Researchers and theorists involved in creating criteria for
substance abuse in the revision to Diagnostic and Statistical Manual of Mental
Disorders IV for version V are suggesting using language that implies substance abuse as
a “developmental disorder.” They believe
that substance abuse is a disorder that onsets when we are youth evolving in
chronicity the older we get. Along with
developmental foundations of the disorder, most see substance abuse evolving
out of many cultural contexts which either promote permissiveness or increase
healthier perceptions of substance use.
This is especially obvious for all of us that live and grew up in
Wisconsin where rates of alcohol abuse are astronomical.
Thus to treat substance abuse, the leading research and best
practices are promoting using both developmentally and culturally informed
methods to treat substance abuse. This
has been so obvious to many that have attempted in the past to treat adolescent
substance abuse using an adult model or people of color using a primarily
Caucasian normed methodology – it just doesn’t work. In fact, it does more than just not working
it often times increases substance abuse and repel individuals and families
from seeking help. Ask anyone that grew
up in the 70s, 80s and 90s and had to go through or be a professional in a substance abuse treatment program
and they will tell you that it was an awful experience with generally horrible
results. A common response of
professionals during this period was to blame the Teens for being untreatable
or too reactive when in fact it was the model of treatment that was flawed and
not the youth. An adult model of
treatment has substantially lower effectiveness rates with youth because it is
developmentally inappropriate. A very simple example of this that many treatment programs that are developmentally informed harness the natural forces of adolescent individualism to be used as part of the therapeutic process rather than miss labelling this resistance and trying "break" a teen of their defiance like many of the historic models attempt to do.
In the same vein, using Caucasian informed, normed, and
researched methods while working with African Americans or Native Americans
often results in the same perceptions by those seeking services or treatment
professionals. For example, a Caucasian
defined treatment approach is usually very individualistic and can use
disempowerment (i.e. confronting powerlessness) as a framework. Both these concepts can be more culturally
appropriate to white folks, but when working with many African Americans these
concepts can create frustration, fear and discomfort especially for individuals
that are strongly identify themselves within the black community. Similarly with Native Americans, using a
perspective that is not informed by culture and spiritual perceptions along
with not addressing historic and present experiences of prejudice can lead to a
non-empathetic experience which highly correlates with reduced effectiveness in
treatment.
Jeff Ryan, LPCIT, CSAC
Therapist
Get Connected Counseling, LLC
Appleton, WI
920-7506120