The Real Common Treatable Podcast

How To Talk To Your Spouse Or Family About Your Teen or Young Adult's Substance Use

June 30, 2021 Clint Mally with Sandstone Care
The Real Common Treatable Podcast
How To Talk To Your Spouse Or Family About Your Teen or Young Adult's Substance Use
Show Notes Transcript

This episode explains how to talk to a spouse or family about your child's substance use or substance abuse. 

Here are just some of the questions we'll cover:

  1. How do you talk to your spouse about your child's treatment?
  2. What's the most effective type of therapy for substance use and mental health?
  3. How will you know if a treatment is effective?

If you'd like some support call (855) 958-5511 or live chat with us at Sandstonecare.com

When we look internally into our family dynamic and our family system, we have to make sure that everybody is looking for the same things and that everybody is on the same page. Because a lot of times when we talk about what we're seeing, when we operate in a silo or independently, we're oftentimes missing context. Welcome to the sandstone care podcast where we help teens, young adults and their families overcome the challenges that come with substance use addiction and mental health conditions. Welcome to episode number two of the sandstone care podcast with me, Clint Mally, I'm joined again, with Sara Fletcher, she is sandstones. Chief clinical officer. Anytime you have the word Chief, and officer in your name, it sounds super important. And sometimes that's not well deserved. But in her case, it's very well deserved. If you missed our first episode on how to talk to your child about their substance use, then you need to go back and check it out. It was gold, beautiful, beautiful stuff. But today, we're tackling a different issue. First, Sarah, welcome to the podcast. Hi, thank you for having me back. I appreciate it. Yeah, so you are super knowledgeable. And I love how when you explain things, you explain it in a way that anybody can understand it. And the people who are going through stuff can get a very simple and direct answer. So I know that everybody who's tuning in today, especially if they got a lot of value out of that first episode, they're definitely going to get a lot of value today, too. Because today we're talking about how do you talk to your spouse, right? How do you talk to your spouse about your child's substance use? Oftentimes, in the household, you'll see that people don't necessarily agree on the same issue, or look at the same issue the same way. And you know, what, if you think that something's a problem, but your spouse doesn't, right, or the other way around. So today, we're going to kind of talk about all those nuances. And we're going to hear from an expert opinion, so that we have some practical go to steps that we can take to be able to make sure that our child is our young adult, our team is getting the support that they need. Yeah, I think when it comes to family involvement, and looking at the fear surrounding the the potential of development of a substance use disorder, we really want to focus on education, and communication. And then we also want to make sure that we're communicating internally as a family system. And so what we talked about in our first episode is really looking for those signs and symptoms of a substance use disorder. And so when we look internally into our family dynamic and our family system, we have to make sure that everybody is looking for the same things, and that everybody is on the same page. Because a lot of times when we talk about what we're seeing, when we operate in a silo or independently, we're oftentimes missing context. And so we're missing really important experiences that our spouse or other family members have noticed, but haven't really spoken up about. So my recommendation is always to internally communicate, and make sure that everybody is on the same page about what we're looking for. Okay, so I want to put us in the situation like, I'm a mom, and I think that my child has a substance use disorder. But every time I bring it up to my husband, or vice versa, right, either way, they shut it off. And they're like, it's actually not that big of a deal, or it's not what you think it is. What do you tell parents when they're kind of in this tricky dynamic where one person thinks there's a problem, and the other person doesn't? Yeah, I think when it comes to the disagreement internally, between your spouse, your partner, or your loved one about what you're experiencing, versus what that partner is experiencing, we're not in a place where we can even address the adolescence behavior yet. The number one thing that I recommend for couples and families is that they need to be a united front and they need to be on the same page before they move forward. And so communication, I know that I go back and forth, over and over again, about communication and how important it is. But it really is the staple of being able to address what's happening within a family dynamic. So for me, if there is a spouse or loved one who's expressing concern about their child adolescence behavior, and their partner isn't on the same page. They need to see Support first, whether that's through therapy, it's just through internal communication and checking in with each other, to make sure that they understand where the other person's coming from before they move forward. Because the first thing that is not going to work is if everybody's not on the same page and a united front, then we're already setting ourselves up for splitting behavior for our long term arguments down the line, and really creating disconnect with that child. So it's absolutely fine in my mind to have a difference of opinion. We're supposed to disagree, we're supposed to challenge each other, because that's the only way that oftentimes we come to a better solution. However, when we aren't on the same page, it's super important that we listen to each other and we feel heard, and then in my mind, develop a plan to get to a good place. Yeah, so if a parent, if two parents don't agree, they have to be on the same page is what I hear you saying. And I would just, I think, if you went into a situation with a child, and there was obvious contention between a mom and a dad or mom and a mom, or dad and dad, whatever, right? If there's obvious contention between the parents and the child, then the child might feel like, I'm causing my parents to fight. Like, I'm the source of my parents strife, or whatever problems we're having. And so it seems like that might compound the problem that you started with, which is about substance use. Now, it's not just is it wrong, that my kid is using substances? It's like, also, am I causing a marriage relationship problem between my parents, right? Yeah. And not only can that cause and bring on those feelings of guilt and shame around, gosh, now I'm causing issues between my parents, it also gives opportunity to, hey, this is something that I could probably get away with, or this is something that I can use to my advantage from a strategic standpoint, because adolescents are very clever, and they're very crafty. It's what makes them fascinating. It's an incredible stage of life that we all go through. And so adolescents and young adults will pick up on that tension, even if it's the very smallest level. And so that is why it is so incredibly important to make sure that both partners are on the same page before they move forward with any sort of intervention. Because I've had families come who are in disagreement. And my first recommendation is you guys got to get on the same page. We don't have to move forward with treatment. But if we're going to, we need everybody aligned. Otherwise, the chances of this being successful are really low, and then we're wasting everybody's time. You know, this reminds me of a story when I was in, I'm going to say, sixth grade. And there was a, I had friends and another teachers class, right, that I wanted to go hang out with during dismissal. So when parents are coming to pick up their kids, or you're waiting for your bus to be called, and, and I wanted to go and hang out in this class, also, I was kind of a problem child. So like, it's a hard sell. You know, it's one thing if you're like a goody, goody teach tissues, is a tissues or tissues, it's tissues, right, goody, goody tissues. To shoes. If you've got two shoes, and you're a goody, goody, let's just say that, that that wasn't me is what I'm trying to get across. And the point is, so I had a tactic because the teachers were separated in different classrooms. What I did is I went over to, I would go to my teacher, and I would say, Hey, I would like to go into this other teacher's classroom. Is that okay? And what what do you think they would always ask? Is it okay with the other teacher? And I saw, I said, let me go ask. And so I would go to the other teacher, and I would say, Miss, sell and sell asked me to ask you if it's okay, if I come in there, right. And what I was doing was playing off of the barrier between them, because it wasn't like the teacher was asking for herself. She wanted me to ask for myself, right? But because there was this barrier, or this wall between the two. The teacher didn't want to like refuse a colleague right. And so they would allow me to stay in the room. My point is that when we have this barrier between between parents, it's easy to be able to exploit the system. If there's not clear communication, if they're not on the same page, then it's easy to find a loophole to kind of explain if that makes sense. Does that doesn't relate. So what's the most effective type of therapy to be able to address a child, a teen, a young adult with a substance use disorder, or who's using substances and you think they might be addicted? You know, the best treatment modality for substance use disorders in particular is something called cognitive behavioral therapies, or CBT. And what that entails is really talking and creating a skill set around understanding a precipitating event. So what led up to this behavior, identifying the behavior, which most of the time is using substances, creating dishonesty within the home? And then the consequence of that behavior? And so what is the outcome? And when we create that chain of events, it also loops in that education piece of Okay, so if we choose a different behavior, what is the different outcome that can come from that. And from there, it stems off to create a toolbox of coping skills to be able to guide your mind and your behaviors into an i deal consequence or something that is more pleasurable. So for example, if the precipitating event is that I snuck out of the house, so I could spend time with my friends, even though I didn't have approval. The behavior of that is that now I'm with my friends, and maybe I'm using marijuana, or maybe I'm hanging out after dark or after curfew. And the consequence of that is that I've grounded now for two weeks, because I wasn't following the rules, and I engage in a behavior that was from this precipitating event. And so what we look at is, okay, so what, what was the precipitating event, what brought this on? Was it that I got into an argument with my parents was it that I was feeling really lonely. And so we really look at the emotions that come along with that. And then we look at the behavior as a whole and what we got out of it. So what was the positive outcome from this, and then we look at the consequences. And hey, if that consequence wasn't super desirable, let's find a way that we can adjust to make the consequences, a more desirable one. And that works. And it's statistically proven to work well with the early addicted mind. Because we're able to create new neural pathways in our mind in our brain every day, we're able to create new habits, and create new ways to function and cope with what we're struggling with. And it's also a very black and white mentality, it's very easy to understand, it's very easy to pinpoint. And it allows us to really create a plethora of different skills that can help bring peace to what we're struggling with. So that reminds me of one of the things that I learned about when I got my master's in teaching humblebrag when you when you're working with middle schoolers, or like people who are in that middle school range, like 13 years old, apparently, their brains are more apt to be able to learn new things. And the only time in which they can learn new things better than that is when they're a baby, like when they're when they're an infant, right. So that stage of development, that teen young adult age, our brains are hardwired to be able to learn new things really well. And sometimes that means that we can learn bad things really quickly. But also that we can learn new, helpful, good things really quickly. And so it sounds like one of the things you're saying is, you know, we can teach new ways of thinking. But you have to be intentional about how you are training people to think is that right? Yeah, absolutely. And it, it also goes into the fact that our again, our brains create new neural pathways every single day. And so what that means is, if we think of our brain, and all of our neural pathways, kind of like a forest. And if we're watering and nurturing those trees, they're going to continue to grow. If we don't nurture and take care of those trees, they're not going to do very well. And eventually, they're going to die off. And there may be some deep seated roots that still remain, but we're not going to see them growing and really flourishing the way that the trees that we're nurturing are. And so that's very, very similar to how building new habits and creating new coping skills works in our brain. The more that we practice them, we talk about them. We understand what works and what doesn't, the more solidified those are going to be and so it's not that Using and struggling with substance use is going to be the same level of cravings, the same level of need forever. And sure, cravings are a very real thing. And they can come up from time to time. And the more that we practice those healthy coping skills, and really gain education as to why they're happening, and how we can counteract them. That's us nurturing those healthy trees for a metaphor. What's the best therapy for substance use specifically, or addiction or mental health? Is? Is there a best a best treatment approach for all three of those? Or do each one of those types of domains like Substance Abuse and Mental Health? kind of have their own types of therapies that tend to work? Well? Or is it dependent upon the person, a little bit of all of that, so it's definitely dependent on the person. And what they're struggling with. So I don't like to put anybody into this is the end all be all, for substance use disorders in particular, and addiction CBT has been statistically proven to have the most positive outcomes. with mental health, we look a lot more at something called DBT, or dialectical behavioral therapy, which is similar in nature. But it's more designed towards how to get our needs met without the use of manipulation, and how to understand how to communicate with others about what what's happening for us in a really healthy and authentic way. And so, again, very similar to a CBT model, where we're looking at what happens in our minds, what are the behaviors that are going on for us? And how do we curb those behaviors. With that being said, there's also a ton of research that shows that meeting clients where they're at in their recovery process, and staying mindful in the present moment is also really beneficial to recovery and stability with mental health. So it does depend on the person what that person is particularly struggling with. And the stage of change that they're really in, I would work with a client in a very different way, if they were very pre contemplated in nature, they were not interested in receiving support, they felt very nervous about the process. And they weren't really interested in the recovery journey, I would use a different model with that client than I would with a client who was saying in more of an action stage and really was able to practice some skills, and had goals and really wanted to practice sobriety and emotional stability. And neither client is right or wrong. It's just diff, it's not a linear process. We, we go through stages of change, and then big life events happen. And sometimes we take a step back, and, and that's okay. And the the modalities of treatment vary depending on on what that person's going through. Okay, so you've talked about CBT, you've talked about DBT. And just to rephrase, we've got cognitive behavioral therapy, and dialectical behavioral therapy that I said those right. Okay, I feel super proud of myself for saying that, you know, is there? Is there also like a delineation between group therapy and individual therapy and family based therapy? Is there some sort of combination? Do people do CBT or DBT? With all of those things? Or do people do group therapy? With CBT? Not I'm mixing these up. Again, I'm not an expert. Right? So. So how does how does those types of therapies also play a role? For sure, there's there's different ways that these therapeutic modalities can be used. group therapy is the most effective way to deliver service services for someone struggling struggling with a substance use disorder. It's what we call kind of the power of peer, if you will, it's very comforting to know that you're not alone. In this process, it goes back to all of our struggles with stigma and shame and guilt, to see other people in a similar position makes you feel like you're not alone. And it also naturally brings people together and allows them to share without fear of being isolated, which is oftentimes what they experience early on in their addiction. And so, with mental health. group therapy has also proven to be extremely helpful and supportive. And individual therapy specifically with DBT. There is a very specific model that's utilized so it's a combination of group work of individual therapy have independent journaling, and what they call a DBT diary card which is kind of essentially a check in throughout your day. And so there's definitely a combination of different approaches. depending on the age range and where that person is at in the recovery process, I will say that group therapy for substance use is incredibly beneficial. It also helps encourage not keeping secrets, which the addicted mind, your secrets keep you safe when you're using. And so a saying that we use in the recovery community, his secrets keep you sick, because when we're not sharing what's really happening in an authentic way, we're protecting that addiction. Question for I've talked to people on our admissions team, and one of the things that they told me that I was actually really surprised about was sometimes parents will be hesitant to want to put their kids in group therapy. And I could see this also being a source of contention between parents, right. So maybe one parent says, Hey, you know, Sarah, over here says that group therapy can be really good for substance use, because, you know, we sometimes do substance use because of our peers. And so interacting with peers who are trying to become sober is also a helpful way to get out of that. But I don't, what if I don't want my kids to interact with people who are doing different types of drugs? Maybe your child is smoking marijuana, and you're afraid that they're going to talk with kids who are using what's in your mind is a harder drug like opioids or something like that? Right? So what would you tell parents who are hesitant to allow their kids to be in group therapy? Because they're interacting with other people who might be at a different stage than them? Yeah, I get this question all the time. And I see that because I want to normalize that that is not a really off base way of thinking. Right. So if parents when parents do have that fear of, well, my I don't want my child interacting with with heavy drug users. My number one response to them is, first of all, in the group therapy setting, in a treatment center, I have fairly high confidence that the folks who are in those groups they're not using, because they're entered into treatment, right. And so there are multiple different ways that we hold accountability in a treatment setting. There's your there's urine tests, there's breathalyzers, and, and there's also communication and sharing authentically if there is intermittent use, or a lapse versus a relapse. So my first, my first kind of point to families is that putting your child in treatment, they may not have the same substance use that other folks in that group maybe have experienced. And they're all in a place where they're working to make changes and work towards sobriety. Second to that, I would say that the people in this group setting are all learning and practicing coping skills. So they're actively learning how to stay sober and emotionally regulate, and learn to live a really healthy and effective life, where the people who are not engaged in group therapy or in a treatment center. Unfortunately, they're not practicing those skills. And so I like to normalize that. First of all, that's not a crazy question. And my recommendation is that kids and young adults are actually safer in a treatment environment, even though that means that there is they they could be working and learning skills with others who have used different substances. But again, that really insinuates that blame and shame my kid is going to be with, you know, bad people. And they always go back to that the people that we work with every day, they're not bad, they're not broken. There's nothing wrong with them. They're some of the most incredible and brave human beings that that I get to work with every day. And I feel super lucky to be able to spend time with them, just like that parents, adolescent or young adult, I would feel the same way about them. So just removing that blame and really educating around the nature of working in a treatment center, and what the participants who are in that group are working towards. Yes. Wow. I feel like so many parents are really going to appreciate one the fact that it's not a crazy question and two that I don't have to be fearful about help because it's one thing to come to grips with, okay? My child needs to get some help. And I am not the person who has all the tools to be able to do it. And at the same time, you don't want to make things worse. If there's any indication I told a story in the last episode about how sometimes Don't we try to do things on our, our on our own, we make things worse. And then there's also the idea that if you try to do too much, you're gonna make things worse, right? So that is not a fear that they need to have that going into group therapy is going to be the thing that kind of derails their child from being the good kid that they know that they are, right. That's not the situation that we find. So I think that's going to be really refreshing to a lot of parents, I'm coming back to this spouse thing, and I keep going back and forth, about how does a parent talk to their spouse about their child's substances. And I think having a clear idea about what makes treatment effective can be super helpful. So Sarah, you know, when you're talking to parents, and they ask you the question, will this work? let me pose the question a little bit different. What makes a treatment effective? I would say that what makes treatment effective is the willingness of everybody involved, to recognize that this is a process, there isn't a start and an end to it. And when we I mentioned a little bit earlier that I would use different modalities, depending on what kind of stage of change my client is in. And making treatment effective is no different than that. It takes time. And it's not a perfect process, and some days are really, really hard. And then some days are really, really fun and light. And I think my recommendation for anyone who asks me, will this work? I would say, you get out of it, what you put into it. And so if you're coming to the table completely open and ready to look at the hard stuff and answer really tough questions and go through some heartache. Because with substance use and mental health, it is really hard. And being open to understanding that you don't understand sometimes is is the most effective tool that you can use. So for me, it's it's absolutely treatment is effective. And there are so many different layers and levels to the treatment process. Depending on that person. We're all completely different human beings, we're all beautifully different. And we have different coping skills, and we have different interests. And that's what makes us so amazing is because we're not the same and we have different interests. And so that really is where I like to start and that when we come to the table completely open, we're going to go on a really beautiful journey together. And when that journey comes to an end, it doesn't mean that the work is done, it just means that we're ready to do something different. So I know that's a little bit vague. And I wish I could say that this was a you know, we start here and in three months, everything's going to be fixed. But again, human beings don't get fixed, we're perfectly imperfect, and we make mistakes. And all the treatment process can do is, is help you identify a way to live in a peaceful environment. I love that you talk about not wanting to think that we're, we're broken, just need to be fixed, right. And at the same time, I want to dig into kind of an element of that openness that you just talked about. So one of the things that sandstone care does is we involve the family in the recovery process, instead of it just being about the child so that when the child goes through treatment, you know, and they come back. if nothing's different, sometimes that might be a thing that prevents them from being able to stay sober or stay off of substances. So can you kind of speak to the openness needed by the family and part of as part of their child's substance use treatment? Yeah. When it comes to the openness from the families, side of the treatment journey, I always ask families to come to the table prepared to look at themselves. I've had several families come to me and say, you know, I want my son or daughter or my adolescent to stop using drugs and to be happy and those to me, are very hard. They go back to cognitive distortions, right? They're very over generalized requests. What I'm interested in is looking at behind the scenes of what what got us here, and I know that you mentioned earlier, you know, this is a family process. And again, this is not about blame. This isn't anybody's fault, we all have a hand in the treatment journey, we all shake each other, every family dynamic is different. And my recommendation to families that come into the treatment process with Sam stone, or, frankly, with any family therapy community, is that you have to be willing to look at yourself, this isn't about what the other person did wrong or did right. This isn't about pointing fingers, it's about taking your own accountability for your part in the process, and then owning your part in the recovery as well. So you get to own what hurt in the past, and then you also get to own how you're going to make this a wonderful experience moving forward. You know, I love that you talked about that whole ongoing recovery process, you know, if I'm candid enough to be a little bit vulnerable, you know, my brother, a couple years ago, died of a heroin overdose. And I know that you've had some experience with this as well, Sarah, and it wasn't because he didn't go to treatment, he went to a treatment center, he was involved with a really good group of guys who helped him to get sober. But the process of staying sober was the thing that was lacking, because his job required him to travel a lot, right. And you know, he had fiance that he left behind, he had a little girl that he left behind. And, but when he was traveling, he was isolated. Right. And so being in community was one of the things that was preventing him from being able to stay sober. So it wasn't just about like this one time, like, go to a treatment center and cure forever, right? Like, it's not that way. It is, hey, I need to be in community with people who are like minded and who also want to be sober, in order to stay sober. And that support is paramount. Right. And so I wonder about how his life might have been different if he if he had been in a community that was actively checking in on him in that way, right? Because, as I've heard you say before, there's a lot of shame. And there's a lot of guilt attached to being being and staying sober, we would love to be able to say, yeah, that was something I used to deal with. But now I've got everything under control. And in reality, everything that is beautiful, and that is good about this world requires community and requires a diversity of opinion and experiences. And there are things that you know, that I do not know. And there are things that you have gone through that I've not gone through, and being open to hearing other people's experiences, and also to share your experiences with others, is one of the best ways to help to maintain sobriety, at least when I'm talking to some of the alumni in our sobriety program that we have our alumni program that we have. That's like one of the best ways is having a sober community. So, you know, just to kind of piggyback off of that, Sarah, could you tell us what you know about staying sober and like, the ways in which staying in recovery or being in a community is helpful to stay sober long term? Sure. Recovery communities and alumni programs are so incredibly important. And they're so really monumental in order to, to stay out of that isolation piece that you spoke about. It's one thing to complete a treatment program and to gain that toolbox of skills that we talked about in the past. And it's another thing to actively practice those skills every single day. If treatment was a one and done part of someone's life, there wouldn't be the amount of addiction that we have today in the world, we just wouldn't, because it would be Oh, gotta go away for a little bit. And then you come back and everything's fine. And so for me, it's talking through the importance of having a community of people who understand what you're going through. And even when you leave treatment, maintaining community and support through a group of individuals who truly understand what it's like to walk in your shoes. And so holding on to that empathy, I think is something that is highly undervalued. treatment is is an incredible staple to starting the recovery journey. And continuing to practice those skills is also something that You know is on the person to be able to continue to work through. And having a group of people that surrounds you and supports you and, and cares about you is equally as important in my opinion. Sarah, thank you so much for just being able to dispel so many myths, to be able to, I feel like your words when people are hearing this are something that helped them to just take a deep breath, right? We are not in this alone, you are not in this alone, you don't have to be in this alone. And there's enough people who really care about this and who really care about you, who are willing to come behind you and support you. And I appreciate you just being able to knock down all of these barriers of guilt and of shame, that of miscommunication and lack of education, and being able to just say what is true in a way that that anyone can access? Right? But it's not, we're not filled with tons of jargon, that we're not filled with all these medical terms, and that it doesn't seem so scary. So if there was somebody, you know, last question, if there was somebody on the fence about talking to their spouse about getting treatment for their child, like, what, what would you tell them? For me, I would, if somebody was really nervous, or had a gut feeling that something wasn't right, I would encourage them to be 100% authentic, and share everything in anything, share all of their fears, share the reason behind why they have these fears. And just communicate that is the number one thing that makes a difference in this process is communicate all of your feelings, all of your fears, all of your reservations. And the other piece of that is be willing to hear the other person's point of view. Because we can get really stuck in our own heads again, operating in that silo, when we're not willing to hear another person's perspective. And a lot of times we think we're right, because we are our narrative, our perception is our experience. And so when we take the time to hear the other person's point of view, and make sure that we're valuing where they're coming from in their perception, it can, it can be really helpful to, to come to the table and really come as a united front. So communicate is my number one thing. Communication, you guys heard it Listen, if you're looking for some sort of treatment help, you can reach out to us at sandstone care. I am, I am, this is like the one job or the one position where I do not feel bad about saying, like having a plug for what we do, because it is so important. It can be helpful, sandstone care, calm, you can talk to an admissions expert, they're going to hear about your situation, they're going to help you with any insurance benefits or, or even just refer you to the person who can help you out if we can't, right so and then get connected with the treatment that you really need. So if you're that person, you're on the fence, then I would strongly recommend go to sales, don't care calm, or call us today, live chat with us. And I think the cool part about that is that you also know that you're stepping into a community that is about keeping you sober or your child's sober past past when treatment is happening, right. So we have awesome alumni group that gives you access to people who are like minded who are trying to stay sober, too. And that is a super valuable thing when it comes to your sobriety. So, again, thank you so much, Sara, you're amazing. Coffee, no problem. Me moved and I'm gonna I'm gonna beg and plead to get her her on her here. Again, I'm sure you can agree anybody who's listening that her words were awesome, and they're going to help a lot of people. So thanks again, Sara, and we will see you on the next episode. Thank you so much. If you want to learn more about treatment options for you, your teen or young adult, then tell us about your situation on a confidential call. Using the number in the show notes or live chat with us at sandstone care calm. We'll connect you with the treatment that you need and if we're not the right fit, we'll get you where you need to go. Be well and remember that change is possible.