Working with Hesitant Clients
Working with Hesitant Teen Substance Abuse Clients and Families
Seeking help for a substance use disorder through addiction treatment is a difficult decision to make. Inpatient rehab programs require clients to put their lives on pause, sometimes for months at a time and far from home, while trusting themselves to the care of strangers — it’s a major step to take. For adolescent clients, that decision is often made without their input or consent, which creates even more barriers. Recognizing the factors that may cause hesitation from prospective teen clients or their families is vital in providing the support and guidance necessary for lasting success in recovery.
During this week’s Partners and Providers roundtable, host Tiffany Krause, Safe Landing Recovery’s Adolescent Outreach Coordinator, led an open discussion on how to recognize and navigate hesitation when communicating with prospective clients and their families.
Getting Cold Feet: Recognizing Signs of Hesitance
Discovering your child is using drugs or alcohol can be shocking and distressing. It’s not a scenario most parents or guardians anticipate, so their first instinct is to seek help from someone more equipped to handle the situation. Safe Landing Recovery receives many of these calls and emails every week. While in some cases the family is fully committed to the recovery process from the very beginning, this is not always the case.
As Tiffany states:
“Some families are very on board and don’t waver. Some of them are 100 percent from the first call until the day we get the youth into the program. But I always know when that hesitation is coming if the first day the parent is very enthusiastic, and then the next day there’s no contact. They don’t return my calls or text back — just a huge change. Then usually around the third day they’ll call and say ‘you know, I think I’m just going to watch them a little bit extra. We can manage it at home. I think we’re okay.’ Then usually not long after that they’ll call again, frantic, because ‘the teen went out, they were partying under the influence, and we have to get them into care now. I’m ready, I shouldn’t have waited.’”
Another participating panelist notes that word choice and verbiage is also an early indicator that the client or family may not be ready to fully commit to treatment. Use of phrases like ‘I may’ or hyper-fixation on irrelevant details may reveal reluctance or indecision. For parents and guardians of adolescent clients, this is often born out of fear of relinquishing control.
“There is a lot of hesitation because they don’t want their kids to just disappear. They have this fear of that person just going on the run and not contacting them, so they’d rather sit there and enable them and have them at home rather than risk it.”
Adding to that point, Tiffany says,
“Having that open time where the individual could run is scary. I spoke with an interventionist recently and he said that’s why sometimes you have to create a secure space where they are surrounded by support and loved ones to let them know, ‘hey, this is what needs to happen, and it’s happening right now.’ To try and minimize those risks of the person attempting to make an escape.”
What options do families have for getting their resistant loved one into treatment? Legal measures can be taken to involuntarily admit someone to rehab, but it’s important to recognize the serious nature of court orders before initiating the process.
As one participating clinician said,
“Sometimes it’s that they were just trying to prove a point, or they didn’t actually fully understand the process that they were getting into. They use the threat of treatment as a punishment, consequence or scare tactic. Then they go through with the Marchman Act, a court order that mandates an individual to complete a substance use or mental health program. They start the process as a threat and then realize later what that really means.”
Another participant added,
“We see this quite often with Marchman Act cases. Because we’re working with adolescents, a lot of the time it’s parents who petition the court. But once there’s been an assessment and it comes back that there’s a recommendation of residential treatment — meaning you have to go back to court and it’s going to be court-ordered — we see a lot of petitioners dismiss the case. Sometimes it’s ‘oh, we just wanted them to know they had a substance use issue, we didn’t want them to actually have to go through up to 90 days of treatment.”
Even once families get their child into treatment, the fear of the unknown and lack of control in the situation can continue interfering in the recovery process.
“Once a teen is in treatment, the parent is calling every single day. ‘How much longer? I think they’re okay. I just miss them.’ It’s that need for control. They’re realizing they wanted to help their child, they wanted them in treatment, but now they’re left without them. They’re having to learn to deal with that.”
Safe Landing Recovery and other adolescent substance abuse treatment facilities offer facility tours and encourage family involvement throughout the course of care to help mitigate these concerns and fears. However, this isn’t always enough to completely eradicate all concerns.
“It’s scary. Even after clients come and do a walkthrough, meet the clinical team, and get all this information about what to expect and the next steps, actually taking that step is hard. Even if you know it’s the best thing to do.”
For parents and guardians, taking that first step of admitting their child to treatment also stirs up feelings of guilt, even when they know rehabilitation is the best course of action.
“Parents are super reluctant to say to their child, ‘hey, you’re going to go to treatment, this is happening.’ It’s hard stuff to do, let alone take as a teen.”
Because adolescent clients often come into treatment without having much, if any, input, breaking down that initial hesitation, rebellion, and defiance is vital. Addiction recovery requires a level of trust and vulnerability to be truly impactful. Getting to that place takes time, effort, and earnest compassion.
Breaking down barriers of distrust and resistance begins at first contact with prospective teen clients and their families. The situation may be high-stress or contentious, which takes away from the actual focus: helping that individual find healing. Despite their best intentions, families, friends, and other outside influences can further complicate the situation. Getting through that noise and connecting with the client directly helps to ease the transition into care.
“If that individual isn’t ready it’s just not going to work. It’s all about getting to the individual you’re actually going to be working with, tuning out the family and other outside influences, and giving them a voice.”
Adding to this, Tiffany says,
“You have to start by reassuring the teen that you’re on their side. I’m here to work with you, not against you. It has to start there so you can build that trust. We take a trauma-informed approach. We’re dealing with people who have trauma, so that trust is important. The next thing is building the plan. ‘Okay, this is what we’ve got to do.’ Then you try to reassure them, ‘I’m here to support you, to help you.”
Safe Landing Recovery is dedicated to supporting families on the journey of healing and recovery from the moment you give us a call. Our person-first approach to care keeps clients and their needs at the forefront of everything we do. For more information about how we can help you, call 855-993-6311.