•Analysis of individual and group dynamics.

•A clear tendency to destroy the traditional relationships of authority and to level the hierarchical pyramid.

•Possibility to participate in social structured and unstructured social activities in the community.

Children and adolescents that suffer from substance abuse problems

can gain a highly therapeutic benefit through a program like TC

that takes in consideration a holistic perspective of the difficulty,

from the environment to the individual and their mutual interactions.

http://laingsociety.org/http://www.fullspectrum.cc/http://www.therapeuticcommunities.org/http://pettrust.org.uk/index.php/Planned_Environment_Therapy_Trusthttp://www.pettarchiv.org.uk/biblio-tc1-20byvolume.htmhttp://www.nida.nih.gov/ResearchReports/Therapeutic/Therapeutic4.htmlhttp://www.transitionsgi.com/