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White Pages – Teen Relapse Following Residential Drug Treatment

Despite the increasing number of adolescent treatment facilities in the United States and significant strides of the mental health care field as a whole, the proportion of adolescents who suffer relapse following residential treatment is alarmingly high.  In 2011, the United States Department of Education conducted a Recovery and Relapse study that reported that about 144,000 adolescents receive treatment for substance abuse every year.  Of those studied in 2011, 85% relapsed, reporting at least some substance use only a year after treatment.  This is not only very concerning because of the stress these adolescents continue to experience during this time of relapse, but furthermore, because of the considerable risk of negative health effects, due to the increased time of their substance use.


This perilous timeline of substance use is most pertinent in adolescents, as the research continues to show that the early initiation of substances is associated with negative effects and/or disruption of proper brain development and functioning, as well as health and behavioral health problems.  Even relatively small amounts of substances that may have little to no negative health effects on adults can cause substantial difficulties in teenagers, due to the fact that their bodies and minds are still developing.  Some of these effects to teens’ brain development and physical health are irreversible, making successful and lasting recovery of adolescents of even more importance.  Such dire relapse statistics speak to the urgency of treatment centers and facilities re-evaluating their diagnosis and treatment processes, in effort to provide adolescents with the most thorough, extensive, and lasting treatment possible.


One of the most obvious considerations that need to be made with regard to thorough diagnosis practices is that of co-occurring disorders.  All of the research continues to show that co-occurring mental health disorders are common among adolescents with substance abuse issues and the vice versa is true as well.  In 2001, 43% of adolescents receiving mental health services were diagnosed with a co-occurring mental health disorder.  With these numbers, taking special care to test for co-occurring disorders should be an automatic practice of treatment centers and therapy teams.  Yet unfortunately, as common as this co-occurring disorders are, they continue to slip between the cracks, going undiagnosed or missed in too many situations, resulting in teens being mis-treated and/or under treated, thus making teens vulnerable to relapse and future struggles.


One of the reasons for co-occurring symptoms going undiagnosed might very well be the tendency of adolescent treatment centers to serve either substance abuse disorders or mental health disorders, but not both.  This narrow focus, in and of itself, leaves a gaping hole for co-occurring disorders to go missed, as even in cases where they might be identified, the treatment centers are not prepared and/or willing to provide treatment accordingly.  This sets the teen up to lose before they even begin.  If a teenage girl is struggling with alcohol abuse and Depression, and gets treatment for and perhaps even temporarily recovers for drinking, she will then have to return home and face the symptoms and struggles of her untreated Depression, which might very likely trigger her to return to drinking.  This difficult cause-and-effect relationship, between substance abuse and mental health disorders, is proven to go both ways, with either the substance abuse or the mental health disorder being diagnosed first.  Therefore, parents and their teens might make an uninformed decision to get treatment for one of the disorders, without knowing there is another significant issue at hand.  It is frustrating and saddening to think that at this crucial, opportune time, when teens and parents have turned to a therapist or treatment center for help, that the proper and thorough diagnosis does not happen.  Proper diagnosis and treatment for co-occurring disorders is an integral element of successful and lasting treatment for adolescents.


Another prominent deficiency that’s so common among residential treatment centers is the lack of focus to provide treatment that is specifically designed for and around adolescents.  Many treatment centers serve both adults and adolescents, while others simply take techniques and approaches designed for adults, and then apply them to adolescents.  While some of the practices and approaches of therapy of course may be applicable and poignant to adults and adolescents alike, it is a missed opportunity not to implement the abundance of growing knowledge, research, and progress we’ve made in the mental health arena, specifically related to adolescents.  We continue to gain more information and findings regarding their experience, their mental and physical development, and their process that is uniquely different from that of adults, so why is such specificity not being implemented?  Adolescent treatment should be as precisely designed as possible, according to the unique experience and needs of adolescents.


When evaluating the high percentage of adolescents who relapse following residential treatment, it’s clear that there’s a disconnect between what the adolescents experience in treatment and the applicable skills they have, upon returning home.  In order, then, to help teens succeed not just inside the treatment center, but in the real world, treatment must be designed and implemented to be as thorough and far-reaching as possible, addressing all different fundamental aspects of teens’ lives.  If, while adolescents are in treatment, they can be provided with the skills and knowledge necessary to support themselves when faced with the struggles and conflicts in their lives, then they are much less vulnerable to previous triggers and using, and more likely to succeed and continue in their recovery.


It’s with these core issues as well as a number of other careful considerations that Paradigm Malibu’s treatment approaches, practices, and team have been created.  We have always been, and always will be dedicated to the fundamental principles of providing the highest quality adolescent treatment in a small setting, implementing a combination of the most traditional and creative approaches available, within treatment plans that are all individually designed.  Paradigm was founded and is operated and run by people who have dedicated themselves exclusively to the work with adolescents and are professionals in their fields.  We are dedicated to not only treating adolescents for mental health and substance abuse disorders, but doing so by the most specific and precise means possible.  This means using the most thorough assessing and diagnostic practices available, and then creating treatment plans designed and tailored specifically for each adolescent.


Paradigm’s Assessment and Diagnostic Practices:


In order to ensure that all of our adolescents at Paradigm are provided the fullest, most thorough treatment, addressing all present symptoms and conditions, we implement a multi-step evaluation process that begins before the teens even arrive to our campus.  This pre-assessment includes a Psychiatric Evaluation, Psychological Assessment, Medical Evaluation, Educational and Nutritional Assessment.  This allows the teens’ treatment team to begin designing a treatment plan before they even arrive, making the absolute most of time at Paradigm.  Then, once the teens arrive, they take part in the second phase of the assessment process, our comprehensive diagnostic testing, which incorporates special measures to test for co-occurring disorders.  This occurs within the first 48 hours of treatment, upon teens arriving at Paradigm.  It’s our belief that it is impossible to create a meaningful, individualized treatment plan without first conducting such assessments. Furthermore, when teens have committed themselves to residential treatment, time is of the essence, and we find that the more intensive, thorough, and efficient treatment is, the more able teens are to engage, from day one, and the more successful the results are. The goal of effective treatment should be to get the relief, support, and life skills you need, and then return to life as quickly as possible. Thirty days is widely considered to be the norm for an adolescent’s residential treatment stay and yet, unfortunately, there are some providers who will ask that families commit to longer stays before doing thorough diagnostic testing, while there are others who will require that commitment before even meeting the adolescent.  Quite often, programs requiring a minimum stay of 45 days, or longer, are not intensive in nature, but rather, afford time to things like excessive chores, community meetings, and other busy work, while implementing treatment sessions only a few times a week.  Such an approach has been proven to provide poor long-term results.


The Paradigm Way of Treatment:


If the Paradigm Treatment approach was to be narrowed down to a single attribute, it would be that we design each treatment plan according to the individual teen’s symptoms, needs, experience, strengths, and interests.  We do not have a single Depression Treatment Plan or an Alcohol Abuse Plan that we apply to all teens struggling with these issues, and in fact, shy away from any repetitive practices that mimic a one-size-fits-all approach.  Because of our commitment to operating a small treatment facility, we have the advantage of taking the time to work individually and very precisely with every adolescent we see.  Our goal, then, is to see what works with each individual and do more of it, building on each teen’s strengths and interests, as opposed to their weaknesses and struggles.  The only way we feel this level of precise, individualized treatment can take place is for each teen to have individual therapy sessions every day they’re in treatment, in combination with other treatment modalities, such as group and family sessions.


Because of our commitment to creating individualized treatment plans, we’re careful not to subscribe exclusively to a single process or approach, while assuming it will work for every adolescent we encounter.  Though the benefits and successes of the two most popular programs, the 12-step Program and the Medical Model, are obvious and numerous indeed, a careful examination also reveals that they don’t work for everyone.  This is why we implement a combination of both of these programs as well as others, in an effort to more precise treatment.  As a result, we use evidence-based treatments that couple the best of traditional and alternative modalities. We believe that this enriches the experience for all, and furthermore, is essential to effectively meet the diverse and complex needs of teens.


Our extensive range of modalities include, but are not limited to: Psychiatric Evaluations, Psychological Assessments, Nutritional Evaluations, Educational Evaluations, Medical Evaluations, Neurotransmitter Testing, Urinalysis, Individual Therapy, Group Therapy, Family Therapy, Multi-Family Therapy, Psycho-Education Groups, Narrative Therapy, Recreational Therapy, Bio Feedback, Yoga, Detoxification Massage, Somatic Therapy, Acupuncture, Parent Effectiveness Training, Equine Therapy, Psycho-Educational Groups, Gender Specific Groups, Animal Assisted Therapy, and Accelerated Learning Services. We also well known for our comprehensive array of Expressive Arts Therapies including; Art Therapy, Drama Therapy, Dance/Movement Therapy, Poetry/Written Therapies and Music Therapy.


Another fundamental aspect of Paradigm treatment is that we are committed solely to the treatment of adolescents.  Adolescent treatment is a highly specialized practice and as such, we have devoted ourselves exclusively to serving this complex, dynamic population. We do not provide treatment for adults, or anyone over the age of eighteen.  Developmentally, there are stark differences between these groups and a mixing of these populations can result not only in many undue complications, but furthermore, less specialized care. Similarly, all members of our staff and team are specifically trained and experienced with adolescents, having dedicated their careers to this work.


The result of designing individual treatment plans, based on thorough assessment and diagnostic processes, and by drawing from a range of different approaches and modalities, is a very holistic treatment, in the truest sense.  The reason the list of the programs and types of treatment we offer is so extensive is because the range of adolescents’ interests is so diverse, and we want to be able to provide them with a treatment plan that is as unique as they are.  We find that engaging teens positively throughout treatment, in an activity or other supportive context, is a powerful force in encouraging them and furthering them in their journey to recovery.  Our treatment programs are designed to support adolescents above and beyond their most acute and/or urgent needs of their mental health and substance abuse disorders, by addressing myriad aspects of their lives.  We find that this not only empowers teens to fight the symptoms and struggles of their disorders, but also supports them to maintain their recovery, as a result of having positively invested in so many aspects of their own lives, including physical, nutritional, social, and spiritual awareness.  And to assure that our teens have the necessary support they need following treatment, we offer free unlimited after care services, including therapy sessions, parent support, group sessions, and alumni meetings.


The result of Paradigm’s vision, approaches, treatment, and team is an adolescent treatment facility that has won numerous prestigious awards and honors, including Psychology Today’s Best in Treatment Award for 2014.  Our other rankings include, but are not limited to, Parent and School Counselor’s Organizations, Teen Advocacy Groups, and Treatment Professional and Consumer Organizations. It’s also very important to us that a key factor in our rankings is the satisfaction of our alumni families. Though awards and accolades are nice, it’s the testimony of families, and the successful recovery of adolescents, which we prize most highly, and furthermore, that we have dedicated ourselves to, so entirely.  This is the Paradigm Way.