The Mad Rush to Abstinence

The Mad Rush to Abstinence

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More often than not when a teenager or young adult walks into Potomac Pathways for the first time they are doing so at the requirement of outside forces.

From a ‘stages of change’ perspective they are usually somewhere between pre-contemplation and contemplation. They feel like they have lost control over their lives. I frequently hear that pressure from parents, friends, social media, academics and the general competitive nature of living in the Washington D.C. metro area have them feeling pulled in too many directions at the same time.  While healthy outlets like sports, community service, and exercise offer structure and help to manage stress, sometimes extracurricular activities end up adding even more pressure. The result is not always predictable, but we frequently see: emotional problems, anger, substance use, dishonesty, excessive screen-time, and other problematic behaviors. Parents also feel scared and like they’ve lost control.  Some parents describe feeling like correctional officers in their own homes, trying to monitor every minute of their child’s life. Frequently, the family system is over stressed and parents are desperate for change. This can create reactive cycles which only add the problems at home for both parents and young people. The more parents try to control, the more out of control things can feel.

This is what Dr. Robert Schwebel calls the “mad rush to abstinence” when treating substance abuse, and a concept that I believe generalizes well to many other problematic behaviors. This is where well-intended people rush action before the issue has even been identified.  Good parents and therapists make the mistake of focusing on boundaries or punishment/rewards too soon. The carrot and stick approach, while effective in shaping some behaviors, rarely addresses the underlying issues and lasting change. Contrived consequences don’t usually work.  In D.C., for example, I immediately think of speed cameras on our streets. Everyone slows down…for the camera. Speeding persists where the cameras do not.

There are some things I do differently when working with a young person at an outpatient level of care.  At my first meeting I usually find them cooperative but guarded; bright but unmotivated. Sometimes they look at me as if I’m some authority and they’re in trouble.  It’s uncommon that I see the behaviors that are most upsetting to their parents. I speak to all young people as intelligent beings worthy of respect. I intentionally create a non-judgmental environment where they feel safe and where they won’t feel punished for being honest.  By focusing on building rapport, acceptance and trust as a first step, I can begin to truly understand whatever their complex situation is. I wish I could get to full understanding in a first session, but building a trusting relationship takes some time. I recognize small successes in an outpatient setting, like the willingness to return for a second or third meeting or sincerely thanking them for their efforts if they show up 30 minutes late.  

My approach is invitational, empathetic and very different from a traditional 12-step or the sometimes confrontational approach used in some interventions.  An empathetic approach is one that I find young people early in a stage of change, are most likely to respond well to. By recognizing that they’re feeling out of control, stressed and uncomfortable on day one, I’m able to change their expectations and offer them help.  Step 1, build trust, rapport and safety. Step 2, understand the things that are causing them the most pain/pressure. Step 3, consider appropriate clinical interventions to help them navigate life’s challenges. Step 3 is the step that may lead them to treatment or to community support groups like Alcoholics Anonymous.  And I do encourage this. But the timing needs to be right. If we rush this process and rush change, parents, educators, therapists and other influential people in these young people’s lives end up diminishing their significance and ability to support change. The mad rush to abstinence might actually be harming - more than helping - these young people we all care so much about.


Chris Peckham, M.Ed, LCPC, NCC has a Master’s degree in Clinical Mental Health Counseling from Clemson University, and is a licensed clinical professional counselor in Maryland.  He began working in wilderness therapy in 2006 when he joined the Aspen Education Group and began working as an instructor with Four Circles, a program for young adults in the Ashville, NC area.  Most recently he provided family, group and individual therapy at a small therapeutic boarding school, the Cherokee Creek Boys' School.  He has thru-hiked (that means he hiked the entirety of) both the Appalachian Trail and the Pacific Crest Trail. When he's not at Potomac Pathways, Chris can often be found hiking with his wife, his two youngsters, and a couple of dogs. Chris says, “Outdoor experience has the power to heal and enrich lives.  With a little guidance, it can serve as a catalyst for change and the backdrop for extraordinary learning.  I came to Potomac Pathways because I enjoy being a part of that change.”