The First Step on the Road to Recovery

October 24, 2019

Recovery means something different to every person. Most of us are in recovery from something. Recovery from the end of relationships, from substance use, from an addiction to eating or shopping, or really any struggle that has impacted life in difficult ways. As a teenager I needed help find recovery from the struggles that high school brought: bullying, lack of self-esteem, and difficulties feeling okay in my body. Most teenagers today have a lot going on and could use mental health supports to just navigate that time, let alone any traumas or sadness outside of the norm.

Most therapists and mental health workers believe in a recovery model. The recovery model assumes that it is possible to recover from a mental health condition and that the most effective way to do so is to work with a client in a patient-centered way. This means that the teenager who is accessing services gets to define the road to recovery based on their individual goals, interests, needs, and preferences. Therapists, psychiatrists, and counselors do not define the way for them. They let the young person do the talking and help direct them on the path to recovery.

Regardless of what a teenager is seeking to recover from, one of the first steps on the road to recovery typically involves counseling of some kind. The modality that someone is interested in may be different, but a licensed counselor can provide these person-centered and holistic supports.

For example, a teenager with depression may first identify the need to go to counseling and the second step may be actually going to counseling. Often their friends or parents help them to decide that counseling is the right step. Being in recovery from depression or being free from extreme symptoms of depression and managing life well, may be one of the last steps of their recovery journey. The person gets to define the way.

There are many ways that attending counseling will benefit a teenager on their recovery journey.

A counselor can help someone to identify that they have a need that recovery can help them with. For example, oftentimes individuals go to counseling because life does not feel manageable, but they are unable to identify the ways that they are struggling. Perhaps deep down they know but they are struggling to admit to themselves this is a struggle. This may be a common experience for a teenager who has low self-esteem. For example, they know they generally do not feel okay about who they are but cannot exactly pinpoint why.

The next helpful realization that a counselor can assist individuals in finding is the reason that they began whatever behavior they are trying to recover from. This is a very difficult step in the recovery process because often this involves processing any childhood or lifetime traumas that occurred which may have led to the development of negative behaviors. For example, if we follow self-esteem struggle, the counselor could likely uncover that the teenager was bullied as a child. The childhood bullying that they experienced has made them feel bad about their weight, their intelligence, and their ability to establish and maintain friendships.

Time spent processing is often the bulk of what counseling consists of. This is the middle portion of the recovery process. It can take weeks, months, or even years in counseling to process life’s traumas, challenges, and ongoing needs. Counselors will be well trained to provide this support. There are many different forms of therapy that they can provide. Examples include Cognitive Behavioral Therapy, Dialectic Behavioral Therapy, Behavioral Activation, Trauma Therapy, and more. You can find more information about our therapy treatment options here. Generally for young people, it is more important that the counselor and the teenager are able to establish a therapeutic relationship. Because many teens may feel a stigma about going to therapy they may not want to attend. This makes it even more important for the counselor to use a modality with the teenager that is going to best work for them. They will likely have a trial and error period as they get to know the teenager to find what is most appropriate.

After someone feels they have processed or are doing good work processing their life’s events, they will typically focus on skill-building. This involves a counselor teaching the teenager more effective methods of coping. For example, a counselor and the individual who has low self-esteem may work at adding in skills to promote their self-esteem. This could be exploring something they enjoy that makes them feel good and developing goals around that. A good example of this would be for the teenage boy who feels best playing basketball would be to try out for the high school basketball team. This could help him to improve his self-esteem and make friendships with other kids with similar interests. This could truly change his life and beliefs about who he is and why he matters.

After someone has adequately developed skills, they often plan for maintaining their recovery. This could include things such as going to group therapy for maintenance, attending a 12-step program, continuing to see a counselor, reading recovery books, and more. Remember that this will be a person-centered plan. This means that the teenager gets to decide what will work best for them and their particular needs. A counselor will help them develop this plan, which will often include a crisis and relapse plan in the event that they begin to struggle again. Please know that often relapse is a normal part of the recovery process and the right counselor will be prepared to address this with the teenager.

Counselors are important providers to have during the recovery process. The way that a person accesses the counselor can look very different.

One of the most intensive forms of counseling is the inpatient rehabilitation process. This is where an individual resides in a hospital setting for several days, weeks, or even months to access treatment. Depending on the reason for their admission will direct their care. For example, a teenager who has severe suicidal ideations may meet with a counselor more often than someone who does not. Individuals in inpatient will often go to individual and group counseling and meet with psychiatrists and other types of therapists to meet their individual needs. Teenagers in inpatient settings will also likely participate in family therapy with their legal guardians and even their siblings. This allows everyone in the family unit or household to engage in the recovery process so that the family learns skills together and becomes healthier together.

Another common form of counseling is in a group approach on an outpatient basis. Common groups include groups for people with anxiety, depression, or substance use needs. They can be held in clinics or community centers by licensed and trained professionals. Many school districts have after school programs for group counseling for students. The counselors will offer direction for the group but often times it is led by the members. There will typically include a new lesson, practice or homework review, and discussion about how things are going. Of course, everyone in the group must agree to maintain the confidentiality of members in order to participate.

Another form, perhaps the most common, is individual counseling. This is typically done in 45 to 60-minute sessions on a weekly or biweekly basis to set and achieve mental health goals. Individual counselors often make themselves available in the event someone is in crisis as well. Counselors who adhere to a recovery model will be operating on the belief that you can recover from whatever you bring to therapy. They will help you achieve that recovery.

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The principles of treatment with recovery are as follows: treatment should be self-directed and person-centered; it should empower individuals; it should be holistic but we should not expect it to be linear; it should be strengths-based; there should be hope and respect present between the counselor and individual, and there is a level of responsibility on both parties. The responsibility is on the individual that they show up and do the work and the responsibility on the counselor is that they provide ethical, evidence-based practices within their certification and licensure. Showing up and doing the work for a teenager can be difficult. It is important that the counselor is experienced in working with youth.

While all of this may appear simple or seem easy in writing, please note that counseling can be very difficult, and recovery is not easy to achieve. Often things tend to get worse before they get better. This can prompt individuals to want to stop engaging in treatment, especially young people. For example, our teenager with low self-esteem who has a history of being bullied may not want to discuss and describe that experience. While we know that processing it is necessary in order to heal, it may be extremely painful at first and make low self-esteem symptoms worse before better. Another example is that for people with depression, talking about their depression in counseling may make it worse at first. They may need a few months of treatment before they begin to feel better. It is important that people keep going, even when it is difficult, as this is a normal part of the recovery process.

As we discussed earlier, part of the recovery process is skill-building. This inevitably means that in order to build skills we must practice many different strategies and techniques to see what works best for us. This can be very uncomfortable for teenagers. Having a counselor to practice with and who can provide encouragement when it feels difficult is really an important and special part of therapy.

Finally, knowing that someone will be there if you struggle or even fail can be incredibly empowering and comforting. To expect that recovery is linear is to be unfair to ourselves and our young people. We all fail at some point on our path to recovery. I have personally experienced depression so many times after I promised myself I never would again. It happens and each time I get back on the recovery ‘horse’. For me this looks like going to therapy more often, perhaps having medications adjusted, and reintroducing new skills into my depression management plan. For parents, this may mean helping find creative ways to engage in healthy and hopeful behavior with their teenager.

This will look different for everyone. The teenager could access counseling in a variety of different settings such as in an inpatient program, in an outpatient group, at school, or in outpatient individual therapy. However, it looks, it is most important to access counseling. This is often the most important and early step in the recovery process.

Theodore Roosevelt once said this: “if you believe you can, you’re halfway there”. Getting the teenager to counseling is one of the most important steps in the recovery journey. The counselor will help them to figure out what the rest looks like in a person-centered and meaningful way. Recovery truly is waiting for anyone willing to do the work.

Are you a teenager that’s found themselves ready to take the first steps on your own path to recovery? Ask your parents to reach out today in order to find out how Hillcrest can help you forward! Our dedicated staff understands how hard it can be to heal and manage a mental health issue and/or addiction. We’ll work with you to get you on the right track!