Substance abuse is a common issue that we work with at Open Sky, in both our adolescent and young adult populations. Substance abuse, while unhealthy, is a widely-used coping method for many young people. For some, substance abuse can be an occasional and short-term occurrence, and, for others, it can become a pattern that develops in frequency and severity over time.
Dr. William Glasser, a psychiatrist and the developer of Reality Therapy and Choice Theory asserts that everyone has a few basic needs. Dr. Glasser asserts that “all behavior represents the individual’s constant attempt to satisfy one or more of five basic inborn needs. In other words, no behavior is caused by any situation or person outside of the individual.” (http://www.choicetheory.com/ct.htm).
Substance abuse can be seen as a coping mechanism that meets one or more of Glasser’s needs. Glasser offers that our five basic needs, in no specific order, are: survival, belonging, power and control, freedom, and fun. “Even though human needs are essentially the same for everyone, the behaviors through which individuals choose to satisfy those needs may be quite different” (http://www.choicetheory.com/ct.htm). Simply put, one can choose to meet their needs in healthy or unhealthy ways. Meeting needs in healthy ways honor positive core values while meeting needs in unhealthy ways violate core values. If one is unaware of how to meet a need in a healthy way, or is unwilling to meet a need in a healthy way, the need still exists and the person is highly likely to meet the need in an unhealthy way. These are the kinds of patterns that bring students and parents to seek treatment at Open Sky.
Self-harm, disordered eating, and substance use are among the more common ways the adolescent girls that I work with have met their needs for belonging, power and control, freedom, and fun. In doing so, they have violated their core values. Such behavior typically results in negative feelings – insecurity, self-doubt and shame – and a sense of powerlessness over these undesirable feelings. Since these feelings are undesirable, the girls usually look for an escape – a way to avoid what they are feeling – and they cycle back to the problematic behaviors as a way to achieve temporary control over the powerlessness. It is my goal to help students understand how they have met their needs, which may provide relief in the short-term, but are not productive in the long-term. Exploring how one’s values are congruent or incongruent with one’s recent behaviors, I encourage my students to begin to act in ways that are value-informed and more effective in meeting their five basic needs in the short and long term.
For many of our students, substance abuse starts with experimentation in social settings, and can lead to isolation in active addiction. We can use Glasser’s needs to inform our work with students who struggle with substance abuse and addictions. Love and belonging is considered the most important of the five needs as it allows for connection with others. However, as substance use evolves to abuse, love and belonging are often sacrificed.
I have observed a common shift in attempts to meet the needs of fun, power and control, and love and belonging as use progresses to abuse. Early attempts to meet needs for fun and love and belonging may involve recreational drug use at a party. As recreational use continues and life stressors accumulate, the use shifts from a way to make connections at parties to a way to deal with life’s problems. As the powerlessness over life’s stressors increase, so does the substance use. Now instead of being a means to secure belonging, the use is a way to manage powerlessness.
Often, girls I work with share feelings of guilt or shame as a result of unhealthy behaviors required during use. This is an indication of the actions that have conflicted or dishonored her positive core values. I then partner with the young lady to address the patterns of behavior that were not aligned with her positive core values. I start by validating her desire to meet a need while helping her identify healthier alternative behaviors that meet the need more effectively and promote long-term health and wellbeing. My hope is to illuminate the need she has struggled to meet in healthy ways and assist her in exploring healthier choices that are aligned with positive core values.
Glasser’s Needs and value-based decision making are tools that can help a struggling adolescent better understand her past decisions and ways to make value-honoring choices in the future. Consistently making healthy choices supports the individual’s behavioral congruence with core values and leaves the person feeling more positively about themselves over time. When continued throughout time, this process allows for long term meaningful change.
Because Open Sky’s vision is to be the premier family-centered wilderness program, we provide multiple opportunities for the family’s involvement over the duration of the program. These include: weekly phone calls with the therapist, weekly treatment planning sessions, weekly written correspondence, weekly parent support group teleconference, written therapy assignments, Parent Wellness Weekend, and the Graduation & Family Reunion, as well as optional Family Quest outings.