what will it take?

getting out of decision-paralysis around finding or offering substance use treatment for your teen or young adult child

originally published via email to The Stream Community members

Life with a child involved with substance use often requires you to make seemingly impossible decisions. There’s no right or wrong answer so you can get stuck in a cycle of decision-making paralysis.

In my work I frequently see parents in this state when it comes to seeking treatment when their son or daughter is misusing drugs or alcohol. When there’s not necessarily a definitive “diagnosis” that says, “he’ll need to start chemo in 2 weeks” it can feel like a somewhat subjective decision on how, and when, to move forward.

There’s a helpful question I pose when I’m coaching with parents which is, “what will have to happen to move you to a decision about treatment?” 

This starts making things a bit more concrete because it forces you to consider different events or circumstances that may likely take place, and what your response will be to them. It also allows you to make plans and seek resources that align with these different situations.

What are some of the events or “triggers” you might think about?

(you can add an “again” after each of these)

  • If he gets in legal trouble

  • If she comes home high

  • If I find drugs in our house

  • If she overdoses

  • If he runs away

  • If he fails this semester

  • If she steals money or possessions from us

  • If he gets a DUI

  • If she becomes suicidal

  • If he asks for help

  • If she refuses local therapy and/or school

  • If it’s not (just) weed and alcohol

  • If he loses his job 

  • If she gets expelled from school

I also encourage you to think about less obvious inflection points like:

  • When his/her anger/depression/anxiety/oppositional behavior isn’t moving in a positive direction (within a timeframe)

  • If she’s not communicating with us proactively anymore

  • If he’s continuing to withdraw from family and friends

  • When she’s using alone

  • If his behavior is often erratic and aggressive or violent

  • When our home/family dynamic has become toxic and unbearable

  • When his/her physical appearance & hygiene has noticeably declined


The reason I share these considerations is your tolerance and “acceptability” set point may have adjusted over time given what your son or daughter is going through. I personally lost sight of what normal, healthy teen behavior looked like and it took several professionals to shed light on how far my son had strayed from anything resembling ok.

The decision to engage help for your family isn’t easy, whether it’s a local, outpatient option, wilderness therapy, or in-patient detox and rehab. The cost is significant, the implications for your entire family are real and there’s no guarantee that whatever you choose to do is going to “work.” Treatment for substance use can, and often does, take multiple attempts before a person finds lasting recovery. And they can find lasting recovery.

If you’re in a state of decision paralysis perhaps spend some time making a list of events and what your response could be to those. If it’s available, talk it over with a family therapist, educational consultant, counselor, social worker, or someone trained and familiar with the myriad treatment options available.

To learn more about the community created just for moms of kids misusing drugs or alcohol please visit The Stream.

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