How to Support Your Adolescent Child Through Dual Diagnosis Treatment

The hope felt when a child enters dual diagnosis treatment is unparalleled. But there are probably some concerns, too. What if treatment doesn’t work? What will life be like when while they are in recovery? What about relapse?


By empowering yourself with information about dual diagnosis and how to support your child through treatment and beyond, you will experience greater peace of mind and increase your child’s chances of successful recovery. Here, we look at the best ways to support your teen before, during, and after dual diagnosis treatment.

Before Treatment: Arm Yourself with Information

The best thing you can do for your child once you’ve located a high-quality dual diagnosis treatment program is to dive in and learn everything you can about addiction, mental illness, and co-occurring disorders. The more you understand how these occur and how they’re treated, the better you’ll be able to support your child.

Dual Diagnosis: A Quick Primer

Dual diagnosis is very common. According to the National Alliance on Mental Illness, one-third of people who have any mental illness and one-half who have a serious mental illness also have a substance use disorder.1 Conversely, one-third of people who abuse alcohol and more than half of all who abuse drugs also have a mental illness. Anxiety, depression and eating disorders are among the most common mental illnesses that co-occur with addiction.


When addiction and mental illness co-occur, it can be difficult to determine which developed first. That’s because mental illnesses like anxiety, depression and eating disorders are major risk factors for substance abuse as a way to manage symptoms. However, drug and alcohol abuse affect the chemical functions of the brain, often worsening a mental illness or even causing the onset of a mental illness that didn’t previously exist.

How Dual Diagnosis Treatment Works

Treating only a mental illness or only an addiction will do little to end either disorder. Integrated treatment is central to successful dual diagnosis recovery. A dual diagnosis treatment program treats the addiction and the mental illness at the same time, each in the context of the other. Treatment is a collaboration among treatment teams for each disorder.

Through a variety of traditional and complementary therapies, classes, and support groups, your child will:

  • Find their own intrinsic motivation for wanting to recover
  • Develop skills and strategies for coping with symptoms of mental illness
  • Develop skills for coping with stress, cravings, negative emotions and other relapse triggers
  • Address underlying issues, which may include a history of trauma or stress
  • Identify dysfunctional thought and behavior patterns and learn to think and behave in healthier ways
  • Learn to relax and have fun without drugs or alcohol
  • Find purpose and meaning in a life of sobriety
  • Repair damaged relationships and learn healthy communication skills

Traditional therapies commonly used in dual diagnosis treatment include cognitive-behavioral therapy and dialectical behavior therapy, which help your child identify, examine and change self-destructive thought and behavior patterns. Complementary therapies like art therapy and adventure therapy increase self-awareness and help your teen look at a variety of issues from different angles. Psychoeducational classes help your child better understand addiction and mental illness, and peer support groups reduce isolation and help with developing healthy social skills, higher self-esteem, and greater self-awareness.


If it will be a few days before your teen heads to treatment, find out as much as you can about the program, including what types of therapies are used, the sorts of recreational and social activities that are available and what a daily routine will look like. Knowing these things ahead of time will help reduce your child’s anxiety about going to treatment.

Before your child enters treatment, express your love, and tell them how hopeful you are for their future. Even if they don’t realize it now, treatment will change the way they see themselves and the world, and they’ll have a much better chance of finding happiness and success in life as a result.

During Treatment: The Importance of Family Support

Addiction is a family disease, according to the National Council on Alcoholism and Drug Dependence. 2 It affects every member of the household and leads to dysfunctional ways of coping with the stress and chaos it brings. Your child’s successful recovery depends in large part on family support and a safe and stable home environment.

When your child enters recovery, the whole family enters recovery. Family members of an addicted individual often develop enabling or codependent behaviors that can contribute to the substance abuse and dysfunction in the household. Most of the time, family members don’t realize that they’ve developed these behaviors, but identifying and changing them are extremely important for giving your child the kind of support needed after treatment.

Enabling and Codependence: Healing the Family

Enabling behaviors include avoiding upsetting your addicted child; minimizing the situation or thinking it could be worse; and minimizing the consequences of the addiction, such as making excuses for them or taking care of their responsibilities when they can’t.

Codependent behaviors include avoiding contact with others because you don’t want anyone to know how bad it is; lying to family members and friends about your child’s addiction; neglecting your own well-being to focus solely on your child’s; and engaging in unhealthy activities that help you cope with your reality. Any family member can develop these behaviors, but just because your teen is in recovery, it doesn’t mean these behaviors will end, and they can derail your teen’s success.

Tips for Supporting your Child in Recovery

With the health of the family system in mind, here are four essential ways to support your child during treatment.

Participate to the Fullest

High quality adolescent treatment programs have a family component to help improve the functioning of the family system. Family therapy will likely be a part of your child’s treatment plan, and the treatment center may offer family support groups, workshops and classes to educate and support family members as they learn to navigate life in recovery.

Get Support

Family members will benefit greatly from joining a support group like Al Anon for parents and Ala Teen for other children in the household. A support group offers a place for family members to express difficult emotions, ask hard questions, celebrate milestones, and exchange tips and advice with other families going through similar experiences. Support groups reduce isolation and fear, and they promote feelings of hopefulness. They offer essential practical and emotional support during challenging times.

Engage in Therapy

Addiction takes a toll on the health of the family system. Restoring function to the household should be a major priority in early recovery. Individual therapy and family therapy help family members identify and change the unhealthy behaviors and thinking patterns they’ve developed as a result of living with the addiction. Therapy will lead to better communication and healthier interactions within the family unit, and it can help improve each family member’s mental health. New York Center for Living offers a Parent-Only program designed to provide tips on how to influence your child’s behavior, improve family communication and heal the family system overall. Parents also learn about the basics of substance abuse, acquire prevention tools and attend group and individual support sessions.

Take Care of Yourself

By the time your child enters treatment, you may have had a rough time of it. Taking good care of yourself is one of the best ways you can support your child during and after treatment. Spend time relaxing and having fun with friends or family. Set aside quality time with your spouse or partner. Get plenty of sleep and exercise and maintain a healthy diet. Start making small lifestyle changes that will support a healthy, active life in recovery.

After Treatment: Supporting Your Child in Early Solo Recovery

It’s exciting when your child completes treatment, but it can be a little scary navigating those first early weeks back home. Engaging in therapy and joining a support group during treatment will help you know what to expect and how to best support your child once rehab ends. It’s also vital to support your child’s ongoing recovery by:

Follow the Aftercare Plan

Once treatment is complete, an aftercare plan will provide additional support as your child returns home. The aftercare plan will likely include ongoing individual and family therapy, participation in a support group, and ongoing monitoring of the mental illness and any medications being used to treat it. Adhering to the aftercare plan will be important for successful recovery.

Set Clear Boundaries

Let your child know right off the bat what is and isn’t acceptable behavior at home. Have clear expectations and prescribed consequences. Some things to consider are abiding by a curfew, waking up at a reasonable time each day, helping around the house and limiting the amount of time your child spends alone in their room.

Spend Quality Time with Your Child

Parents have a lot of influence over whether their child engages in substance abuse, according to a study published in the Journal of Addictive Behaviors. 3 Experts agree that spending quality time with your teen enjoying life together is one of the best ways to help with abstinence. Have fun doing the things you and your teen enjoy and engage in conversations about topics your child cares about. Listen to your child and let them know you love and appreciate them.

Make Your Home a Drug-Free Zone

Keep all drugs and alcohol out of your home. If anyone in your household is taking a prescription medication that has a high potential for abuse, such as opioid painkillers; stimulants like Adderall or Ritalin; or sedatives like Klonopin or Xanax, keep them locked up.

Maintain a Healthy, Active Lifestyle

 

A healthy lifestyle is an important factor in successful recovery. Make sure your child gets plenty of sleep and exercise and eats a nutritious diet. Help your child reduce stress and encourage healthy hobbies.

Prevent Isolation and Boredom

 Feelings of boredom and isolation can lead to relapse. Keeping your child busy with activities they enjoy will help with a focus on recovery. Encourage participation in the community, such as volunteering or joining a club. Help them find activities that use your child’s strengths and encourage healthy relationships with non-using peers.

Promote Mindfulness and Self-Awareness

It’s important for your teen to stay aware of emotions, thoughts and behaviors so that corrections can be made wherever necessary. Periodically, ask how they are doing and remind them to stay aware of how they’re feeling. When your child feels overwhelmed, remind them to stay in the present moment instead of worrying about the past or future.

Get Your Teen into a Routine

 

A routine keeps things even-keeled and familiar for your teen, which is important in early recovery. Work with your child to come up with a daily routine that works for both of you and which includes plenty of time for fun and relaxation.

Hold on to Hope

There will be setbacks in recovery and maintaining hope that things will get easier for your child will go a long way toward getting through challenging times. Remind your child often that you have confidence in their ability to recover for the long-haul. Instill hope in your teen and keep a positive attitude during rough patches.

What You Need to Know About Relapse

According to the National Institute on Drug Abuse, relapse rates for addiction are similar to those of other chronic diseases like heart disease and diabetes. 4 Between 40 and 60 percent of people in recovery will relapse at some point, and up to 90 percent will lapse without relapsing. A lapse, or a slip-up, is an instance of using drugs or alcohol again after a period of recovery. A lapse can lead to a relapse of the addiction, once again characterized by compulsive drug or alcohol abuse despite the negative consequences.


According to an article published in the Yale Journal of Biology and Medicine, relapse occurs in three predictable stages, and knowing the signs of each stage can help you intervene before a slip-up or relapse occurs.5

Stage One: Emotional Relapse

During emotional relapse, your teen isn’t thinking about using, but emotions and behaviors are setting up a lapse at some point in the future. Signs of emotional relapse include:

  • Feelings of isolation
  • Skipping meetings or not participating during meetings
  • Neglecting self-care
  • Focusing on other people’s needs and problems
  • Bottling up emotions

Stage Two: Mental Relapse

During mental relapse, a war is going on inside your child’s head: Part of them wants to use again, but another part doesn’t. Signs of mental relapse include:

  • Increased cravings
  • Reminiscing about the people, places or things associated with past use
  • Glamorizing past use or minimizing its consequences
  • Looking for opportunities to use again

Stage Three: Physical Relapse

According to the National Institute on Alcohol Abuse and Alcoholism, some common causes of relapse include being in a high-risk situation, such as a party where drugs or alcohol are being used; negative emotions like anger, anxiety, frustration or intolerance; peer pressure; chronic stress; and feelings of isolation and boredom. 6

What to Do After a Lapse or Relapse

There’s a good chance your child will lapse or relapse after treatment, but there’s also a good chance they won’t. Knowing the signs of relapse and supporting your child through challenging times reduces the risk, but a lapse or relapse may still occur.

The most important thing if and when a relapse occurs, is to stay calm. Relapse is considered a normal part of recovery. A relapse is a sign of a missing skill, and identifying and developing that skill, whether it’s managing emotions, surviving cravings or staying mindful, is paramount to ongoing recovery.

After a lapse or relapse, contact your child’s aftercare case manager, sponsor, or treatment program right away. The aftercare plan will be reviewed and amended to include items like more frequent or more intensive therapy and heavier participation in a support group.


How you and your teen approach a lapse or relapse will make a big difference in how quickly recovery gets back on track. People who beat themselves up after a lapse or relapse and feel negatively about themselves because of it often take longer to get back into recovery than those who approach a relapse with a positive attitude. Encourage your teen to look at a lapse or relapse as an opportunity to fine-tune and strengthen recovery.

Dual Diagnosis Treatment Works

Most people who engage with their treatment and aftercare plan enjoy long-term recovery from a dual diagnosis. Hope, according to the Substance Abuse and Mental Health Services Administration, is the foundation of recovery, which is a process of change that leads to a self-directed life. 7Recovery is supported by good health, a stable home, having a purpose in life, and engaging with the community.


The more you learn about addiction and dual diagnosis, the more it becomes clear that recovery is a holistic endeavor that requires nurturing body, mind and spirit for whole-person healing. Just as it takes time to develop an addiction and the dysfunctional thinking and behaving patterns that come with it, it takes time to re-learn healthier patterns of thought and behavior and develop a non-using identity. Your support during the learning curve will be a major boon to your child’s success. Above all, maintain hope, engage with your own support system, and help your child practice a healthy lifestyle that will promote long-term, successful recovery.


Resources

  1. National Alliance on Mental Healtth
  2. National Council on Alcoholism and Drug Dependence
  3. National Center for Biotechnology Information
  4. National Institute on Drug Abuse
  5. National Center for Biotechnology Information
  6. Alcohol Research & Health
  7. Substance Abuse and Mental Health Services Administration
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