Opinions & Essays, 8/1993 - 12 Step/Whole Child Programs

The decision by CEDU Schools to add 12 Step work to the regular CEDU curriculum, is, in my opinion, an exciting and constructive development in the field of special purpose schools. CEDU has always been a pace setter with high quality work with behaviorally difficult teens. I hope this action signals the start of a very big trend in Special Purpose Schools.

As a person who has had a long career with adolescent drug and alcohol abuse, I have been alarmed by the tendency at some of the structured boarding schools to confuse oppositional behavior and addictive disease. The two conditions can look very much alike to a referring professional. The appropriate interventions for both conditions have much in common. With over twenty years experience in dealing with both conditions (my mother still considers me oppositional) I am still not always sure which I am seeing.

There are really two problems. One is that teenagers who need addiction treatment, but are placed in a program for oppositional behavior (or vice versa) simply are not going to leave equipped to function well in the outside world. The other is the lack of excellent programs equipped to deal with both issues, when we know both are issues for the same youngster. Just because Fred is oppositional, that doesn't mean he can't have a drug or alcohol problem. CEDU's move addresses both problems.

We often attempt to make a school designed for oppositional behavior work for teens with drug alcohol problems for several reasons:

First, the behavior which presents in either case looks so much alike. It is really hard to tell the two apart. We think of drinking and drug use as a special case of oppositional behavior.

Second, 99% of the time we underestimate the seriousness of the drug/alcohol use impact on the teenager. Teens usually minimize their use and parents don't want to think in terms of addiction. So we hear phrases like "this kid's behavior is out of control, but the drug use is just minor experimentation. Of course, he drinks. Doesn't everyone?" Minor experimentation does occur with well functioning teens, but quotes like that, in my experience are almost invariably self delusion, when applied to an oppositional youngster.

Third, the type of program which effectively addresses oppositional behavior will be an environment in which the drug/alcohol user (who is not otherwise oppositional) will thrive and appear to be a super-star (The converse is not usually true; an oppositional student will usually become more actively oppositional in a setting for drug/alcohol intervention only). For as long as the drug/alcohol user is in the school, parents and referring professionals are likely to react by saying things like, "What an amazing change! Too bad we did not do this years ago."

The problem is, the change may just be due to the fact that the student was temporarily denied access to drugs or alcohol, not that they have learned anything at all about how a person stays sober when addictive substances become available again. The student, if merely addicted, probably did not need the therapy offered; s/he probably only needed to be kept sober in a healthy environment. Very often this student will become a campus leader, and will seem to best personify what the school is trying to foster, just as any healthy non-oppositional teen would do in the same environment. In just a few months after discharge, the same student is very likely back at the height of active addiction, as if the school had never been there. The disastrous results of the fact that the student got no help at all with the matter of how to stay sober after leaving the school, do not surface until after discharge. Of course s/he is responsible for his/her own behavior, but the specific skills needed to meet that responsibility were never offered.

Fourth, the types of intervention look very much alike. So the question gets raised, why have a special program for the addicted, when special purpose school "A" does most of the same things as an addiction program? Actually, this goes straight to the heart of why it is so appropriate for a school like CEDU to add an addiction component. Most of the program is applicable either way. But the component does need to be added if addictions are to be confronted, because a program for just oppositional teens will not address the special skills and practices an addicted youngster must make part of his/her lifestyle in order to survive after discharge. Conversely, a program for addicted teens only will not adequately address the need for the youngster to establish complete independence from all supports. In addition, the many (but not all!) teens with primarily alcohol and drug problems, will progress much faster than oppositional youngsters, and need an environment flexible enough to allow high levels of responsibility early, in selected cases.

Of course there are those special purpose schools which say "We meet the drug/alcohol need by advising the affected students to go to AA or NA after graduation, although we make no modification while they are with us." That kind of approach is either incredibly naive or intentionally deceptive, as there is no way kids involved in intense personal growth programming will begin to work with the complex issues of addiction and integrating into the adult dominated environment of AA or NA, when their school did not see these things as important during their stay. Oppositional and addicted kids share an uncanny capacity to detect double messages. In my over twenty years in addictions, I have never known a single case in which a teenager has actually gotten involved in a twelve step group by this type of route.

My own choice for teens who may be both oppositional and substance abusers, will be facilities like CEDU, which are prepared to address both issues.

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