Clinical Reference Systems: Pediatric Advisor 10.0

Many children and adolescents use alcohol and other drugs. Some develop serious problems and need treatment.

There are many types of substance abuse treatment. It may be based in offices, special treatment centers, or hospitals. The decision to entrust a child or adolescent to any type of treatment deserves serious consideration. When you are making a decision about substance treatment for your child, talk about it with your child's physician and possibly other specialists. If you are properly informed, you can contribute more effectively to the treatment process. Asking the following questions will help you obtain important information.

1. Why do you believe this treatment in this program is indicated for my child? How do the other kinds of care compare? Choices for treatment may include:
   • treatment in a psychiatric hospital
   • an inpatient specialized substance abuse treatment program
   • an educational program
   • a residential substance abuse treatment program
   • a day treatment program
   • outpatient treatment
   • a mutual-help program such as Alcoholics Anonymous or Narcotics Anonymous
   • no treatment at this time.

2. What are the credentials and experience of the members of the treatment team? Will the team include a child and adolescent psychiatrist or other professional with specialized knowledge and skills in substance abuse treatment?

3. What treatment approaches does this program use for:
   • chemical dependency
   • detoxification
   • abstinence
   • individual, family, and group therapy
   • use of medications
   • a twelve-step program
   • mutual-help groups
   • relapse prevention
   • a continuing recovery process?

4. Based on your evaluation, does my child have other psychiatric problems in addition to the substance abuse problem? If so, will these be addressed in the treatment process?

5. How will our family be involved in our child's substance abuse treatment, including the decision for discharge and the after-care?

6. What will treatment cost? Are the costs covered by my insurance or health plan?

7. How will my child continue education while in treatment?

8. If this treatment is provided in a hospital or residential program, is it approved by the Joint Commission for the Accreditation of Healthcare Organizations (JCAHO)? Is this substance abuse treatment program a separate unit accredited for youngsters of our child's age?

9. How will the issue of confidentiality be handled during and after treatment?

10. How long will this phase of the treatment process continue? Will we reach our insurance limit before treatment in this phase is completed?

11. When my child is discharged from this phase of treatment, how will it be decided what types of ongoing treatment will be necessary, how often, and for how long?

12. As my child's problem improves, does this program provide less intensive/step-down treatment services?

Severe substance abuse and chemical dependence in adolescence may be a chronic relapsing disorder. Parents should ask what treatment services are available for continued or future treatment.

You should be careful not to be pressured into a treatment decision. If questions or doubts persist about either admission to a substance abuse treatment program or about a denial of treatment, a second opinion may be helpful.