Power to the Parents: From Rehab to Home: Managing the Transition

Power to the Parents is a feature that appears in every issue of The Guide to Good Health to help parents who are concerned about the widespread problem of young people and substance abuse. If your child is using drugs or alcohol and you’re trying to deal with that, or if you’re working to prevent your child from using, you’ll find practical advice here from the expert professionals at Gateway Rehabilitation Center. In this issue, Frank J. Salotti, M.S., Director of Outpatient Services at Gateway Rehab Center, talks about how parents can best manage the transition to home after their child has been in rehab.

For parents whose teenaged children have been in treatment for substance abuse in an inpatient setting, discharge can be a mixed blessing. Parents may feel relieved that their son or daughter has completed a treatment program, but that is simply one stage in their journey as a family. The next stage, the transition back to the home and school environment, is a worrisome time for parents. What is the best way for parents to approach this?

There are so many challenges for families in this situation. They worry about relapse, about the child’s socializing and returning to school, and about their own relationship with their child. At Gateway Rehab, we strongly encourage families to be involved while their child is receiving inpatient care, and to continue with outpatient treatment on some level. There are different levels of outpatient care, and the family should be involved in outpatient treatment, in structured family group activities. We also offer consultation for families outside of the group, and provide a lot of telephone support.

We help families develop a “cooperative agreement structure” before discharge that defines expectations and sets limits. Every family is unique; we look at the family history and the parent’s greatest concerns and help guide the family through this process, of setting and negotiating limits. Parents have to put it on the table.

What might some of those limits be?
The kids have to earn their parents trust again. That might mean that they have to give up their cell phone for a specified period of time, or trade the use of the cell phone for something. It may mean that parents delete the contacts that are stored in the child’s cell phone and defriend them on Facebook, to limit their access to dealers and peers who sold them drugs in the past. It may mean a curfew. This is a lot to ask of kids: to give up drugs, friends, a lifestyle. It’s very hard for them and it’s hard for parents to insist on it. It’s really a matter of daily decision-making, and the relationship is the key.

Many parents are especially concerned about their child reuniting with a former peer group, with whom they used drugs. How can the parent best handle that?
Going back to school, seeing old friends that they used with, is clearly a high-risk situation. Some schools have a Student Assistance Team, and parents can tell them what has been going on so that they can help monitor the situation at school. This issue is a very uncomfortable one for both parents and kids; kids are at an age when their friendships and peers matter so much. But the old peer group can be dangerous when the kids come out of rehab.

We encourage families to take the kids to 12-step meetings, to search for one that has a lot of younger people so that the kids can develop new relationships there. It’s best if the kids can develop a recovery-focused friendship. It’s not easy; lots of kids resist going. Parents themselves should go to meetings, to Nar-anon or Al Anon.

How do you give support to families through this process?
We recognize that parents are holding their breath when their kids come home, for many reasons. They feel alone with their fears and isolated by their experiences. It’s tough to talk about this with friends and family, when they feel so much shame, anger and fear. They may not have, or know of, available resources, so we help them find those.

Going to a group is encouraged because it “normalizes” the experience, in the sense that they are likely to discover that their experience is not so rare. They will see other families going through the same thing, and they feel less alone. At group meetings like Al Anon and Nar Anon, you get personal support.

In general, how should parents act with their kids, after rehab?
Be assertive without being harsh. Respect your child’s strength and let him or her know that you’re proud of them for completing their rehab treatment. Most likely, the parents, and other family members, have had some significant discord and mutual loss of trust with the child who has been in treatment. It’s essential to have patience with the process of restoring trust; it can take a long time.

To learn more, visit gatewayrehab.org.