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Adolescent Residential Inpatient Program

Is the disease of addiction different from that of adults?

The central nature of the disease of addiction, the dysfunction of the mesolimbic reward system in the brain, is the same for adults as for adolescents. The speed of onset, however, can be dramatically different.

One scientist, Dr. Anna Childress of the University of Pennsylvania, describes a “stop,” “go” mechanism in the brain. The “go” system is the primal older part of the brain that responds to pleasure and pain – the mesolimbic reward system. The “stop” system is located in the frontal lobes of the brain and helps manage our impulses toward immediate rewards. The frontal lobes of adolescents, however, continue to develop into their twenties so that their initial reaction to alcohol/drugs, when pleasurable, is often not interrupted by the voice of reason. If the predisposition to addiction is present, the disease may then develop instantly. The disease and its physical, behavioral, and spiritual consequences are the same, but the onset is usually much more rapid than in an adult. Once addicted, however, adolescents should receive much the same treatment as adults.

Admission

Following assessment, a patient is admitted and welcomed to the community. If an adolescent needs medical detoxification, he/she can be treated for the medically necessary period at our Kirkland facility. The patient is assigned a “buddy,” a patient who is involved successfully in the program, to familiarize the new patient to the facility and the program. More than likely, the new patient will attend their first group within hours of admission.

The Nature of the Treatment Community

The strongest influences for adolescents, for better or worse, are the peers that dictate the behavior of the group. Most adolescents who are addicted and in need of treatment have adopted a group in which drugs and drug taking are the norm. Treatment begins with exposure to another peer group, a group of adolescents who believe there is a better way to act, think and believe. The milieu at the adolescent unit is designed to promote that better way and to help patients begin acting, feeling and thinking their way to sobriety.

A Highly Structured Routine

Drug addicted adolescents, like adults, lose all sense of self-discipline and structure in the grip of the disease. They become impulsive, dangerously risk-taking and resistant to any authority.
The staff of the adolescent unit understands both adolescents and the disease of addiction. Patients are asked to adopt a structured day of education, group counseling, recreation and exposure to 12-step programs. While there is often initial resistance to structure, patients gradually are attracted to the benefits attested to in daily groups – a letting go of shame and guilt, a new and different kind of energy to move forward, meaningful relationships built in trust and mutual sharing.

Involved Parents

Addiction splinters relationships. As drug taking becomes foremost in the addict’s thoughts or behavior, the adolescent usually becomes a stranger to parents. Parents often believe at some level that they must have done something wrong for their child to have become so isolated from them and other meaningful friends and family.

It is critical that parents understand the disease of addiction and its progression. For this reason we require at least one parent to attend family week. In addition, there are education sessions two times a week and a communication workshop on Saturday following visiting hours.

Academic Tutoring

A local school district provides tutoring for patients during their stay. The tutor oversees the adolescents continuing involvement in class work from their schools. The tutor will also coordinate with the adolescents schools to provide a smooth transition back into their grade level.

Staffing

From the physician who oversees the medical program to the maintenance and dining room staff, we are careful to choose employees who not only understand addiction but also like working with adolescents. The staff collectively knows when the patients need words of support and when they need to be reminded of their responsibilities in the community. Part of the treatment experience for adults and adolescents is a modeling process – watching and learning from recovering adults who have become well adjusted decision makers.

Continuing Care

Returning to daily life after treatment is precarious for any addict without a solid plan to stay in recovery. It is imperative for adolescents to have a structured routine that includes solid support for the new behaviors learned in treatment. We believe in the process of continuing care so strongly that we have twice weekly groups available for as long as medically necessary to adolescents who complete primary treatment. Meaningful involvement in a 12-step program provides another piece of an armament to protect against relapse.

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