Substance use and addiction issues appear so prevalently as part of other clinical disorders that they have been recently termed Co-Occurring Disorders. In addition to the obvious health and safety risks, substance use and addiction problems can affect every level of a child's life and future, whether at home, educationally/vocationally, or in the community.

Through my extensive experience and training in this aspect of clinical work, I know this to be a most challenging problem area, but one that can be successfully treated. It is important that young clients have a safe place to learn how to tolerate and explore their painful feelings; to understand how substances deceptively appeared to help; and, perhaps most importantly, to develop and practice healthy coping skills.

The provision of ongoing familial, social, therapeutic, and medical support throughout this process is a key element in successful, lasting Recovery. Clients identified as either at-risk for substance use, or those working on Recovery, respond well to a clinically-coordinated mixture of Cognitive-Behavioral Therapy (CBT), family interventions, group therapy, and adjunctive community-based supports such as 12-Step work. In this context, CBT focuses on finding new ways of coping with family and social pressures; on developing new and healthy peer groups; and on building relapse-prevention strategies.

Family therapy can play a vital role in finding expression for deep, emotional sources of the addictive process, as well as providing the basis for rebuilding a strong, loving home foundation. Peer group and 12-Step meetings add a social dimension to the healing process by reducing shame, sharing practical wisdom, and reinforcing success. All play a crucial role in substance abuse treatment.

A clinically-coordinated treatment approach focuses on:

• Assessment of current substance use and evaluation of appropriate course of treatment. Level of overall psychological functioning, degree of risk and harm (based on drug of choice/frequency of use/available supports and resources) are factors that determine appropriate treatment milieu and interventions
• Providing structure and containment so that chaotic, destructive functioning is curtailed
• Stetting attainable and realistic goals. Harm Reduction Therapy has been proven to help reduce "all or nothing" thinking while moving towards sustained abstinence
• Maintaining an ongoing treatment focus on sobriety, hopefulness, and creating a thriving future