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And hello, this week I am talking with my colleague Dr. Andrew Finch, a prominent expert from Vanderbilt University regarding recovery support for youth. Dr. Finch, a professor of the practice in human and organizational development, co founded the association of recovery schools in 2002, and has conducted research on recovery high schools. His notable works include starting and recovery school, and approaches to substance abuse and addiction and educational communities. Dr. Finch has been involved in supporting teenagers recovering from substance addictions at Community High School in Nashville, Tennessee, and was instrumental in establishing Vanderbilt University's collegiate recovery program. His current project involves a history of recovery high schools, published by Oxford University Press, Dr. Finch, His research focuses on schools as continuing care for substance use disorders, counseling and human development and the school environment. Welcome, Mandy.
Thank you. Thank you. Happy to be here. Yeah,
I want to get right into it your origin story. Could you talk to us about what was the journey that led you to work with substance abuse prevention and treatment?
Yeah, that's one of those things where it wasn't something that I had been planning. For my life. It wasn't something that I was planning growing up or into my undergraduate experience, a lot of serendipity went into it, I must say, I, my undergraduate was in broadcast journalism. I did that sports denouncing for a couple of years professionally, and just decided I wanted something a little bit more with my life and my career and applied to Vanderbilt's Human Development counseling program, and moved from the Midwest to Nashville for that program. And I'll be honest, I really didn't know what I was getting myself into. I knew I wanted to maybe work in schools, I had met some school counselors. But beyond that, I didn't have a full understanding of this profession. And it was while I was in school, that I started to really understand what counseling was all about. And the very first course I took at Vanderbilt was the addictions class. It was just the way that the curriculum rolled out at the time. I actually started that class before all the other classes started, it was a weekend course. And the professor had asked to start it a week before orientation. So I was literally in an addictions class, before I had even been fully oriented into the program. And I also found myself in the class with mostly second year students. So I was one of the few first year students and I talked about serendipity, I think that's one of them. I signed up for that class that probably wasn't necessarily the way it would typically flow in the curriculum. But like so many people, you know, we take coursework, sometimes we start to explore our own lives and explore ourselves. And I think it was through the addictions class, that it really started to understand some of the things that I had grown up around some of the issues that were in my own family. And, like is so often the case with people who grow up in alcoholic and addicted homes. I just wasn't aware of that's what that was, I had just kind of accepted things that's maybe not normal, but at least it was my normal and I didn't really ever put labels or anything like that on it. And as I started to explore, I realized that yeah, this was probably extreme. And a lot of the things that I had been going through was because of my own family and family dynamics. And so I immediately developed an interest in that I did some research into it. And so that's that's kind of the backstory of I think, where my real connection to this comes from. But honestly, as I went through the graduate program, I wasn't thinking I would get involved in this field. I mean, I took that class. I put it into the back of my mind, and I didn't even take a job in that field. After graduating I took job with a local mental health agency. And one day I was driving to work, I had newspaper with me on my way to work, I literally stopped at a traffic light. And I look at the headline of the paper. And it says that this local agency was starting a school for kids in recovery from addiction, and I'm at traffic light. I'm reading this article. And I just immediately felt like, that's the place I want to work. I felt like it was a real connection between my own personal history and lived experience, my training, my desire to work in schools, and I called them that day, and things ended up working out that they ended up hiring me about a month or the school open. And I've spent the rest of my career in some way, either working for programs like that are doing research for programs like that. Wow.
And then full circle, you get to teach the addictions course now that kind of started all of this. Yeah,
it's ironic, when I actually did come back around and get hired on the faculty at Vanderbilt, someone else was teaching the addiction class. And, you know, as people may know, it was not a required course, in the counseling curriculum. It wasn't one of the things that the accreditation body was asking us, and requiring us to teach. And so it was an elective, and someone else was teaching it. So I started teaching other classes, and I wasn't teaching the addictions class. And in fact, over the years, that class didn't even make a few times. So we weren't even offering it. I tell I tell our students today that are in the class. Just imagine the generations of counselors that were going through programs without even one course and addiction. And now, of course, we're required to infuse it in the curriculum. But it's, it was that was a long time coming. And eventually, our professor stopped teaching that course. And when it came back around, they asked if I'd be interested in doing it. I really
want yeah, and here we are. So let's dive a little bit into what you've really come to understand about youth and the struggles with substance use. What are some particular difficulties that young people encounter regarding substance use?
Yeah, I think what's interesting is so often when we talk about substance use and substance use disorders, it is through the framework of adults, you know, a lot of advocacy right now around trying to decriminalize drugs, and, and, you know, how do we make them more available, maybe for therapeutic purposes, those kinds of things. And so often it's framed through the adult lens. And having worked for years with teenagers, I came to understand that they do face unique challenges around alcohol and drugs. First of all, a developing brain, you know, in substance, when students put substances into their body, they're affecting their own growth. And there's really not a lot of research into how and how it differs from the adults. And one thing that we do know, empirically is that the earlier someone becomes involved with substances, the more likely it is they're going to develop a substance use disorder. Now, we don't know if that's just because it's using substances that early age, it could also go the other direction, you know, the reasons that they're using substances could also give them more complicated lives. But we just know that developmentally, the age a person is when they're using is a huge factor whether or not they'll develop a disorder. Beyond that, though, we also know developmentally for teenagers, the peer group is so critical, and who they hang out with, who they associate with, is going to go a long way to determining what they do, what they do recreationally, how they handle their problems and issues. And when alcohol and drugs are part of that equation, first of all, it means that young people aren't necessarily learning healthy social skills and coping skills, they're using substances to help them through difficult times. It also means it's forming the foundation of their peer group. And if they start to develop a problem with alcohol and drug use, it can be very difficult to pull away from that, to find other peer groups to support them. And for a couple of reasons, one, that's who their friends are. That's what their fun is. But on the other end, for the kids that have chosen a different path and have chosen not to use alcohol and drugs, they've often been framed as negative, bad, dangerous, risky. So are they going to go hang out with the kid that using alcohol and drugs a lot or who has developed a problem with that? Likely not, and their parents aren't going to want them to hang out with them either. So suddenly the teenager who might want to change Their actions is having a hard time finding people to hang out with. And that is actually where any type of program that supports them through that is going to be beneficial, primarily because it connects them to a new peer group.
Yeah, where I think about how we've kind of fallen short and this, I immediately think about these labels and judgments where that person is just a burnout or they're a bad influence. And so these, these kids kind of get more and more isolated in these groups where then that need to self medicate probably is even further perpetuated in the cycle.
And one of the first things that I talked about in the addictions course, is, what are the models of addiction? What what are these classic models? What are the current models? And and some of that's just an exercise and understanding theory. But the real power in it comes from asking the students themselves, what do you believe? What do you think, is the cause of someone developing an alcoholic drug problem, and even with counselors, they can so easily fall into a moral, moral thinking, it's a bad choice, that person just, they just need to stop doing this. And it can so quickly move into a judgment of not the person, at least their actions and their behaviors and their choices. And if that's counselors, if that's arguably some of the most empathic people around, what about the rest of society? What about, again, friends, parents, teachers, very quickly, they move into that, and the judgment of the alcohol and drug use very quickly becomes a judgment of the person. And that just feeds the stigma. The stigma, yeah,
I think like as a biological model, even when we say like, it's a disease, which I think at first we thought was, you know, being even more advanced, but then it's like, well, your brain is disease. And then what does that sort of stigma mean? And as a sense of hope, how does that come when there's something wrong with my brain, and so how the models really have kind of done a disservice when we look in hindsight and understand addiction more? Well,
like so many things, we use these to, to make it more simple to make something very complicated, more simple. And the reality is, calling addiction, a disease was a huge advance in society. I mean, we used to think of it as criminal behavior, or somehow people were had an extreme psychiatric disturbance that needed to be locked up or put in an asylum or something like this is what we did with people with addiction. And so to start seeing, it's a disease more along the lines of diabetes, and cancer, humanized. And I think it was a lot closer to the truth. I think, today, when we start to understand what actually is a disease, what, what, what, what is the foundation of a disease, I think we find that substance use disorders probably don't fit all of the same criteria as other diseases. And yet, I do think of seeing someone as maybe sick or ill needing healing, it's a much more compassionate way to look at them. And for them to look at themselves, by the way, than to see them as just making bad choices. I think it's when we start to move beyond looking at the person as the center of the issue. Now we start to realize, okay, we go beyond that now we can start to see this as society, we can start to see it as things that have happened ecologically. Maybe it's poverty, maybe it's discrimination. Certainly, a good chunk of it could be a person's own biology, outside their own choice. Data that suggested maybe up to half of it is explained by genetics. So now we start to realize, okay, this isn't just a person's bad choice, or maybe them quote, unquote, getting sick. There's all of these factors in place. And when we start to think of it that way, in my view, it's very hard to stigmatize person. If not impossible to do, it's a lot
easier to empathize and connect and have that compassion than when we can't just separate it using a disease model or even old models of Yeah, morality choices. This a lot reminds me of sort of like the school to prison pipeline, though, that when a kid kind of get stuck in this concept of, you know, using or he's a bad kid, or any of the judgments that we might have now, then that limits potential it limits opportunity support. So in your opinion, what are ways that sort of the systems have failed youth in recovery or even just in their substance use?
Well, it's interesting, you know, one of the benefits of taking a very simplistic view of substance use disorders and addiction is that it suggests there are simple solution, right? You just either make a different choice, or you just go to that support group or go to treatment for 30 days and everything's going to be okay. I think when we start to step back and realize how complicated it really is, And when we say something like bio psychosocial, you can kind of just toss that off like, oh, yeah, bio psychosocial. But we really look at that. That means it's multi layered, multifaceted, which means the solutions are multi layered and multifaceted. And I think that's where the system has not really stepped up. I think, when we look at, you know, sociological issues, and we look at discrimination, we start to realize that, from the very first days of youth treatment programs, we started to see separation and segregation along the lines of race and income. And we started to see and we talked about mass incarceration, and the criminalization of drug use, well, that's disproportionately affected people of color, disproportionately affected people who can't afford treatment. And so when youth treatment started to really grow in the late 70s, and early 1980s, we started to see white children and especially upper income white children find their way into treatment programs, and usually rather nice treatment programs, residential treatment programs, this wonderful places to get well. And we started to see children of color. And and children who could not afford those treatment programs get diverted into a punitive programs, disciplinary programs, if they got any treatment at all right if they got any attention at all. And so when you talk about the school to prison pipeline, that pipeline is so much defined by how we handle youth, alcohol and drug use. That's where it begins. I think one of the things I've loved about recovery, high school work is a long ago started to see it as a way to break that school to prison pipeline. And it there's a lot of potential there. I can't say that it has been as successful as quickly as I would have hoped. But it certainly is an opportunity for that. Yeah.
So you kind of already brought it up recovery schools, maybe we can start talking about some approaches that you have found either beneficial, or is giving you hope in the process, and then talk a little bit about recovery schools for people who don't know about them.
I think one of the things that seems to work well, you know, outside of special specific programs, like recovery, high schools, is early identification. If we, the earlier we become aware that a student is having an issue or even at risk of developing an issue, then of course, we could intervene earlier. And that's what we know about tiered prevention, we start to look at kids who have high risk or exhibiting maybe risky alcohol or drug use, well, if we can get in there and start to provide them programming or services early, then we really diminish the chance that they're going to develop a real problem with alcohol or drugs. So to me when I've seen programs installed, that have that have tried to address that, you see some real success rates. Unfortunately, those typically take funding, they take it well, everything takes funding, right. But it takes additional funding, that in the school system is considered external. Most school districts don't build that funding into their budgets. And so if a school is going to do anything around alcohol or drugs, they're probably going to have to find that funding externally federal funding, community programs, nonprofits, and that has just been very up or down. It's been inconsistent. And so what I have found is that even though those programs have shown success in certain places, what's happened is a lot of schools default to programs that serve a wider base of people. So we're going to focus more on primary prevention universal prevention program, we're going to frame substance use as just a mental health issue. So if we deal with the mental health crisis, we're just gonna hope substance use goes away. And what I have seen is the reality is substance use, and mental health issues can co occur, but they aren't the same thing. And to deal with one doesn't by default, deal with the other. And it can be very difficult for a young person to know, what's the primary issue here? Is this a mental health issue? Is this a substance use issue? And I think in the field, we have gotten very caught up historically in trying to say this is the primary issue. This is the secondary issue. And I think for young people that's really hard to distinguish. And consequently, I think you have to deal with both, and you have to approach it that way. and understand that the treatments we have and the approaches we have for substance use are distinct in many ways from the treatments we have for a mental health issue. And there are some overlap, certainly, but I think what is most successful around the substance use is, is using interventions that actually do focus on that, and do help with that, and don't just try to somehow ignore the substance use and think it's gonna go away. Because we've helped the child with their depression, their anxiety, their ADHD, or whatever it may be, like, oh, well, once we get that taken care of the substance use of this take care of itself, that this does not seem to work. Yeah,
it's almost like this tightrope of not oversimplifying it, but also not making it more convoluted and complicated than it is. Which already, to me, I'm thinking when I grew up, I mean, the only option we have is like the DARE program and just kind of like abstinence only and more fear based. Talk to us about recovery high schools for people who are unfamiliar with this.
So recovery high schools were really set up as programs to support kids especially gone through treatment. I mean, the original recovery high schools in the 1970s actually opened before there was much adolescent treatment available. So you know, those early schools, were enrolling kids that had any type of substance use problem and trying to provide them support and scaffolding to help them get an education to finish their diploma, and to do so in an environment in which they weren't surrounded by alcohol or drugs and could get counseling that was specific to that issue. As adolescent treatment expanded in the 1980s, into the 1990s, what we saw is that recovery high schools became almost like an aftercare model, that most of the kids that would go to recovery high schools had been through 30 days of treatment, if not more, and that the recovery high school then would be a place where a child might enroll after they finish treatment, very small schools average about 30 students in size. And the original schools were set up to be time limited, maybe a student would go there only seven months, nine months, that part has changed. Students now go into recovery high schools and finish their diploma there they stay. Some stay three, I actually had students in our recovery high school in Nashville State all four years, they came after middle school and did their entire diploma there. But it's a it is a school, by definition. They're offering all of the academic subjects. They are very individualized in their education approach. But the thing that makes them different is that in the midst of the school day, we're having checking groups at the beginning, check out groups at the end. During the day, there might be some type of therapeutic support group in the middle of the day counselors on staff. So someone has to come and talk about something, they can check out a class and go talk to a counselor in the middle of the day. And whereas in the traditional system, that can often be frowned upon, because oh, that kid's going to miss that class time, I'm going to have to make all that up in a recovery school, we find that the teachers really support that they realize that if something getting in the way of a child paying attention, they're not going to learn the material anyway. And so we have these environments that are supported both of a person's recovery from substance use disorders and their education, while building a peer group of people who have similar lived experience. And that peer group becomes the support outside the school day, the people that the kids can hang out with that they can go do fun activities with. And that to me, is kind of the the secret sauce, so to speak of the recovery High School is that peer community.
Yeah, I'm thinking it's almost like you've reworked a sense of belonging that you feel maybe and using and now it's more this lived experience and this overcoming of it, then.
Yeah, they used to call it positive peer pressure. I don't know that I really love that term. Because no idea of peer pressure kind of has a negative connotation, but it really is that I think certainly peer accountability maybe feels better. And and, you know, there's not a lot for teenagers in our society to do for fun, whether they're using alcohol or drugs or not, it just very limited in what they can do. And I think that kids in recovery high schools, one of the challenges they faced is, they really have never learned how to have fun without having alcohol and drugs present. And so just learning what to do learn how to enjoy other people's company. When something becomes difficult or hard, finding other ways to deal with it, having to learn how to talk to one's family be in one's family. You know, I think a lot of the complications that would happen with anyone, I have become even more so for a person in recovery, because they just have never really learned how to do it. That never tried to do it without alcohol and drugs. And I think that's where the recovery High School is so valuable. It gives the kid a chance to learn how to do these things, and a chance to struggle. These are not, these are not utopian settings, right, like kids are struggling. In fact, in some of the empirical work that we've done, we've realized that the kids that come into recovery, high schools actually are more severe and acute in their issues and struggles than kids who don't go to recovery, high schools, the kids that have gone and maybe gotten some type of treatment, you can see a real distinction in the ones that go to recovery, high school, we see more severe mental health issues, more severe drug use histories, more difficult family situations, higher incidences of mental health issues, all of these things are there, and the recovery high schools trying to navigate through that. So as you can imagine, it can be very challenging environments, but also very rich environment for counselors to work in.
And love that you said that because I think it's been more my experience were working in substance use, primarily with adults, but it can be very easy to become jaded to kind of use a manualized approach to kind of already assume negative intent to kind of have this guard up. And I get why clinicians feel that way. Like it's certainly very difficult work. Clearly, that's not how you feel it to the point that you've even advocated in how to grow this idea of these recovery schools. Are there any contributors to that? Or what do you think sort of aided you in finding more determination in your approach versus defeat?
Well, I have to admit, you know, the early years of doing this work as a counselor, you know, there were moments where I certainly felt like, oh, boy, is this working, you know, if a student would be dishonest or lie to us, oh, goodness, we're just trying to help them and they're, they're being this way, and you could get really upset with the person, I think the thing that probably changed my mindset a little bit, was when I did really start to understand the the breadth of the situation for the child, you know, kind of like what I was talking about earlier, in this discussion that if I can move away from blaming the child, seeing them as somehow some broken individual and start to understand they're a human being embedded in a family that's embedded in a system. And certainly they have choices to make in that. However, there's so many other pieces to this. Now I can see this young person as a human being doing their best with the tools that they have. And it's kind of the old version, Syrian, unconditional positive regard. And I find that if I can get to that place with a client, which I shouldn't have to try too hard, right. That's what our that's what we're trained to do. But I do think in the addictions field, I think of all of them that one does kind of push the button sometimes like, Okay, can I really, unconditionally accepting of this person. And I think when you get to that spot, and you just are, it is so rewarding, because in a recovery, high school, I think that first word, recovery, you are working with people who are trying one day at a time to work through this. And of course, they're going to have setbacks, and of course, they're going to fall back into old behaviors. But when you work with them every single day, you also can look at it and see, Wow, look how far they've come. And I feel like that's one thing in our profession, we, we sometimes think we always have the opportunity to do it. If we work with a client long enough. I think sometimes we don't get to work with clients long enough or frequently enough to see that growth. And, you know, to set the scene in a school, you see your clients every single day. And I think in school counseling, we usually have so many clients assigned to us. We don't get to know very many of them. And the ones that we get to know it's only because maybe they're having some big issues all the time. I think in a recovery, high school average size of 30. You get to school every day, and you do a check in group with every one of those kids and for the ones that stay six months, which is the app The length of stay on up to one or two years, you watch them grow up as, as children into, you know, young adults or older adolescents. And you start to realize, okay, this is who this person was on day one. And look at how far they've come look at how they've gotten through that challenge. Look at what they're doing. It's so rewarding. I, I look back, and I worked in that recovery High School for nine years. And I said it at the time. And I say it today. I felt every single day, I saw people grow. And I felt like that school, in my own work was making a huge contribution. And I, you know, I think that's difficult to say about many things. And I feel like that was true every day. And I tell people all the time, as a counselor, there is no more rewarding place to work, the math. It
reminds me I was telling our students yesterday, the usefulness of kind of challenging the sense of being critical versus curious. And then if we can sit in curiosity, and we can name the critique part, the critical part, because that's, that's ego that I feel a judgment on this, because somehow it might represent the quality of counselor, I am the work I did. But if I can catch that, and try to be curious, it is so much easier to humanize understand the nuances and actually really see a person, like you said, who is trying their best with the tools that they have? And with what they know.
Yeah, I think it's finding the humanity in your clients. And, you know, you take every day as a learning opportunity. I feel like, you know, when you have 30, young people, and all these different challenges are coming at you, I think being able to try to understand, you know, that that always trying to understand, realize, you know, something, I'm not the expert here, I am trying to learn, that takes a lot of that pressure off to be perfect. And I and I also think it takes away that self judgment that can be so sinking. And I feel like it allows you then to zero in on on the growth that you see, I don't want to make it sound though that it doesn't have its job. It certainly does, you know, in places that are dealing with addiction, you know, along with that comes people who have returns to us people who leave the school people who have to be asked to leave the school, because they're just back to using again, they're not necessarily safe for the environment. You know, with the with the growth of the opioid epidemic, we've seen a real rise in overdose deaths as well. And so there's grief and loss and transition. So there's heaviness, as well. I mean, I think that heaviness is just a part of our field. But I think there is certainly that in the recovery high school, I think what's nice is that there's enough growth and development, I think, to balance that out. It's not only the heaviness, and you always as long as that young person is coming every day, you always know that there's that opportunity for them to continue to get well.
Yeah, and just knowing that a lot of our work is planting seeds, even if we don't see the outcome of it. And that even if a youth isn't ready, right, then to make some of these choices, it doesn't mean that down the road, these conversations don't impact them or sort of what what that surface was didn't impact them.
I think one of the biggest changes we've seen in the field and just understanding addiction is that I think we realize that young people who might choose to stop using alcohol or drugs when they're 16, or 17. You know, they may use drugs again sometime in their life, you know, they may adopt a narrative when they're 17 years old, that says I can never use alcohol or drugs successfully in my life. But that's the narrative that's working for them right now. And you know, I've always thought, if they can stay clean and sober long enough to get a high school diploma to build those social skills, then if they actually do return to us anymore, maybe manage their use or those kinds of things. They at least have built that foundation and gotten their brain to a place that they will be better able to deal with whatever issues may arise. And the reality is, you know, maybe what was looking like a substance use disorder when they were 16 or 17. You know, maybe actually it wasn't, you know, maybe they were just having extreme issues or extreme problems at the time. And when the other pieces get taken care of. Maybe it's family, its relationships, maybe there's mental health, all of these things start to fall in place. Maybe we find ultimately the substance use disorder isn't so much that maybe they were having problems with their substance use. So I think as we back away from this Need to say diagnose someone or put a label on someone that they're going to have to carry for the rest of their life. And we say, you know, I'm here to help you. Now, I'm here to help you today. And this foundation that you have today will help you tomorrow, and it will help you next year. Regardless of what happens, we have to get out of the prediction business. And say that this 16 year old is going to be an alcohol and drug addict for the rest of their lives and will never be able to touch alcohol and drugs the rest of their lives. That may be true, but you know what? It may not be. And then that historical work I've done, you know, talking to kids that went through schools 30 years ago, some of them have started using again, or drinking again, some of them never have, they have 30 years of sobriety under their belt now. But all of the people I've talked to look back and say, you know, that period of time, whether it was a few months, or a couple of years in that recovery, high school, is what I needed at the time, it was what I needed as a teenager, to be able to get through high school and make it to the next up. And they are they are very positive about having that in their lives at that time.
It makes me think so I don't work with substance use of recovery. But in the adults that I see, there is this sort of narrative about the kind of parents they had, who maybe struggled with substance abuse, and sort of when we explore and unpack that, that for many of their caregivers, or parental figures, it's almost like that development, like you said that foundation was never established. And so it creates this environment of just constant chaos, which then further perpetuates being victimized, you know, being entangled in like the legal system. And so kind of going back to how education can contribute to substance use recovery. Could you expand a little bit about that, as we talk about, we can get the education piece and then sort of the role of counselors? How have you seen education contribute to recovery?
Sadly, I must say, I think more often than not, our schools probably contribute as much to the problem as they do to the solution, just by the way our systems are structured, and how big our schools can be some of the disparities in the system, I think, sadly, our school system more often than not, and make things worse, or at very least, not make things better. I think the opportunity, though, exist in the school system, because they have the students under their care, most of the day, you know, from the time a child is very young, until a child graduates high school, they're in that setting eight hours or more every day. And if they're doing clubs, it could be 12 hours a day, in that space, with caring adults with people who have training, and with peers. So when you think of it that way, the opportunity for the education system, to be a real positive force is there. I think some of the issues have come from the fact that schools tend to only think of themselves as educational institutions. And I think that has changed a little I think that the the mental health crisis that our young people are facing, especially after the pandemic, I do see a little bit of cracks in the armor, so to speak about, we're here for the academics, and that's our primary goal, I see some openness to letting mental health in, it feels sometimes maybe a little bit flat together, and maybe not as well thought through as I would like. But I think that opportunity exists to provide a continuum of care, to have professionals that are there to identify things early, that can be done through screening. It can be done just through regular check ins with students. And then when a problem is realized when someone's starting to see things to be able to either refer or provide the services. You know, many of our schools do have mental health agencies in the schools. But again, notice how I continue to say, mental health. It isn't as common to have substance use services in there, or the mental health clinicians are tasked with doing it, even if they don't have the training. And so I think making sure that the mental health professionals in the school have the training and addiction and especially the specific properties of youth and substance use so that they understand that they know how to approach it. And then I think if we could have a stronger treatment infrastructure, I would love it if our education systems would find ways to provide Free, low intensity outpatient services somewhere. There are examples of that, by the way, there have been some districts around the country that have done that, it's very uncommon, but that our students might be able to get treatment services at no cost. And then if that still doesn't work, partnerships with other community agencies can now start to bridge the gap of the kids at the most profound issues. But that's a continuum or cascade of care. That could exist in our education system that honestly doesn't except for just, you know, unique pockets around the country. Yeah, it
almost seems like if we can build in more support than using the substance or spending time with people who would, you know, promote using the substance, that's just one of many tools youth can use. And then instead of it being the primary tool, because they don't have adults, they can talk to you about some of this, or they don't have people who understand the complexity of their experiences and challenges. No,
and I think it gets really confusing for a young person, because, you know, the more we talk about decriminalizing substances, and you know, that really is something in my view, that needs to happen so that people don't get put into the justice system in the criminal system because of alcohol or drug use. However, our country is trying to sort through how to best do that. But for you, they see that happening, they see substances like cannabis becoming legalized and sold in stores, the risk of any of these things starts to diminish. And I don't think young people necessarily think through the nuance all the time, what this might mean if they start using the substances. And that part concerns me some, because I think our school system in particular doesn't embrace that challenge doesn't embrace that responsibility to do the proper education, the proper screening, the proper referral, the proper service provision, that that I guess just falls to whose society parents, you mentioned, kind of chaotic homes. Now, for a lot of kids who are getting involved with substances, they're in homes, that don't necessarily have the capacity to know how to handle that. And so the kids are on their own. And that's a tough place to be, especially if your judgments being impaired by alcohol or drug use, and your peers that are doing that. So I think all of those things are places where I think our society be nice if they took this maybe a little bit more seriously for young people, and started to think beyond just overdose prevention, which is great. We need to have overturn prevention, we need to have universal education and prevention. But there's this whole group of people who aren't necessarily overdosing, but are developing a substance use disorder in front of our very eyes, and are not getting the attention they need to deal with it. Yeah.
And I get that for parents and caregivers, it probably seems like a lot, because if we're fighting, you know, the dangers of the internet and having smartphones, and then also, you know, sex traffickers, and there's a lot to focus on. And so in your opinion for counselors, how can we improve our support for young people in emerging adults in this area?
Well, first of all, I think get training, I think, you know, make sure, thankfully, this is now something that is more a part of our counseling, training is addictions courses, right. But, you know, still school counselors. It's not necessarily something that they're required to take. And, you know, in my coursework, you know, the, the school counselors that are in those classes are much smaller in number than the mental health counselors that are in those classes. And then you have to ask yourself, how many of the mental health counselors that are getting the addictions training are ultimately going to work in schools, or ultimately see them working with school aged kids? It's, it's rather small when you think about it. And so now we're realizing that students are working with counselors who don't necessarily have that training. So to me step one, is realize that if you are working as a counselor, whether it's a school counselor, or clinical mental health counselor with young people, addiction will be part of what you're working with, whether it's the young person who's starting to try or use alcohol or drugs, or they're in a family system in which its present. It is going to be something that impacts your work. So learn about it, understand it, look at your own beliefs about it. You know, back to this idea of what do you believe causes addiction? What do you believe is the root cause, challenge your biases, understand the progression of this and then once You've learned that what are the screening instruments? What can you use, so many of our school districts won't even allow that to happen. They won't allow, say, universal screening. Because there's this fear that if we identify something, now we're going to have to deal with it. So it's better not to identify it. So look to those school districts around the country that have implemented things like screening and brief intervention and referral to treatment. That's called SBIRT. And it's an evidence based approach. And there are districts around the country that have implemented it, there are exemplars of it. And I think, once you've got addressed your own training, as a counselor, understand what types of programs work for young people, and start to advocate in your district, to have those put in place, whether you're a school counselor, or a mental health counselor,
it makes a lot of sense, if individuals want to dive deeper into this, so maybe it's not a part of the curriculum for whatever reason, or they feel like they want to know more, are there resources that you do recommend or starting places, books, anything that you would definitely lead individuals to?
Yeah, I think certainly, if you're incident recovery, high schools, the Association of recovery schools, website, and and there's a annual conference that that is done in conjunction with collegiate recovery programs. So there's lots of information out there for you to educate yourself on that. I think if you've not, if you don't have a good understanding of us than addiction, I do think there's materials that SAMSA puts out the substance use and mental health services administration. And there's trainings that you can get on that if you don't feel prepared for that. And I've actually found even some barrel popular resources that you may have heard of the movie beautiful boy, I think things that could be, you know, maybe not feel as academic or empirical. But I think when you watch things like that, you start to get an understanding of what substance use can look like. And then the people that put that film together, have they've written books, the father and son T
Yeah, they each have a memoir, just heartbreaking, but so beautiful.
But you read that, and now I think you get maybe a little bit of personalization. And that's not an extreme case, you know, I, I, when I watched that movie, I thought, wow, that could be any one of the kids recovery, high school, he didn't have access to that. But that's what happens when you don't. And he's fortunately, he's alive today. But that could have gone another direction. And so I think you see that and you start to maybe get an understanding of what this could look like, outside the school day. And so I think those kinds of things can also be very helpful.
I'm glad you brought up the media, because I do think that can be, you know, while it might be like Hollywood's version of it, it can be very powerful to get that message. Like I even think back I show this clip of The Basketball Diaries, when I talk about, you know, how to help equip family to support those that are in addiction to recovery. And it's just excruciatingly painful, especially if you're a parent to kind of put yourself in that position of Leonardo DiCaprio is mom and how you support your child, beautiful boys. Another beautiful example of that, too. And I tried to recommend for individuals, if you have a bias, read those memoirs, watch the movies, because in reality, if we humble ourselves, we're only X amount of decisions away from even finding ourselves or the people we love in that place. And so I know with my adults, when there is some judgment with my adult clients about, you know, good schools for my kid or bad schools for my kid, the fancy beautiful schools also have substances in them, they might be different substances, they might be masked differently, but that that can be a present threat anywhere.
Yeah, and I think the other part we talked about, understand your biases and your beliefs. You know, unfortunately, a lot of our portrayals in the media are not digging into the disparities that exist as well. So I think when we start to see people who don't have access to the treatment system, or don't trust the treatment system because of historical problems with it, how are we helping them? Again, I think it's another opportunity for schools, you have kids in schools, if we can provide services at that level, that we're not having to refer them out to agencies that they either may not be able to access or may not trust, I think sometimes just trusted the system can be really low. But I think we could also as counselors in a school system start to recognize Wait a minute, why is this child getting referred for disciplinary around the same issue that this child is going to treatment to get dealt with? And I think those are things that we can do at a real micro level, to intervene and to recognize, wait a minute. That's not a bad kid doing something horrible any different than this other kid doing that. But that can sometimes be, we have to check ourselves if we have an immediate belief that drug use is just a result of bad choices made by people, now we're gonna start to judge people, and we'll feed the disparities. And so I think those are places to where some of these things that have been portrayed in the movies and media, which I think can be helpful pathways may not be pathways that had been accessible to all. And so I think we have to realize that sometimes that could be our best form of advocacy is to interrupt that disciplinary pipeline when we see it. Yeah, cuz
to me, it kind of seems pretty clear and logical, then that helps to neutralize shame. Because if you're not the, quote, bad kid in the school, if you're not the one that you know, people avoid, then there's this area of like connection of understanding your worth, and maybe neutralizing some of the other compounding factors that even lead to substance use.
We can't just sit back and think, oh, that's going to take care of itself, the kids will find out, let me just put this kid on a team or have this kid work with these pots. Because again, all of those ways that play themselves out in society will play themselves out in the school and those connections won't be forged. I think we have to find ways to help the child find connection. But it starts with us. I think it starts with looking at ourselves and how we view the situation and the depth of the situation.
Yeah, and I know, we alluded that, you know, the work is clearly difficult and hard, like much of what we do. But I also just think how much pain and suffering can be saved if you can be more preventative or get these kids early on versus decades of substance use, because I have had clients of that with this history of it, and just the complex trauma they've experienced because of situations they've been, and that takes so many years to unpack and try to recover from hitting him earlier, like in these recovery, high schools, what just that could do for the whole society?
Well, I think you've named it with the trauma, I mean, trauma is a part of it for just about every young person, whether it's trauma they experienced in infancy, or you or the trauma, they experienced that part of their alcohol and drug use, or both. And so, you know, understanding that trauma is a part of this, and the recovery, high schools, you know, recognize that and that's part of what they are providing is care that recognizes that these are students recovering from trauma, as well. But I think beyond the prevention, I think we have to have I like the tiered view of prevention. I think there are some kids that that universal is going to work. There are some kids that that early intervention that we get to it really early is going to work. But then there's those kids, and it's a smaller percentage, but they've already developed the substance use disorder. So the type of prevention they need is prevention around that becoming worse, and prevention around returning to us that they've decided to stop. And that's a smaller percentage. And sadly, in our society, the smaller group of people sometimes doesn't get the programming is just the money doesn't go as far so to speak. And I think if we can flip that and realize, you know, the ripple effect of helping people who are in the most profound, profound need that ripple effect helps everyone so it's both and and not either or, which
is why we need all hands on deck. So I really appreciate it and you you sharing not only your story, but sort of a pathway that maybe hasn't been explored or maybe counselors don't know about it and that there is work being done and has been done for decades that they can play more into.
Thank you. Thank you. Definitely enjoyed being here. Appreciate you having me on.
Thank you so much. And this is another episode of the thoughtful counselor.
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