Treating Substance Abuse Without Substance Abuse Treatment

Many of the juveniles referred for services come with a package of delinquent behaviors that typically includes substance abuse of some sort. If substance use is not a referral behavior, it often contributes to the other referral behaviors. Research tells us that the same elements that predict other delinquent behaviors also predict juvenile subatnce abuse. Specifically, we know that  associating with other juvenile delinquents is a direct predictor of delinquent behavior, whether that behavior is stealing, fighting or substance abuse. We also know that there are factors in the family and the school that, when not working well, are predictive of the aformentioned peer association.

From a treatment perspective, if we are able to work with the elements of the ecology to be more effective, family and school, then we can expect to see some changes in the peer association. By doing so, we reduce the probability that the youth will be stealing and fighting if we remove them from that social setting. By doing so, we also reduce the probability of substance abuse because the same relationships were supporting the substance abuse that were supporting the other behavior. Substance abuse is frequently considered a "superbehavior" that requires extraordinary measures, but the research on the causes and correlates  of juvenile substance abuse tell us otherwise.

I worked with a child that I'll call Jeff. Jeff was referred for services for a package of delinquent behaviors that had resulted in his being placed on juvenile probation. The probation officer was clear that the main concern was Jeff's stealing. We knew that Jeff was using drugs as a result of urine screens but the level of theft was significant and needed to be controlled quickly, so that was our primary focus initially.

The bulk of the work centered around helping Jeff's mother, with support of family and friends, to be more effective in monitoring where he was and with whom he was associating. She also set firm limits on where he was allowed to go and with whom he could associate. In addition, she worked very hard to improve her discipline strategies. After a period of a few weeks, Jeff's mother was much more effective in controlling his whereabouts and peer asscociations. His probation officer was pleased that the theft seemed to have stopped and there had been no further complaints from local stores.

Following the reduction in the stealing, Jeff's probation officer administered a urine screen, and Jeff's test was negative for substance use. Continued random screens revealed the same result. How did this happen with no direct intervention on the substance abuse? Jeff's mother was successful in removing the influences that promoted or maintained the stealing behavior, and those were the same influences that sustained the substance abuse. If Jeff's rate of theft had not been so acute, the substance abuse may have warranted the referral itself, but that behavior was brought under control as a by-product of the focus on the stealing. This is because the same challenges in the family that were predicting the delinquent peer association and the the stealing, were having the same effect for substance abuse. Jeff's mother was able to address the behavior without sending him to an institution and without the high costs associated with such treatments. She was also able to do so without ongoing, time-consuming efforts that would actually prevent him from becoming involved with prosocial activities. In addition, the changes are more likely to last because the agent of change was a parent with improved awareness and skills that will always be present versus an intervention that ends on the discharge date.

Orange County Curfew Sweep Shows Parents' Help is Needed

A few days ago, police in Orange County, California conducted a sweep and picked up youths who were on the streets after the county's curfew without an adult. This sweep was focused on areas where criminal activity is high. and is an attempt to prevent youths from making decisions that lead them to criminal behavior.

While I commend the police for protecting the community, they need the help from parents and the community to be able to have any realistic chance of curtailing juvenile crime. First of all, they are only able to catch kids a fraction of the time offenses may be committed. If you consider the number of times people drive over the speed limit compared to the number of times they get caught, the lesson about effectiveness is clear. The more effective effort would be for parents to have a punishment at home for each time a child was out past curfew, their curfew or the legal curfew. If people received a ticket for each time their car crossed over the speed limit, they would stop speeding.

A second point is that there is no reason to believe that crime can not be commited by juveniles prior to the established curfew. They may make it home by curfew, but could have stolen, sold drugs, or commited any number of offenses prior to the curfew. It is noteworthy that the youths picked up in Orange County were in high crime areas. A big predictor of juvenile crime is the association with delinquent peers. These youths were clearly not under any meaningful supervision, as evidenced by their being out beyond curfew, and were in high crime areas. It's clear that they were not associating with kids intent on following the law. If we were successful in having these youths in their homes by the curfew, we still have no idea what they were doing until that time. It is extremely important that families understand where their kids are going, with whom they associate, and what they are doing.

This sweep is an example of a significant police effort, but it also shows that police are not able to accomplish the goals on their own. Many youths are arrested several times, which is the police role, before committing a significant crime. Parents are the most powerful forces in their child's lives. If the police could accomplish it alone, they would have done so by now. Parents can do the job, but many need help. They may have their own challenges that serve as barriers, may not be experienced in the necessary skills, may need practical or emotional support etc.There are evidence-based practices that can provide the training and support. The research community has proven it as has the service community. If we support such programs, parents, youths, communities, and police will appreciate it.