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.”

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Nate Luongo, LCSW-C blogs about a recent weekend outdoor adventure…

Nate Luongo, LCSW-C blogs about a recent weekend outdoor adventure…

Posted by PotomacPathways, With 0 Comments, Category: Featured, News, Tags: , , , , , , ,

Outdoor experiences allow teens to unplug from the complex world that we live in and reconnect with nature. Once we are able to reconnect, we can take a step back and examine our lives in a different way. Taking our groups on outdoor adventure experiences allows our young people to return home with a different perspective on how to face challenges in their lives.

Preparation counts

Last month, the First Step group participated in a camping and outdoor adventure, co-hosted by Jason Drevenak, director of the North American Bushcraft School.  Jason, who recently starred in the Nat Geo Channel's Mygrations series, has been a long-time friend of Potomac Pathways, hosting our groups a couple of times a year over the past decade.

"What is Bushcraft? There are so many terms in use for what we mean by bushcraft.  Re-wilding is one of our favorites, but also survival, homesteading, and sustainable living.  We think of it as a journey towards a life of sustainability   We should know how to make and find food; we should be able to find water and shelter anywhere we go; we should be able to make the things we need even if we don’t always do it. These skills help us to understand the impact of our lives on others."- Jason Drevenak, Director of the North American Bushcraft School

During the week leading up to the camping trip the group discussed the importance of preparation in everyday life. Anxiety and stress are areas that some young people struggle with, and the group discussed how stress can decrease once they’re prepared for challenges that may arise in their lives. Our camping trip out to Jason’s proved to be a great metaphor for the need for planning and preparation. The group learned the importance of staying warm by packing the right gear and layering since the temperature dropped very low in the evening. Everyone packed accordingly and was prepared so that they could continue to be comfortable regardless of the weather. In addition, gathering around the campfire allowed the group members to open up more to one another, view and discuss their treatment goals in different ways, and allows the staff (i.e. therapists) the opportunity to intervene in real-time with our teenage and young adult clients.

Nature immersion

This trip helped the group build off of their successes in treatment by immersing ourselves in nature for two days. When we do these excursions, we are typically taking the group into a completely new environment that they have never experienced. This can sometimes be challenging for young people new to outdoor adventure.

With every outdoor adventure that we go on, we have a starting group session where everyone checks in on how they’re doing, address any issues that are concerning for them, and then each group member - including staff - set positive intentions for the experience. We set our intentions and then we practice becoming mindful of how we are doing accomplishing our intentions, individually, and collectively.

On the morning of our first full day, the group packed up our gear and carried it on a long day hike to the Devil’s Nose Mtn., near Hedgesville, WV..  We packed and brought most of our gear on the day hike as a way for our clients to practice preparedness. As a group, we recognized that we needed to be prepared in case one might need to be able to survive a night away from our campsite. Most hiking accidents happen to day hikers since they typically do not take the necessary precautions, such as letting others know where they’re going and when they expect to come back, packing enough water, and having extra food and first aid. At the top of Devil’s Nose, we held a group session.

Taking the lessons home

Jason taught our young people how to make fire by using both bow and hand drills. These activities may not seem applicable to everyday life, but have you ever seen the face of a young man when he’s able to make a fire with a stick? It’s pretty incredible. Having that sense of personal achievement opens up possibilities, including the possibility of becoming successful through one's own efforts, with the help and support of the adults in their life.

We learned how to make shelters in case of an emergency with heavy duty trash bags -- again, a skill that one does not really need living in the DC Metro area, but knowing how to survive and build your own shelter opens up a different world. Some of the group built and slept in a group shelter for the second evening. This experience helped participants work together to plan, problem solve, and execute the plan-- but this time, with a minimum of coaching by the staff.

Nathan Luongo, LCSW-C holds a Master's degree in Clinical Social Work from Columbia University in New York, NY and a Bachelor's degree in Social Work from Catholic University in Washington, DC. Prior to joining Potomac Pathways, he worked with at-risk families in Brooklyn, NY providing an array of evidenced-based interventions for adolescents and adults with substance use, PTSD, and mental health disorders. Nate has worked with a chronically mentally ill population in a number of community settings, addressing substance use and symptom management. After his playing career was cut short due to an injury, Nate served as an assistant football coach at Catholic University. Outside of work, Nate enjoys spending time with family, going to the beach, and playing sports.

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