Does my teen need an IOP (Outpatient program)or group therapy?

Posted on January 1, 2023 View all news

Intro: The Every Brain Matters community understands how difficult and painful it is when you have a child or loved one with destructive behaviors such as using marijuana or any drug. We also know that each family navigates recovery and healing in different ways, applying valuable tools from many types of effective support systems. The information given here is taken from one of these reliable systems.

We are grateful that the Cornerstone Team Counseling community addresses these tough recovery questions and is allowing us to share their insight with you. Since it is beneficial to hear different perspectives, the following answers and opinions are from clinical staff, teens in recovery, and parents and do not necessarily reflect the views of the Every Brain Matters community. We encourage each person to take what they like and make their own decisions that benefit their families.

The Every Brain Matters community also does not recommend specific treatment programs but we are grateful to share the content from the Cornerstone community as a resource.

To learn more, please visit the support and resource page for families and find support meetings here.

Click this link to see this question answered during an ask it basket panel meeting:

What are the signs that my teen needs group therapy (outpatient treatment) or a higher level of care?

Perspective from Clinical Staff: The major sign that your teen needs a higher level of care is when they are not responding to their current program, and they are displaying through their actions that they are unable to refrain from self-destructive behavior without daily accountability. When your teen is not actively taking initiative in their recovery, their behavior is the same as it was when they were using, and they are continuously relapsing with substances or self-destructive behavior. 

Perspective from Clinical Staff: If they are unable to stay sober outside of a structured setting. If they are continuing to engage in old behaviors – dishonesty, not sticking with winners (sober healthy friends), and acting entitled while involved in their current program. Or if they haven’t responded to other types of therapy or counseling.

Perspective from a Parent:

My daughter continued to relapse and resist her current program and remain sober. In my daughter’s case she needed to transition to a higher level of care. Also, for me, it was a gut thing. I could feel it in my gut that my girl needed a higher level of care. I have learned in this program to trust my instincts and not allow fear and denial to overrule my gut.

Group therapy (IOP) was recommended for my teen when:

  • Participation in their current program and individual counseling were not proving to be effective.
  • Continued to relapse and remain sober.
  • Resisted her current program.
  • Previous treatment attempts have failed.
  • The teen is currently in residential treatment and needs to transition into an aftercare or step-down treatment plan.
  • Their use has reached crisis points such as an overdose or use of other drugs.
  • Suicidal thoughts or actions.

Perspective from Teen: If the kid is consistently not following the shots (rules) of the house. If they just want to be in the program for the social aspect and you’re not seeing any real changes in their behavior, then group therapy (IOP) is the next step for a higher level of care. It also provides a smaller and more accountable support group.

Be sure to read the parent story below for hope and inspiration.

When I came to Cornerstone a little over three years ago, all I wanted was for someone to fix my daughter. She was the problem, not me. In addition to being at odds with her, my wife and I were constantly arguing about how to parent her. While we might have looked good from the outside, it felt like our relationships were emotional rubber bands, ready to snap at any time. Prior to joining Cornerstone (our recovery program of choice), my wife and I had tried several things to help our daughter. It seemed like the more we tried, the worse she got as the rebelliousness escalated to new levels. We were concerned about her sneaking out of the house, using alcohol and drugs, and keeping bad friends. In silence, our younger daughter witnessed the arguments and chaos. One particular painful night stands out. Earlier in the week, we had another argument about her sneaking out of the house. Late one evening I heard her coming down the stairs and watched in awe as she snuck out the front doors. I was incredulous and didn’t know whether to confront her or just let her go. I decided to keep quiet and peeked out the window as she ran down the driveway and into the street. I continued to watch as she got into a car that I did not recognize. 

Perhaps a sane person would have woken up their wife to discuss it. I was obviously not sane and went into the closet looking for my pistol. As I was emptying the hollow-point 45 caliber bullets out of my Ruger, I was formulating how I would teach them a lesson. I may not kill the little son-of-a-bitch who was driving the car, but I was going to scare the hell out of him. In the back of my mind, I also hoped this would make an impression on my daughter and that she would mend her ways. After I unloaded the gun, I went outside and waited for their return. The longer I ruminated, the more insane I became. I pictured myself grabbing the kid and pressing the stainless-steel barrel to his head, making it clear that if he ever came around my daughter again he would regret it. I waited outside for 15, 30, then 45 minutes. An hour and one-half later I gave up and went inside. It was about 5 am and I was tired and frustrated. After going in, I locked the door behind me. 

At about 6:30 in the morning, I heard knocking at the door. My wife also heard it and came out of the bedroom as I was answering the door. Before my daughter could get through the door I was confronting her. I remember grabbing her and demanding “who she had been with, and where she had been.” She was crying and screamed that it was none of my business and that she hated me. During all the commotion, our younger daughter also woke up. At one point, both my daughters were crying and my wife was standing in the foyer with a blank look on her face. As I let go of my daughter she ran upstairs. When the door slammed shut I felt the adrenaline drain from my body. I was so hurt and felt betrayed. My daughter had betrayed me by breaking her word. I felt like my wife had betrayed me for not jumping in and agreeing with me. At the same time, I also felt a profound sadness and a sense of shame about exhibiting this type of behavior in front of my family. At the time, I had over 20 years of sobriety. It wasn’t long afterward that my wife spoke with a friend about Cornerstone. My spouse mentioned that she didn’t know a lot about it, but it was her understanding that it was a recovery program for adolescents. I assumed it was just another program and that being good parents, we would go through the motion. Having had a successful run at sobriety, I assumed I knew what it took to get sober and that my daughter wasn’t ready – that she had not hit bottom. After all, how could a 15-year-old hit bottom? At the same time, I also had to admit that I did not understand some, if not most, of her behavior. I was puzzled as to why she had no self-confidence, why she chose bad relationships, and had such a strong need to gain the approval of her peers. I now realize how little I knew about recovery. 

My wife and I decided to attend a meeting. Like most new parents, we were wary of this group of tattooed kids with body piercings. My daughter was led to another building, and my wife and I went into the parent’s meeting. I don’t remember a lot about the meeting other than an informational packet that looked like a hell of a lot of paperwork. I also remember that someone suggested we purchase copies of “From Monsters to Miracles” and “Recovering Our Children,” which we did. 

After the meeting, our daughter ran up and wanted to know if she could go to “coffee” with the group. Although I was pleased to see that she was excited, I was also a bit confused…were her Mom and I supposed to take her, how would she get home, who would she be with and what time would she be home? I am sure that I had a stunned look on my face because one of the other parents simply said “…don’t worry, one of the kids will make sure she gets home, and it is important that she go.” 

We continued attending Wednesday meetings and after a couple of weeks, I picked up the book “Recovering Our Children.” As I read the introduction, I was stunned to find out how my daughter viewed her world. The book explained that adolescents didn’t believe that their parents knew anything about drugs or alcohol. They didn’t believe we knew anything about having fun, relationships, and sex. However, she did believe that her peers did not only know about these things but that she also trusted them. As I continued reading, I faced the realization that it was probably true. I finished the book and the next evening started “From Monsters to Miracles.” 

Early on, our daughter stepped through the Cornerstone threshold and embraced the program. Although I thought it was great that she was involved, I would continue to hedge my bet for some time. It wasn’t until a men’s retreat that I was challenged to open up during a “one-on-one,” and I felt any connection. Although I cannot explain this conversion, I have witnessed that it frequently occurs during retreats. Perhaps it is when we realize that it is safe to share and become vulnerable without the fear of being judged. Maybe it is from the hope offered by a parent who has been through a similar situation and the connectedness that we feel when that parent tells us “It’s going to be ok.” After becoming vulnerable, I felt connected enough to make a full commitment. 

I was taught that it is a family disease and that I also contributed to the problem. My first experience with this was when our daughter made the decision to quit school with two weeks left in the semester – to go into treatment full-time. My sponsor helped me realize that this was her decision to make – not mine. And, that in order for her to be comfortable with it, I had to keep my mouth shut and support her decision. Later, I also learned that for her to develop self-esteem, I had to change my behavior and stop rescuing her. Amazingly, one day I realized that I was working the program for me and not my daughter. I felt that I had been given a set of tools and could depend on other parents to teach me how and when to use them. I developed the willingness to put my daughter’s recovery first by not enabling her. 

In two months, our daughter will have three years clean and sober. During her journey, she graduated high school and is currently attending college. While these accomplishments in themselves are admirable, they are not as important as how appreciative I am of my daughter allowed me to be a part of her life. When we started this journey it was difficult for my daughter and me to be in the same room. Today, it is difficult being apart. Rarely a day goes by that I do not seek her advice. She freely gives to others and has taught me that the most important thing in life is love. She taught me that when we act with love, it is difficult to judge others; that in the absence of judgment we have no need to control others and are free to experience our true relationship with God.

Glossary of terms:

Addict: An old term used to describe a person with a substance use disorder that is not currently socially accepted anymore.

Al-Anon: A twelve-step organization that provides support and hope for families affected by another person’s marijuana use.

Awakening: A term used after Completion of the 12 steps and the requirements of the Cornerstone community. Like a graduation but it’s viewed as a “spiritual awakening”

Climbers: an interactive educational group for family members to bring issues, questions or concerns, and receive direct feedback from a counselor and other family members. As well as learn tools of recovery to help you and your family. The Every Brain Matters community offers a Climbers meeting every Wednesday.

Destructive Behaviors: Self-destructive behavior is when you do something that’s sure to cause self-harm, whether it’s emotional or physical. Some self-destructive behavior is more obvious, such as: attempting suicide. binge eating. compulsive activities like gambling, using harmful drugs, gaming, or shopping.

IOP (Intensive Outpatient Therapy): treatment programs used to address addictions, depression, eating disorders, or other dependencies that do not require detoxification or round-the-clock supervision.

Mar-Anon Family Groups: A twelve-step organization that provides support and hope for families affected by another person’s marijuana use.

Parent-Driven Recovery: Tools that Work is a must-read for parents of substance-abusing teens. You’ll learn how to maneuver through the chaos to create a harmonious family life. Even if your teen is not ready or willing to change, there is help and hope.

Recovery: A return to a normal state of health, mind, or strength. A healing process.

Shots: A term used in the recovery community called Couerstone Team Counseling. It’s a customized list of rules and consequences each family makes for their homes. To learn more, attend the Every Brain Matters Climbers meeting on Wednesday evenings at 7 pm Central time. A list of our meetings is at this link.

SO: Stands for Significant Others, a term sometimes used when graduating from an IOP (Intensive Outpatient Program) after making amends to our “significant others”, or people we have harmed.

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