Engaging Parents In Addressing Teen Substance Use Patricia Aussem, LPC, LMHC, MAC, NCC Partnership for Drug-Free Kids Consultant

Stages of Change Parents are in different places along the path to changing behaviors so different strategies and messaging may be required.

Pre-contemplation Unaware of Risk Factors Unaware of Use for the First Year “A lot of times I would sleep over at Bill’s place, cuz that was kinda like the place, like his parents didn’t care so we’d always have a bunch of people over there, a lot of times I just wouldn’t go home at night.” (male, initiated in middle school, Kingston et.al. 2017) Unable to Recognize Use/Intoxication Not Living at Home SBIRT and HIPAA – you know but parents don’t know Unaware of risk factors – Have ADHD or other underlying mental health problem, but aren’t made aware that this child could be at risk for an SUD Unable to recognize use/intoxication – are gummy bears gummy bears, not knowing Juul has nicotine, Not Living at home – at camps, college, living on own

Pre-contemplation Permissive Perspective Know kids are using – no concerns due to own experiences Rite of Passage View substances in classes (alcohol and marijuana are ok) Necessary to inoculate children

Contemplation “Slow dawning” phenomenon “I had a feeling that something was wrong but didn’t want to confront my child until I was definitely sure.” “My teen’s grades dropped, but I just thought it was a phase he was going through.” Complicated by stigma, beliefs about fitting in, and perceptions about what other parents allow Aware of risk factors but don’t know what to do about them 1 in 5 families with children ages 10-19 believe they have a child with a potential drug or alcohol problem (PATS, 2009) Slow dawning: 53% acted immediately, 22% waited 1 month to a year to take any action, 25% took no action at all. Complicated by stigma and beliefs about fitting in (Debbie and “normal drinker” or Sharon and a win if autistic kid is invited to a party. Aware of risk factors but don’t know what to do about them (ADHD treated but not helpful) – often given a list of protective factors but is it enough and how do they get implemented.

Contemplation Not sure how to parent an adolescent When asked to think, as a parent, about why parents don’t speak to their children about marijuana, the most cited reason 36% Not Knowing What to Say 32% Lack of Comfort with the Topic 23% Not Wanting to Encourage Use Marist Poll on “Weed and The American Family” 4/17 % Not sure how to parent an adolesent = Stacy’s work as well as PATS Data PATS, 2009

Preparation Where to go for help/an assessment? Will they help? Is therapist trained in substance use disorders “Bigger fish to fry” phenomenon Risk minimization vs abstinence messages Issues with cost, transportation, time – job commitments, care for other children, stigma – if people find out will my kid still have friends? Experiences with Steve, reaction of counselors at Northeastern Child and Parent Society, panel presentation by pediatrician – don’t drink/smoke and drive – mixed messages

What to Consider Strategies and messaging by segments Pediatric mental health assessments Education of parents on risk/protective factors Educate parents on SBIRT screening process and recommendations What constitutes risks related to HIPAA – when can disclosure occur? Brain development – for parents and kids Norms correction Education of parents on SBIRT screenings and having conversations with kids about substance use – they don’t know that docs are looking at more than once a month as a problem – missed opportunity