What’s different about AOD treatment for young people?

By Cameron Francis Social worker, Dovetail

In this article, I will give you a quick overview of some of the ways AOD treatment for young people is different to treatment for adults. Young people are more than just mini adults. They are as diverse as any other group in the community, and so some of what we’re talking about may not apply to all young people, all the time. Instead, this is a rough guide, designed to get you thinking.

Who are young people anyway?
Different government departments and jurisdictions have different understandings of what ‘young people’ means. It can be defined as 10–17 years of age, or 12–25 years of age, or any number of other combinations. The service provided to a 12 year old will be quite different to that provided to a 25 year old. There are specific issues with managing these age ranges within one space. Do we want our comparatively naive 12 year olds hanging out in the waiting room with our more streetwise 25 year olds? Workers may require specific training to work across these age ranges. Very young people may not have highly developed verbal abilities, and could need creative approaches to exploring thoughts, feelings and behaviours.

Exposure to risk
We know that young people’s brains continue to develop into early adulthood. Young people aren’t as good at assessing risks as older people are. Young people often have very little power within the illicit drug market; they can be exploited, ripped off, or sold adulterated substances, whereas a seasoned user would have a better understanding of the dynamics of the drug market. Young people sometimes face increased risks in the environments in which they use substances. Many adults use substances in the comfort of their lounge room, whereas many young people need to locate to other places to use substances; this may include public places like parks, or in places away from adult supervision.

Exposure to trauma
There’s a huge amount of research showing high rates of trauma experienced by young people and adults in AOD treatment. For some young people, this trauma can be very recent and in some cases current. They might be living in an environment where they are still experiencing physical, sexual or emotional abuse. The constant exposure to trauma can make treatment difficult. It can mean that the focus of our treatment shifts away from their substance use, and onto the immediate risks they face and strategies to keep them safe.

Family involvement
Everyone comes from a family of some kind, but for young people their family is often—but not always— central, and needs to be addressed in treatment. We know that young people do better in AOD treatment when there is family involvement. This can be difficult to negotiate, especially if a young person really doesn’t want their parents involved. Perhaps even trickier, is the scenario where a young person’s parents have significant AOD problems themselves, and in some cases may have introduced their young person to substance use. Services need to be prepared to manage these kinds of family dynamics sensitively and supportively.

The conventions of help-seeking
Many young people don’t understand the conventions of seeking help for a problem. For young people, the service system can be confusing. Talking to strangers is daunting at the best of times, but talking about personal problems (sometimes including illegal behaviour) with an adult you don’t know, can be too much for some young people. We can’t just sit back and wait for young people to rock up to our service, and ring that little bell sitting on our front counter. We have to actively get out of the office, hang out in spaces and services that young people do go to, and show our worth.

You’ll notice that many of the above issues are also relevant to adults. We agree! We think that every service can benefit from being more youth friendly. If you make your service youth friendly, you are unlikely to scare off your adult clients. But if you work in a cold, clinical AOD service—full of plexiglass and grey walls—young people might not feel as welcome they should.

Youth friendly service checklist

Environment

• Does the service look and feel youth friendly (e.g. posters, music, magazines, colour)?
• Is the service easily accessible by public transport?
• Can young people happily walk through your doors (i.e. confidentiality)?
• Are young people kept safe in your waiting room and areas around your service?

Values, attitudes and practices

• Do you have a clear confidentiality policy which is explained to all young people in simple, easy to understand terms?
• Do staff have access to ongoing training and professional development around effective work with young people?
• Are there effective feedback mechanisms that seek out the opinions of young people, and takes their feedback on board? (Hint: a complaints policy is not enough!)
• Does your service have some clear policies and procedures around family involvement in treatment?

Access

• Do you have a simple intake procedure that allows a young person to speak with someone immediately (e.g. without a Medicare card)?
• Do you have a short waiting list?
• Do you offer SMS, email, Facebook etc. appointment reminders?
• Do you have appointments available outside regular hours, and in other locations closer to young people (e.g. like school).
• Does your service consider the specific needs of Aboriginal and Torres Strait Islander young people, young people from culturally and linguistically diverse communities, and/or LGBTI+ young people?

Learn more about youth and AOD from Dovetail.

Photo cc by 2.0 State Farm