Most adolescents do not find the holidays to be “the most wonderful time of the year.” The holidays bring time with family that is often involuntary, or at least not a preferred activity for many at this age. For too many adolescents, the holidays also mean facing dysfunction, past trauma or abuse, substance abuse, and mental health issues within the extended family. Or, at the minimum, family drama. For adolescents who are in treatment or recovery for substance abuse or mental health diagnoses, facing family dysfunction also puts them at high risk for relapse.
Familial Risk Factors for Addiction Relapse
The increased likelihood of alcohol or other substances being used or available in the home around the holidays is an obvious risk for an adolescent coming out of treatment or beginning recovery. In many situations, substance abuse and mental health behaviors stem from addiction, mental illness, abuse, or other dysfunction within the family environment, so being home for the holidays could be the worst place for an adolescent new to sobriety.
However, those dysfunctional situations are not the only familial risk factors for relapse. According to a 2018 article published in the Indian Journal of Psychiatry, families who disengage from the adolescent or try to avoid the addiction or mental health issues altogether are linked with greater episodes of relapse. Adolescents in families with dysfunction are less likely to relapse by relying on recovery and other community-based support. Unfortunately, many adolescents who are still living at home or under the age of 18 may not have as much control over their environment, especially during this time of year.
Teaching Skills to Avoid Buying Into the Drama
The goal of treatment for addiction is to give the adolescent enough relapse prevention skills as well as practice using those skills to give them a sense of self-efficacy regarding their recovery. Sometimes, this requires longer than a typical residential treatment program to achieve. The adolescent needs to be confident enough to face even the most stressful of situations.
Adolescents who abuse substances are often using them as a coping mechanism for dealing with their personal problems, and family drama and dysfunction are high on the list of those problems for many of these adolescents. Addressing the actual problems themselves helps significantly to reduce the desire for substance use. Teaching coping skills such as mindfulness, clear communication, and setting clear boundaries can also help them avoid buying into the family drama. By learning and practicing these tools, they can develop the self-efficacy needed to face difficult family situations.
Supporting Adolescents in Setting Holiday Boundaries
While adolescents may not make a lot of effort to spend time with a dysfunctional family when given a choice, the traditions of the holiday season make it more difficult for them to set appropriate boundaries for themselves. Cultural and media expectations can add to the difficulty of making the right decisions for themselves. Stressing to them the importance of breaking the cycle of addiction, abuse, and mental illness can help them see the big picture.
Help them to discover solutions to maintain their sobriety by avoiding excessively stressful or triggering situations, or dinners, parties, or other activities where they know substances will be available. Encourage them to use the support of sober friends and family members, to potentially only attend an early portion of a dinner or party, or to even attend a 12-Step meeting instead. Knowing that it is okay to set boundaries with their family, even during the holidays, will help them avoid additional stress.
Recommending Alternatives for Adolescents at Risk of Relapse
For some adolescents, it may not be safe at all for them to be at home. For those who have relapsed multiple times before, an extended residential program may be perfect, especially at this time of the year — not as an avoidance of stressors, but rather to develop the skills, trust, and self-efficacy needed to face familial and other stress later on. They may also be ready for outpatient or intensive outpatient services, a sober living environment, or another environment rather than simply being at home.
As a clinician, you will be able to evaluate the situation on an individual basis and make the appropriate recommendations for the adolescent and their family, taking into consideration past experiences with family, the support level, and family environment, as well as how the adolescent reacts to and interacts with their family. Determining the risk for relapse also takes into consideration whether or not your client has developed honesty and trust in themselves, as well as the skills and self-efficacy to face difficult family situations. Facing family dysfunction and drama puts adolescents at much higher risk for relapse, but with the right tools and support, they can gain more confidence through their experiences.
Because families present such high-risk factors for adolescents to relapse during the holidays, teens need the tools and support to help them succeed at this time of the year. Helping them to set boundaries and find alternatives within serious family situations can help them sustain their recovery and develop greater self-efficacy. Sustain Recovery works with families as part of our curriculum. Our extended residential program offers adolescents the opportunity to slowly transition home rather than abruptly leave. We seek to develop trust in themselves and their ability to maintain their recovery by addressing the underlying problems beneath the coping mechanisms of substance abuse and mental health issues. We offer a structured program that teaches them the value of making their own choices and is run by a staff who are passionate about helping adolescents succeed. Call Sustain Recovery today at (949) 407-9052 for more information and find out if our program would be a good fit for your client.