If Your Child Is Asking For Help — Motivated To Attend:
Give your child as much information as possible regarding the treatment providers that are available. Encourage him/her to be part of the selection process. If your child is mature, socially skilled and assertive enough, have him/her participate in the initial telephone consultation described in section 4 of this booklet.
If Your Child Is Denying And/Or Resisting The Need For Help — Not Motivated To Attend:
Introduce the idea of seeking professional assistance to your child at a time when emotions are calm. If your child gets angry, denies the need or rejects the idea and you feel strongly that treatment is necessary, then proceed by researching and selecting a treatment provider on your own. Do not include your child in this process and do not keep him/her posted on your progress; to do so may create counterproductive conflict and stress.
Once you have made the initial appointment, inform your child about the appointment and your expectations for him/her to attend.If you anticipate a strong amount of resistance from your child, inform him/her of the appointment shortly before you need to leave your house to attend. Do not allow for a large gap of time between informing your child and leaving for the appointment. To do so may provide your child with the opportunity to argue, challenge and wear you down enough that you find it difficult to follow through with your decision.
Suggestions for informing your resistant child about your expectations for him/her to participate in therapy.
- Sit down with your child (both parents whenever possible) in a private and comfortable place.
- Use a calm, respectful but assertive and directive tone of voice.
- Explain to him/her exactly what is about to take place. Provide as much detail as your child is receptive to hearing regarding the time of the appointment, the treatment provider you have selected, the location of the provider’s office and what he/she can expect during the first meeting.
- Take full ownership and responsibility for your decision to seek professional help. A good strategy is to say, “Today we are going to meet with a counselor…I have decided to make the appointment because I am concerned about what is happening in our family…(Be concrete and specific) We have had five “fights” in the last three weeks…” If you must place your concerns directly on your child’s behavior, say, “I am concerned because your grades have dropped from B’s to C’s…you seem real angry, you yell and curse at me and your brother…You were suspended from school and you keep telling me you don’t care about school or our family…” Conclude with your expectation for cooperation by saying, “I really need and expect you to cooperate…”
- Avoid blaming comments, “You are going to the counselor because you are doing terrible in school…” Avoid sounding angry or frustrated. To do so will put your child in even a greater defensive state and intensify the resistance and stress of the moment.
- Decide on and tell your child the exact number of sessions you are going to require him/her to participate in. Set the number of sessions at an amount you think your child can accept. The benefit of providing your child with a “light at the end of the tunnel” is that it usually helps take some of the edge off of his/her resistance and helps get him/her through the front door of the treatment provider’s office. Once there, it becomes the treatment provider’s responsibility to make a connection with your child that will hopefully lead to your child deciding to voluntarily participate beyond the required number of sessions. If your child does not choose to participate voluntarily beyond the required number of sessions, my experience has been that forcing him/her to do so will have little to no benefit. In fact, it may make things worse by further straining and damaging the relationship between you and your child. If your child participates in no more than the required number of sessions, at the very least the treatment provider will have had the opportunity to complete an assessment and report back to you his/her findings and strategies for addressing your child’s difficulties through means other than individual outpatient therapy.
- Inform your child of the following principles he/she can expect in meeting with a treatment provider: Say, “You will be asked questions about school, family, friends, areas of interest and how you are feeling. You do not have to talk about anything you do not want to. If the treatment provider asks you a question that you are not comfortable with, you do not have to answer it. What you discuss with the treatment provider will be confidential with the exception of behavior that might be of danger to you or someone else (includes substance abuse). The main goal of your first meeting (and the first several sessions) is for the treatment provider to get to know you and what’s going on with our family”. If your child seems receptive, educate him/her as much as possible about the counseling process. The only exception to this is in situations concerning substance abuse treatment. If your concern is substance abuse please read the recommendations below being sure to follow the prescribed precautions.
WHEN THERE IS A SUBSTANCE ABUSE CONCERN: If your primary concern with your child is substance abuse, you can probably expect a very high level of denial, resistance and anger from your child when informing him/her of your plan to take him/her to a counselor. Be prepared to handle and not allow your child’s resistance to deter you from your planned course of action. If you are a single parent and you do not have the support of your child’s other parent, you may want to ask another adult family member to assist and accompany you to your first treatment session.
If you have selected a treatment provider that is qualified and trained in the treatment of substance abuse (it is highly recommended that you do), you can expect that a drug and alcohol urine screen will be collected during the initial meeting. To prepare your child for the first meeting, follow the strategies outlined in the IF YOUR CHILD IS DENYING AND/OR RESISTING THE NEED FOR HELP section of this handbook, with the exception of the following precaution: Do not let your child know that a drug and alcohol urine screen will be part of the evaluation process. This is crucial because young people today have methods for passing drug tests even if they have been using substances. It may also intensify your child’s resistance to attending and participating in the counseling session. If your child specifically asks if he/she is going to be tested or evaluated for substance abuse, tell him/her that the first session is part of a comprehensive assessment that includes a substance abuse evaluation and that a urine test might be included. Stress to your child that there is nothing that can be discovered through the assessment that you are not prepared for and ready to deal with by being understanding and supportive.
It is important to note that if your child undergoes a drug and alcohol urine screen and it returns negative, it does not conclusively mean that your child is not using drugs or alcohol or that his/her current difficulties are not being caused or compounded by his/her use.
Facts parents need to know about drug testing:
- Young people today have methods for adulterating and passing drug tests even if they are using drugs and/or alcohol.
- Drug-testing standards vary greatly. “Zero cut-off” means that any level of a substance in the body will be detected by the test. Most drug tests do not have a zero cut off limit, which means that even if the test comes back negative your child could have a level of drug within his/her system that was not detected by the test. Many physicians do not use a zero cut off test. Their cut-off level might be high relative to typical adolescent drug use patterns. For this reason it is important to know the cut-off level of the drug test being administered. Whenever possible, request that a zero cut-off drug test be administered.
- Many drugs (cocaine, ecstasy, ketamine, LSD, PCP) have a very short half-life in the body, which means that they may be undetectable by a drug test within hours (3-6) after they are last consumed.
- Drug tests only test for specified drugs. If your child is using a drug not specifically being tested for, then the drug test result will be negative.
Because of the numerous variables that impact on the results of a drug test, no one test should be considered 100% conclusive regarding an individual’s substance involvement. It is recommended that the drug test be administered as part of a comprehensive mental health/substance abuse evaluation facilitated by a professional trained in the treatment of substance abuse. A professional trained in substance abuse can advise parents on the probability of substance involvement beyond that indicated by the drug test results.