Open-ended questions can help you elicit Laura’s own concerns about her drinking. By letting her know that her drinking increases her daughter’s risk of a substance use disorder, you may help motivate Laura to change her behavior and seek treatment.
In addition to helping minimize Katie’s exposure to her parent’s substance use, you also educate Laura on the principles of social control theory to help potentially decrease Katie’s risk of developing a substance use disorder. Social control theory suggests that it is essential for parents to be aware of what their child is doing and with whom they are spending time. You also encourage Laura to let Katie know that her parents disapprove of adolescent substance use.
Laura contacts her primary care physician for a referral to treatment and establishes care with a local substance abuse program. With individual and group therapy, Laura is able to successfully stop drinking and develops alternative coping skills to help her manage increased stress. Laura reports that Katie has been less argumentative. Although Katie continues to want to spend more time on the computer, Laura has been more effective in setting limits around technology use and there has been less conflict at home.
[Note: This is an expanded case from Familial Influences on Adolescent Substance Use, by Amy Yule, MD and Timothy Wilens, MD.]