No. 41; Reviewed July 2013
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Many children and adolescents use alcohol and other drugs. Some develop serious problems which require professional  treatment. Examples of treatment include inpatient units, outpatient clinics, twelve step programs, and dual diagnosis units for individuals with emotional and substance use problems.

The decision to get treatment for a child or adolescent is difficult, and parents are encouraged to seek consultation from a child and adolescent psychiatrist when making decisions about substance use treatment. Other psychiatric disorders often co-exist with substance use problems and need assessment and treatment.

When substance use treatment is recommended, parents can obtain the information they need by asking the following questions from professionals:

  1. Why do you believe this treatment in this program is indicated for my child? How does it compare to other programs or services which are available?
  2. What are the credentials and experience of the members of the treatment team, and will the team include a child and adolescent psychiatrist with knowledge and skills in substance use treatment?
  3. What treatment approaches does this program use regarding chemical dependency; detoxification; abstinence; individual, family, and group therapy; use of medications; a twelve-step program; mutual-help groups; relapse prevention; and a continuing recovery process?
  4. Based on your evaluation, does my child have other psychiatric problems in addition to the substance use problem? If so, will these be addressed in the treatment process?
  5. How will our family be involved in our child's substance use treatment -- including the decision for discharge and the after-care?
  6. What will treatment cost? Are the costs covered by my insurance or health plan?
  7. How will my child continue education while in treatment?
  8. If this treatment is provided in a hospital or residential program, is it approved by the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO)? Is this substance use treatment program a separate unit accredited for youngsters of our child's age?
  9. How will the issue of confidentiality be handled during and after treatment?
  10. How long will this phase of the treatment process continue? Will we reach our insurance limit before treatment in this phase is completed?
  11. When my child is discharged from this phase of treatment, how will it be decided what types of ongoing treatment will be necessary, how often, and for how long?
  12. As my child's problem improves, does this program provide less intensive/step-down treatment services?

Severe substance use problems in adolescence may be a chronic and relapsing disorder. Parents should ask what treatment services are available for continued or future treatment.

If questions or doubts persist about either admission to a substance use treatment program or about a denial of treatment, a second opinion may be helpful.

Also visit AACAP's Substance Abuse Resource Center.

For additional information see Facts for Families:
#3 Teens: Alcohol and Other Drugs
#26 Understanding Your Mental Health Insurance
#42 The Continuum of Care
#68 Tobacco and Kids

See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins)

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