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Substance Use Program and Recovery Settings

Tailored experience for youth-serving professionals in substance use program and recovery settings

Reaching Teens Portal for Substance Use Program and Recovery Settings

Virginia Hoft, NCAC-II, LCDC

Executive Director, Tarrant County Mental Health Connection; Former National Director and Vice President of Substance Use Services, Youth Advocate Programs, Inc


I am an expert on substance use, trauma, and recovery—in my life.

I was one of those young people who found temporary relief from the pain and struggle in my life through the use of alcohol and drugs. I was born into a family with a father who suffered from alcoholism and other mental health issues, which created a highly unstable, unsafe, and chaotic home environment.

As the first born, I was charged with providing comfort and support to my emotionally depleted and financially responsible mother. My job beginning at around 8 was to fill in the gap by providing direction, protection, and discipline for my three younger sisters while my mom tried to “manage” my father and “put food on the table.” The result for this child was having feelings of being overwhelmed and ashamed.

Because of my family’s financial situation, a “scholarship” to the local parochial middle school proved to be both a blessing and a curse. In a well-meaning attempt by the school’s leadership to teach the life lesson of “earning your keep,” I was obligated to mop the floors and dust the administration offices after school in view of the other students. My tumultuous home life combined with being teased for being “a poor kid” resulted in feelings of being different and a sense of being not enough.

That was, until I discovered the magical effects of alcohol and drugs. Because of my genetics and specific brain chemistry, I experienced the physiological relief provided by those chemicals. Also, I accessed a peer culture that was a welcoming sanctuary for “misfits” and a social circle that I could feel “a part of.” That was, until it didn’t.

I represent the one in four whose adolescent alcohol and drug use progress to a substance use disorder in early adulthood. When that happened, my “remedy” became the malady and the cycle of self-destructive behaviors compounded the trauma and hopelessness.

I am an expert in knowing what this young person needed from the adults in her life and the healing power of compassionate and loving relationships. I needed adults who understood that my behavior and decisions were not merely “choices,” but were reactions driven by misfiring brain signals and adaptive attempts to manage my stress, pain, and shame. Because I found those adults—or maybe they found me—I was given the opportunity to parlay that hope, healing, and resilience with education, training, and work experience into a 30-year career in the field of substance use and recovery.

The majority of those years were spent learning from other experts—adolescents and young adults struggling to find relief from their pain and shame in a bottle of beer, or pills, or in a pipe filled with white powder or green leaves. Experts who then scrambled to find an option when the familiar relief was no longer an option, and the shame and isolation had been fed by more voices—internal and external—reminding them that they were “worthless” and “lost causes.” Until people like you and me provided different voices that reminded them until they could remind themselves, that they were extraordinary, but misdirected; they were lonely, but not alone; they were imperfect, but not worthless. Until people like you offered to loan them your hope until they could find their own.

Today, I am a professional who is trauma-sensitive and informed of the impact of trauma on the brain, body, and spirit. I have experience in implementing programs and writing proposals backed by research, neuroscience, and data about what I have learned. I continue to learn the importance of using best practices for listening intentionally, and caring with boundaries, while holding young people accountable. Most importantly, I continue to learn that they are the experts in their lives, and that when I truly hear, respect; respond without judgement and bias; and keep my expertise from getting in the way, I get to be a broker of hope and an example of what’s possible in long-term recovery.

So, why is Reaching Teens important to those of us who work with young people using, abusing, and dependent on alcohol and other drugs? Because it provides those tools needed to learn, listen, and love the real experts. It helps us increase our knowledge and become healthy brokers of hope.


Why a Portal for Substance Use Program and Recovery Settings?

As an observant youth services workforce, most of us recognize that substance use is very often “interwoven” in the lives of young people who have experienced trauma, complex and chronic stress, and adverse childhood experiences. Research has provided a clear link between trauma and adolescent substance use, with trauma as both a risk factor for substance use and, conversely, substance use as a risk factor for trauma. Many are aware that using alcohol and other drugs is an ill attempt by some youth to ease the pain of grief and loss, but understand that in the long run substance use exacerbates the cycle of destructive behaviors, making it increasingly difficult to recover. Consequences of one situation compound the difficulty of the other.

Youth dealing with traumatic stress and those with a substance use disorder have many similar ranges of symptoms and patterns of behaviors. The schism that often exists between the mental-health and substance-use fields can interfere with implementing the most effective and individualized approaches. Consequently, in order to be trauma-sensitive in serving this group, all practitioners must understand the implications of both mental health and substance use. Young people are not served well when only their substance use is addressed without considering underlying mental and emotional health issues. It is equally as true that mental and emotional issues cannot be treated adequately without considering how substance use is exacerbating those issues.

Further, we must look beyond the immediate circumstances and consequences of the youth’s substance use and recognize that it most often began as a coping pattern of dealing with painful experiences. This positions us to help young people consider alternate ways to handle the pain in their lives. If we miss this opportunity, their emotional dysregulation will continue unabated and that can drive increased substance use or a recovery relapse. And, we must identify and understand an individual’s progression of substance use, grasp their stage of change and approach our intervention sensitive to where they hope to go and where they currently feel stuck. We must engage them as experts in their own lives central to their healing processes.

This portal will navigate you to chapters to help you develop understanding and trusting relationships with young people necessary for them to explore both their perceived rewards and consequences of substance use, so you can develop an accurate appraisal of what they need from you.

Many youth-serving professionals have been educated on the amplified impact substance use has on the adolescent brain and how it greatly contributes to early progression from voluntary to compulsive drug use. During this time of the opioid crisis, the increasing popularity of e-cigarettes and vaping, and the growing legalization of marijuana, it is critical that as responsible professionals, we understand the relationship between neuroscience and adolescent substance use. The lack of informed family members, educators, and professionals in the juvenile justice, welfare, and foster care system, and even some in the medical profession, often results in marginal impact or missed opportunities for early interventions. Consequently, many find it frustrating, confusing, and even painful to watch a young person seemingly making choice after choice that has long-lasting and often dire consequences. Armed with this most up-to-date research and best practices, it is the responsibility of those of us working in the field of substance use and recovery to take every opportunity to inform and educate other youth-serving professionals and family members. Their increased understanding can lead to empathy, which is a key to creating a trusting relationship.

All the factors described here make it abundantly clear that understanding substance use is key in being a trauma-sensitive workforce. The documented increase in youth suicide, depression, and isolation resulting from increased use of technology, uptick in community violence, and hate crimes are all indicators of increased youth trauma and consequently increased vulnerability to substance misuse. The current environment requires us to be skillful in identifying behaviors and responding in a trauma-sensitive way to young people to prevent, intervene, or interrupt the progression of substance use. Therefore, we all must bring our “A-game” armed with the most recent research and best practices. It requires that we continue to learn new skills, and have the courage to explore and challenge any biases and uninformed ideas we may still hold about youth, alcohol, and drug use. It also means we must consider new approaches that may fly in the face of the “way we’ve always done it.”


What Is Included in the Portal for Substance Use Program and Recovery Settings?

Reaching Teens provides you with an abundance of skills necessary to meet the challenges presented when serving young people using or abusing alcohol and other drugs. All 95 chapters provide the reader with a breadth of information, examples, and exercises to help develop trauma-sensitive skills and approaches. But, let’s admit it, 95 chapters can be overwhelming. We genuinely hope you will look at the table of contents and engage with as much content as you can, but this portal offers you a strategy to streamline your experience.

This Portal for Substance Use Program and Recovery Settings provides a “navigation table” to direct you to prioritized chapters that will help you in honing those skills necessary to best meet the needs of young people struggling with substance use.

The selection of these chapters was guided by two over-arching questions:


Selected Chapters for Substance Use Program and Recovery Settings

Chapter 70, “Adolescents and Substance Use” and Chapter 71 “ Adolescents and Opioid Use” in Section 9, are devoted to the topic of substance use and provide a foundation for the remainder of the portal.

Below are additional selected chapters.


Helping Young People Learn Self-regulation Both to Calm Their Minds and to Improve Their Behavior

Finally, you may decide that your group wants to navigate Reaching Teens by building skillsets. See Themes and Chapter 10 for all of the units that you might consider. However, one unit that professionals serving youth who have substance use problems might find particularly helpful is below. You will note that most of the chapters are familiar to you as they have been selected as key to your learning. The below unit suggests a group of them that hang together as you support young people to build their self-regulation skills.

Primary Chapters
Supportive Chapters

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