What Parents can Expect While Their Teen is in Residential Treatment

"Robby has been in residential treatment for three weeks. Each time we visit him or have a family session his mood is different. We don't know if "Angry Robby" or "Manipulating Robby" or "Genuine Robby" will show up. His counselor says this is normal for a fifteen-year-old but I don't remember him being so erratic, even while drinking and drugging. Will this roller coaster ever slow down?"
~Mrs. Selma F.~

Normal adolescence – even without alcohol and drug dependence -- is a time of volatile mood swings. Hormonal and body changes combine with lack of social experience to generate alternate cycles of insecurity and bravado. Often it is the intensity of these moods that a teen is trying to control by experimenting with chemical substances.

Regular use of alcohol and other drugs such as marijuana, cocaine and methamphetamine ("speed") create a false sense of personal power, community, and well-being. These chemical props are lost when a youth enters residential treatment; in their place may be underlying depression and anxiety along with ordinary adolescent angst.

Critical to recovery from alcohol and drug abuse is learning about these emotions and how to cope without using chemical substances. During residential treatment, a teen is encouraged to "try on" different feelings and talk about them in counseling. Gradually, a repertoire of appropriate feelings and behaviors will begin to emerge.

In the interim, it is quite likely that your child may appear to "get worse" before he gets better. Remember, you are only seeing the tip of the therapeutic iceberg during visits and family sessions. Staff members are observing and working with your child 24 hours a day, 7 days a week, and are always willing to talk to a parent.

What kinds of emotions and behaviors are you likely to encounter in your newly recovering teen? There is a wide range, but three stand out: anger, manipulation, and joy in new growth.

"Angry Robby"
Entering residential treatment means a loss of freedom -- not just the ability to use alcohol and drugs and but being able to spend time with friends, talk endlessly on the phone, watch MTV until late hours, play computer games, and spend money.

It also means having a controlled and closely supervised day. School is mandatory, as are chores. Lies and/or irresponsible behaviors are confronted immediately. Understandably, many teens are frustrated and angry at these restrictions.

Parents often bear the brunt of this anger. Mr. F. recalls the first family residential counseling session:

"Robby sat across from us with his baseball cap backwards and jaw clenched. At first he would say nothing; then finally he screamed, ‘It's your fault that I am in this awful place!' Even when his counselor pointed out that it was Robby's use of drugs that brought him to residential treatment, our son was adamant. If it hadn't been for us, he would be happy."

Angry accusations hurt and it is easy to feel guilty for not being able to find a less restrictive treatment setting. It is hard to see your child in such emotional pain and have offers of comfort misunderstood and rejected.

"The only thing that saved my wife and me from quitting family therapy after that first session was spending time with parents of other residents in the treatment facility. That, and talking to Robby's counselor, gave us assurance that our son was right on schedule as a teen in early recovery."

"Manipulating Robby"
The initial rage at being confined, controlled and denied alcohol and drugs soon gets replaced with grudging acceptance of the reality of the situation. In a treatment center, privileges and freedoms are dependent upon progressing therapeutically. Successfully navigating the program becomes seen as the easiest path to going home.

As your angry teen moves into this phase of acceptance, it is likely that regression and manipulation will also take place. Robby's mother remembers when he entered this phase.

"We arrived for family therapy and he was eagerly waiting at the front door. It was amazing because the previous week he swore he was never going to talk to us again. Our session was amazing. Robby talked about wanting to come home on a pass and said he had been acting like an angry jerk earlier.

"On our way out he asked if we had any change so he could make a phone call. We eagerly emptied our pockets and promised to bring a roll of quarters next time. He gave us a long list of clothes and junk food to also bring. We felt so good. It was like having the old Robby back before he started using drugs!"

Mr. and Mrs. F. were right about their son acting younger. This regression in age often happens when a teen realizes that adults are in charge and that consequences for behavior are fair and consistently applied. It is as if the out-of-control adolescent feels safer when brought under control, even though she may kick and scream at the initial residential confinement.

Again, it is important that a parent not get too elated with this improvement in outward behavior. Your child will demonstrate an assortment of ages and moods during the remainder of treatment. Remember, they are his or her moods. Your job is to cultivate and enjoy stability in your adult life in order to model such behavior for your child.

"Genuine Robby"
One of the joys of participating in family therapy is witnessing new growth in your child. Somewhere between the anger and regressive manipulation there are bursts of awareness and healthy behaviors.

Perhaps it is on a weekend pass when your son spontaneously takes out the garbage or says thank you for ordering pizza. Or maybe it is when your daughter lingers in the car to share how she sometimes feels scared and that's when she wants to drink.

"Robby was so excited when he got voted to be on level four (the highest) by the community. I know how hard it was for him. He would get to the third level and then run away from the group on an outing. That infraction would take him to basic level one status. But this time he was ready. Not just to be a leader but to help new kids settle in. His mother and I were so proud of him. I think we all cried!"

Anger, regression, manipulation, resistance to the program, and risking new and healthy behaviors are all part of the process of recovery from alcohol and drug dependence.

Detaching With Love
During this time of your teen's therapeutic experimentation with feelings and behaviors, it is important that you not be drawn into immediately reacting to each outburst. Neither verbal attacks or loving manipulations are "really" directed at you. They are about your child's struggle to get healthy.

That means understanding and respecting the recovery process and loving your child enough to let him experience the natural consequences of his behavior within the treatment center structure.

Twelve-step groups, such as Alanon and Naranon, teach how to "detach with love" from your recovering teen in order to take care of yourself physically, emotionally and spiritually. They recommend attending at least six meetings to see if the program is helpful for you. Remember, you are new at recovery, too. Meeting locations can be found in the Yellow Pages of your phone book.

Choosing to place your child in residential treatment and to participate fully in family treatment is a brave and loving decision. Your child will thank you for this gift when he or she reaches adulthood safely.

Copyright 2003 Judy Shepps Battle