teens, addiction, residential care and natural highs, with Derek Bowles
Host: Brenda Zane, brenda@brendazane.com
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Guest: Derek Bowles, co-founder & primary therapist, Crossroads Academy
Resources:
Brainstorm: The Power and Purpose of the Teenage Brain
Enlightenment Now, Stephen Pinker
Journey of the Heroic Parent - Dr. Brad Reedy
Dr. Brad Reedy podcast
Show Transcript:
BRENDA
Hello and welcome to today's episode of Hopestream. This is Brenda Zane and I am very excited for today's episode because I think it's going to help answer a lot of questions that parents have around treatment options for their teen and adolescent children who might be getting into trouble or, or might be abusing substances. When you are looking for help for a teen, it's extremely confusing. There's a ton of information. Google is, is full of data, but you're really scared and you don't know what to do at that time. So I think today's episode is going to be incredibly helpful with lots of information on that. And today's guest is the co founder and lead therapist at crossroads Academy to residential treatment center in Ogden, Utah. He has a master's in clinical social work from BYU and has been with Crossroads since it opened in 2007 and he and the staff at Crossroads are really near and dear to my heart because they had a significant impact on my son's recovery process. So I am very happy and grateful to introduce Derek Boles. Hey Derek.
DEREK
Hey Brenda. Thanks for having me.
BRENDA
Yeah. So, um, it is great to have you on. And, I really do mean that you guys had a significant impact in, in my son's bumpy road to recovery. I will say he was with you a couple of times. And so I'm excited to be able to have you share a lot of the things that I learned, um, from you. So maybe you can just tell us a little bit about kind of how you came to be doing what you're doing, a little bit about Crossroads and why you chose to work with kids in a really, really tough stage in life.
DEREK
Yeah, I appreciate that, that intro and I appreciate this journey we've been on together. It's, it's been a few years and you know, fortunately we've, we've seen some of that really, really difficult and dark stuff together and really some of the light at the end of the tunnel and some of the hope. And so, um, I think this is a unique opportunity to kind of process through that together.
And so, yeah, I started crossroads with my business partner Sam and Eric Dahlin, about 13 years ago. And it was a really cool experience that, that kind of brought us all together. I had finished graduate school and gone into private practice and, and really as, as happens in life, my skillset and the things that I were, that I was really good at kinda landed me really working specifically with adolescents and young adults.
And, and as my, my practice kind of progressed, it really ended up being almost fully adolescents. And so that kind of launched us into, to reconnecting with Sam, who I'd gone to graduate with school and putting our heads together and, and, and kind of launching Crossroads. And when we did that, you know, we're, we definitely had some ideas and beliefs that, that were going to be really different than kind of what was out there and really maybe a little different than, than what a lot of programs at that time. Um, their focus was, or kind of their belief system around treatment for adolescents. We had some, I don't know that they were radical, but certainly non mainstream ideas about how to work with young people and, and that kind of launched us on this process with crossroads.
BRENDA
Yeah. Cause that was what, 13 years ago? Yeah. Now, so what was available I guess 13 years ago compared to what you guys, what your vision was for Crossroads?
DEREK
Yeah. At the time and especially in the kind of the residential area, uh, the mindset was, was really a little bit of let's, let's remove the adolescent from, you know, from the, the home environment or from the area where there was, there was the problems. Let's isolate them a little bit. Um, you know, they used a lot of positive, peer culture, a lot of kinda break kids down, build them back up, kind of, kind of thought process. I think there was really good treatment at the time, mental health wise and, and some good therapy happening. But I think programming wise, uh, programs had had a really different mentality. Um, I think they were very punitive in nature, very, um, kind of token economies and, and really, really difficult for what we believed adolescents would need or want. When we looked at programming at the time, both of us would, we're just like heartbroken in some ways, in the sense of if we had to be in those environments, it probably would been very difficult for both Sam and I. And so we wanted to create an environment that if we had to be sent to treatment at 16 or 17 or, or whatever the age is, what would that look like?
And would we want to be there? Um, one of the things that really stood out to us was, you know, just because you're going through addiction doesn't mean your life stops or that you can't still have a tremendous amount of fun or, or love the good parts of life. And so adventure based living and kind of recreation for us was, was really important. And those things for us happened to be kind of the X games, sports, snowboarding and wakeboarding and skateboarding, um, rock climbing, mountain biking. Um, for me particularly fly fishing, certainly the gym and being physically active were, were a big part of what we thought could be a great way to connect to young guys and as well as for them to be an active participant in their recovery. And so we, we really wanted to build a program that, that had those aspects to it, that that was a big part of recovery, uh, kind of the natural highs.
Um, and then, and then for us, that led to the second piece that, that we knew was really important, which is how much the adolescent connects to the treatment providers indicates really long-term success or how successful a program can be. That's one thing that, that really matters and that is, does, does my kid connect to my therapist is that do adolescents connect to the people around them trying to help their lives? And we just knew if we could do that better, maybe than programming had done. If we could do that by doing these sports with the guys, by being physically active with them, by going on these adventures and having adventure base interactions at that, that would matter longterm. And, and that has really bared out and, and what's really cool now is that the research coming out, um, that are linking those two are, are super positive. And so the research is now kinda catching up to kind of what we thought would be super beneficial and working with young, young people. And this has been kind of the guiding principles in our program.
BRENDA
Yeah, I think, you know, as a parent, at least when we were going through it, I just had this assumption that if my son was going to be somewhere in treatment that it would just be awful. You know, I imagined sort of a what you see in movies like an insane asylum or something. And I just had this really horrible thought about what he would be going through and how he'd be treated. And so I think arriving on your doorstep, um, you know, for a home visit and seeing all these kids doing all these things and trampolining and skateboarding, I was just, it just completely reframed for me how that experience could be. So then to hear that that in turn leads to better outcomes is just like a win-win.
DEREK
Definitely. Definitely. It's been our, our hope as much as possible if these, if these young guys have to leave their homes, which, which we all know is, is can be, you know, if we could do treatment in the home, it would be ideal. Right? I mean, there's no doubt about that, but in some cases we do have to remove them from the environment. And if we have to do that, if we can create the treatment environment to be as close as home as possible, or at least the most comfortable, then we also know that longterm that those outcomes are, are, are much higher as well. And so it's been, it's been really part of our mission from day one, to have these boys to, to have them feel as close to home as possible. Um, and that includes how we interact with families, how we have the boys interact with their families.
Um, you know, traditionally a lot of, a lot of programming has been to kind of separate the kids have minimal contact, minimal interaction. And for us from day one, we really flipped that on its head. We wanted parents involved from the get go. We wanted communication to be really high. And so that, that both the parents felt comfortable with the programming as well as we could kind of see family dynamics and family stressors and family issues and, and so we really wanted that reciprocity where, where there was a lot of communication and connection as well as, as a lot of ability for us to connect with that. So I think that's super important. If you're looking for out of home care, that, that the programming really engages the family, that the environment is one that's, that's very comfortable. It doesn't have to be punitive. It can be a can be a place that's very safe and very warm. And, and really the research shows that, that those kinds of places benefit longterm.
BRENDA
Um, I think that is just so important for people to understand when, when they're starting this process of searching, sort of to, to think about the fact that if, if you're not going to be in touch with your child, then there's a big gaping hole there because obviously it's, you know, it's a family issue. And so that connection, I just, I can't imagine how you would, how would you heal and, and go through the recovery process as a family if you weren't able to have those kind of regular connections.
DEREK
Absolutely. And I think sensitivity to that for the family. Um, I think really recognizing that for parents specifically for moms and dads, um, that, that nobody envisions, their 15, 16, 17 year old leaving the family environment, you know, to have to go get treatment. You know, I think we can wrap our heads around it a little bit in the sense of it was cancer or if it was, you know, a medical condition, we could, we could understand that piece, but, but when it's addiction and we have to have the child leave the environment, that's a huge loss for parents. And, and like you said, a huge gap in, in how we all envision it. Nobody kind of envisions the process of, Hey, my son's going to have to leave my home at 16 and I'm not going to see him for months. And my interactions going to be limited. And I think, I think from our standpoint and from a programming standpoint, it's so important to be super or almost over-sensitive to parents and moms in what that loss means for them. And, and how much of identity and sense of self can be, can be effected by your, your son having to leave your home. And, and I think for us, I think we've tried really hard to be sensitive to that for parents.
BRENDA
Yeah. Yeah. And just, just to clarify, so you guys work with boys only, but there are similar kinds of programs like this for girls.
DEREK
Absolutely. Absolutely. For sure.
Yeah. Yeah. So kind of in that vein, how does somebody end up in a residential care situation? Like can you maybe walk us through what you typically see because obviously you've been doing this for a long time and you see patterns over time. Sort of how does a kid go from being in the home? Maybe 12, 13, 14 years old. Things are pretty good to ending up really needing to be away and in a, in a safe space like with you guys.
Yeah, process is one that that can be really quick in some instances and can be drawn out and, and over years in other instances. Um, and so when we're looking at out of home placement, you know, there, there definitely is some things that we want to make sure of. We, we really want out of home placement to be the last case scenario, right? That, that, that really, we've exhausted all of the resources locally before we have a young kid move out of their home. Because what we know is that that can be super traumatic. And, and especially in the context of leaving, you know, that safety of the home as well as friends. Um, it's difficult as friends can be. And, and we can talk a little bit about that. Having an adolescent at 15, 16 year old have to leave their friends can be in, is a traumatic as times as having a two year old leave their parent.
Um, that's how important friendships are at that age. And so, we want to really make sure that if we're going to have an out of home placement, that, that it really is the level of care. And the way we do that oftentimes is first by exhausting all of the, the resources that are local, right? Meaning that we are going to try, uh, individual therapy, um, you know, outpatient therapy first. We're going to use school resources. We're going to use local doctors, psychologists. We're gonna really go through the steps of using the resources that are local to kind of eliminate ultimately do we then need out of home placement. A couple of the things that we also are going to take into consideration is if the level of risk of the current use would indicate, um, out of home placement.
Meaning we don't, we don't necessarily go through all the other steps if the current use happens to be one where medically, physically, emotionally keeping them in the environment would, would be unsafe. And that can include, you know, some kids on what we're seeing right now is that that the starting of a drug uses in the traditional process where, you know, maybe they start with cigarettes and then they're smoking and drinking and that progresses over time and then maybe they try some harder drugs. Right now what we see is a lot of time, first time use is opiates and benzos, you know, where they're getting them out of, out of the cupboard are doctors are prescribing these drugs and addiction hits really fast and really quick and, and the dependency and the risk is much higher. And so really, really we want to look at how much of a risk is the adolescent at staying in their current environment, and then, have services to match that risk level.
Well, oftentimes parents can't figure that risk out on their own. They're going to need to rely on a therapist. They're going to really need to rely on services in their area, the school system. Um, they're doctors. They're going to have to, really process where, what kind of risks are there, their child is at. And oftentimes the professionals can say to you, okay, listen, this is the risk and this is what we're recommending. And so it can be a little bit complicated, but, but if you get the right people supporting you on the right professionals, it really can become really clear.
BRENDA
Yeah. I think, I think it's so hard for parents because you, really want to assume the best, right? But what you're probably assuming is, is very, under stated compared to what they're doing is at least what I, what I have found is if you think they're only smoking pot, it's probably not just pot. And so I think as a parent, you, it's, it's terrifying to think about that, but you really do have to rely on the experts that you're dealing with to trust their knowledge. Right? It's like you've been doing this for so many years, you know, you've seen this over and over. And so I think, you know, for any parents that are listening, if you've had some of these little red flags and maybe you can, you know, tell us what some of those are. Just, you know, knowing what you said, that kids sometimes now are starting with an opiate or starting with, you know, a benzodiazepine like Xanax or something like that. Um, that's super scary. Cause that's, you know, that's at a whole different level than even, you know, a lot of kids that just start out smoking some pot and they might do that for three or four years. Um, but what, what are some of those things that the parents might look for to indicate that hmmm, this is a little more than, you know, teen experimentation?
DEREK
Yeah, yeah. I think the first piece I always go with is that that relationship, you know, your individual relationship with your child. Um, I think I hear these two worlds sometimes. Oftentimes after kiddos have been in treatment for a while, parents will say this, wow I got my son back, he's reconnected to me. I feel this connection, which, which usually tends to indicate that there was a pretty good connection before. Part of what drugs does in my experience first and foremost is it effects those interpersonal relationships. So in your relationship with your child as they're developing through adolescence, where parents get stuck a little bit is that sometimes believing that that disconnect in the relationship that is happening is just normal adolescence. You know, where oftentimes that's just not true. Normal adolescence doesn't include disconnect from mom and dad or our parents. Um, there is a differentiation that goes on and there is a draw towards friends, but in a healthy development of an adolescent, there shouldn't be the disconnect in their relationship.
Um, and so if you've had a fairly strong connected relationship with your child and then over a period of time you start to really see that change or real disconnect in the relationship. Um, irritability, agitation, less tolerance, more anger. I think if, you know, there's drug use going on, that's a big flag to say, listen, this is, this is moving from what would be just experimental or, or even if there is such a thing as some normal adolescent use to, to an area that's problematic. Drugs should and not should, but drugs, an indication when they become problematic is when they really start to affect those close interpersonal relationships. That should be your first sign. Uh, the second piece are all that secondary stuff that we know about, which is school performance, right? Grades really start to drop, sleep patterns, eating patterns, uh, you know, certainly any kind of problems with legal problems that start to crop up, you know, possession charges, those are all indications that the drug use has probably gotten away from your adolescent and certainly is probably way under reported compared to what your child saying.
I think you hit it on the head in the sense of if you're seeing all this other stuff and your kids saying, well I only smoked pot once or twice, it's probably pretty under underreported. So I think the one thing parents can really kind of start with is that, wow, I've really disconnected. My kid is not my kid. Something's different. It's going on here. Something's affecting that. And, and ultimately their way you, you want to address that. Uh, if it wasn't drugs or alcohol, you'd still want to address that. So to me, I think that's, that's a big piece when, when that starts to go sideways. I think I would be engaging that fairly quickly.
BRENDA
Yeah, that's, that's super helpful. Cause I think a lot of parents, you know, your kid is going through those teen years, so you know, they're gonna sleep more, they're going to be a little cranky, they're going to not want you to hang around. And so I think it's, it can be hard to distinguish that from something that's more serious. So, you know, and as parents do, we always say, Oh, that's normal. This is just what's going on. This is just teenage stuff. But, um, it's helpful to have some of that perspective to say, if you're seeing some of these other signals, that might be a time to step in. So it's a confusing time for kids, but it's such a confusing time for, for parents because you've always had this cuddly fun kid who's, you know, been your sidekick and then all of a sudden it's like they're an alien living in your house. So knowing the difference in what's kind of a normal teenage development versus kind of oooh, you might want to, you know, hop on this. That's, that's really good to know.
DEREK
Yeah, and I think, I think looking at that across those domains, right? If it was one area to school performance but everything else was dialed in, then you could say, well this is probably school issue. If it's, you know, just interpersonal relationships, but everything else is going fairly well, then you can address it at that level when it's across the board and it's multiple areas, that's when, when really you're looking at at probably some sort of addiction or some sort of outside thing including mental illness. I think we could also look at, you know, depressive episode or an onset of some psychosis or bipolar disorder. I mean those can also, it's really start to affect all of those things across those domains. So I think it's, it's looking at it across a lot of different levels that you can ultimately say, yeah, this is, this is something that's going to need multiple levels of care. Right? We're going to need more than just one thing to kind of take care of this issue as well.
BRENDA
Yeah. Yeah. And that's actually a good point. So in a residential care setting, is it typically drugs you know, and behavior or are there some places that focus more like on a mental health situation where maybe they're not using drugs but there is, um, you know, bipolar or severe anxiety or something like that? Or do you find that those are pretty kind of linked together?
DEREK
Yeah, there definitely is within the treatment world some real specialization. There are programs that are just specifically going to be for, you know, for mental health issues. Um, I think within addiction world you're always probably seeing some, some sort of co-morbidity. Um, for us, almost universally there's going to be an underlying depression, anxiety. Um, you know, add, ADHD has a 70% cohort of addiction use with that disorder. And so just with that diagnosis by itself, it's by far the largest diagnosis that has accompanying drug addiction with it.
BRENDA
Yeah. Can we talk about that for a second because I am super curious about that because just in my group of friends and people that I work with and talk with, I, I find the same thing. It's like, Oh, you know, was he or she diagnosed with ADHD or ADD and it's almost always yes. So I would love to know more about that.
DEREK
Yeah, I mean it really is. You know, some of the good research we have really shows why this particular disorder is puts kids at so much risk. Um, and what's even more amazing is that we can look to eighth grade as one of the biggest indicators. Like eighth grade seems to be the linchpin between when we really see things start to go off course we can, we can almost pinpoint it to that grade across a lot of reasons. One of them definitely is school and, and what happens in the education, one of it is about development. Um, what's happening for specifically boys and girls around that age physically. Um, one of them again is that friendship and peer piece. Um, you know, when you have a diagnosis of add, ADHD, you're, you tend to struggle more in school. So then who you associate with in that process really matters.
So there is this domino effect from the disorder that that also leads to difficulties across a lot of domains, which then puts adolescents and young people at risk. Um, also what's going on in the brain, right? And what, what's with add and ADHD that that really affects executive functioning, which is that front part of the brain, which is impulse control and decision making. Right? What's your two huge components in drug use? Um, you know, the inability to think about consequences down the road, the inability to think through your choice or organize your decision making and then impulse control, I'm in the moment, um, I'm stoked. This seems fun. I want to do this. Those all put that out of less of more risk. Um, and so it's kind of that perfect combination of all of those things at around that eighth grade mark that we really start to differentiate and see that separation. Um, I can almost with all of my kiddos, like go back with their parents and it's really within that eighth, ninth grade year, within a year time we can, we can pinpoint when things start to go sideways.
BRENDA
Yeah. That's so fascinating. That's, that's when it was for us to eighth grade. So yeah. That's, that's incredible. So what, just to give people an idea, cause I think a lot of people kind of like me have a, had a vision of what a residential environment would look like from a treatment standpoint. Can you just maybe tell us like what's the average day in the life of one of your kids who's with you? Um, you know, day or week, kind of what are they doing and what's that like?
DEREK
Yeah, you bet. You bet. Maybe I'll, I'll spend just a little bit on talking about the nature of addiction or at least as we see it with adolescents because that will then will lead to, to how to look at treatment. What we know about addiction is that there are a lot of things that cause addiction. Okay. It's poly causational, which means that to treat addiction you have to, you have to treat it across a lot of different domains, right? Um, there isn't just one thing that we say, okay, this is, this is what causes addiction for, for people. Um, there are a lot of things that kind of come and go within our industry, a lot of different kinds of minds, new books, new ideas and philosophies and they're all great and they all kind of tell the story a little bit, but the truth of the matter is that that what causes or what sent your son on his journey may have some similarities to other kiddos, but he'll have some very unique things that are just associated with his journey.
And so when we consider treatment, we really need to consider it across those domains. If you have just a one cookie cutter kind of piece, this is how we deal with addiction. You're going to really lose a lot of people. And this is, this is just a little bit of my problem with like a 12 step program. AA, NN a is that they're great programs and they do help people. Thousands and thousands of people. But the research shows they help about one in seven. And, and for me, I'm interested in those other six, right? What is it about 12 steps that has nothing to do with the other six guys, right? Or the six kids. And, and, and oftentimes that's, that's the part that we have to be really careful. We really do want a holistic, uh, treatment program when addressing addiction. Cause it really does play out across a lot of domains.
So for us, they're gonna play across these domains in the sense of, for my program, one's going to be interpersonal relationships. How do these young people connect to others, their friends, their parents, their peers. So, so interpersonally, what is going on for them? And, and oftentimes we see problems in how, how they connect to others. Um, whether it's age group, their peers, maybe there was bullying going on. Maybe there was, you know, differences in, in friend groups. There was a shift in our friend group. Maybe there's a divorce in the family or a disconnect that way. But what is going on in or personally? So we want to address that. Second is mental health. Like what is happening to the brain and its development? Is there deficits? Is there underlying, you know, mental health issues that need to be addressed. Third is education. What's going on when we look at add and ADHD and we look at learning difficulties.
If you have a learning difficulty, you're going to be at higher risk for addiction because that's gonna make all of those other things more difficult. If you have a processing disorder or a learning disorder, those are going to cause you problems, which then puts you at higher risk for addiction, a fourth physical activity, just what's going on physically for the, for the boy, or the young person is there, you know, underlying medical issue. Um, sometimes it could be as simple as just the onset of puberty, right? What's happening with that? Or the lack of onset of puberty, right? Or, or what might be happening there. And so you really want to address those areas, across multiple domains. And so when we look at residential care, and part of the reason why it's so expensive is because you really do need to address all of those areas, right?
You're going to have an education component, you're going to have a mental health component, you're going to have a family systems component, you're going to have an interpersonal relationship component, you are going to have a physical health component. And so you really are using a lot of resources to address all of those areas. So for us at crossroads, you know, the way we address areas are unique to us and our programming. Um, and for us, you know, the physical health we're going to address by adventure based sports, right? We're going to go just be super physically active and we're going to have that crossover into mental health and interpersonal. The way we do our education is going to help with learning difficulties and ADD and ADHD. And so that's going to hopefully help across different domains. Um, so, so what you're really looking at is you're looking for residential care is a program that has really good insight on how they have decided to do treatment across those domains.
It doesn't necessarily matter what that treatment is. So for instance, there's a program very similar to crossroads except for looking at uh, the extreme sports or adventures based sports. They do triathlon training and so they're going to use more of a model of running and biking and swimming and, and that's what they're using to address that. But their education may be similar to ours. Their therapy may be similar to ours, um, but, but their family component may be really different than ours. What we know is that, that it doesn't necessarily matter what it is, but the fact that you are addressing it and how you choose to address it is what matters. And so for parents, as they look at residential care, I would really want them to look across five or six domains, really look at what it is that their child needs in those domains and try to find the best fit. You, you may come across a program that, that all six areas fits perfectly, probably pretty rare, but you might come across one that addresses five really well in the six one. Okay. Um, so, so when we look at treatment at like crossroads and then when I look at a kiddo, I'm looking at how does he fit within those five or six areas and what's the best fit for him? Um, and can we provide that and then then that lays out what our program looks like.
BRENDA
Right? Right. Because each kid is so different. Like you said there, there might be common symptoms that are happening, but each kid is so different and so you do really have to, to find that right fit for the most part. For sure.
DEREK
I think the nature of where treatment is going is going to, it's that it's going to get more specialized, right? Where whereas crossroads, I have that particular kiddo, you know, that needs this, this, this kind of profile in five years from now, maybe that kiddo who's adopted and red head, right? Like, it's going to just get more and more specialized, which it should, that the best programs are the ones that we can get that, that really fit that model. The, and smaller more craft or boutique kind of process I think is, is the, is the w is where treatments should be headed and it seems is headed that way.
BRENDA
Right? Yeah. And we won't even get started on insurance and how that, how that plays into it cause both of our brains would explode. But, um, yeah, I think that makes so much sense. It's just a matter of how do you, when you do get so specialized like that, obviously that gets more and more expensive and, and how do you do that? But yeah, so, so you've got the sports element, you've got the family element and you're also working with the, the kid, sort of what, what does that look like for them?
DEREK
Yeah. So you're going to have an individual therapist, um, that individual therapist is really going to create an individualized treatment plan. Um, you, you really do want a master's level clinician. Um, meaning that they are, they are licensed to do mental health treatment. Um, and that could be a licensed professional counselor, a licensed clinical social worker, a marriage and family therapist, a psychologist. But, but you're really looking at at least a master's level clinician, um, to be able to address both addiction and mental health issues. Um, so for us we have an individual license therapist who's going to, to really kind of take a look at those underlying issues and created an individualized treatment plan, to work with those, those guys individually. Um, that, that tends to lead to that individual therapy, which we provide group therapy three to four times a week. And then also that family systems therapy, which is, which is just essential, that you, that you're able to work through all of those kind of kind of issues. So family is family visits and coming out, spending time with families is really important. And, that's where you'll get a lot of individualized treatment as well. Uh, so for us, we want that therapist to be able to, to create that individualized piece for the program as well as help the family kind of navigate that.
BRENDA
Yeah, that's got to be a tricky role to play when you've got, you know, multiple family members, maybe, you know, parents who are divorced or trying to work through this with the child. So yeah, I think having somebody at a master's level, like you said, so it's not just a drug and alcohol counselor, it's somebody who's going to help you be able to at a family level, kind of put the pieces of the puzzle back together
DEREK
for sure. And that's where like a mentoring or you know, those kinds of programs, I think they're great for support, but they're not treatment. Um, and, and same with the substance abuse counselor. We have two full time substance abuse counselors, but they act, you know, as, as an additional resource as compared to the primary resource. Right.
BRENDA
And then what role, cause I know it was surprising at least, for me to see the level of importance that the kind of extreme sports, outdoor sports played in, in the program. Like I kind of had always thought that that was like a nice to have like, Oh that's nice. You know, kids will look at that, and want to go there. But I know that there is actually a very, very specific purpose for that.
DEREK
Yes, there's, there's two things. One, what we know about treating underlying mental health specifically depression and anxiety, um, that physical activity and exercise outperform treatment and medication together. So if we can get people physically active that that actually performs and the outcomes are better than therapy and medication. Um, where so many of our adolescents have underlying anxiety and depression, uh, being physically active and no matter how you do that, for us, the hook, you know, the, the part that, that really the extreme sports is that for people who tend to want to do drugs and alcohol, they have that risk. Gene, they really are somewhat impulsive. Those sports are real draw. They tend to be a little counterculture. They're not necessarily team sports, which is more traditional. Um, so there is, there's an initial hook and draw, right? Which yeah, I want to ski.
I want to snowboard, I want to skateboard. Then the activity themselves come with an inherent risk to them that causes them to do some of the same things that the drugs do in their brain. So they get these natural highs by doing these sports, which then helps with things like add, ADHD, depression, anxiety. So it's this kind of dual process where where they're getting brain healing in some ways, by being physically active, by being physically active, they're getting a better sense of self. They're increasing their confidence, they're turning off their inner critic. They're, they're shutting down the negativity. The third thing that's super powerful and what we know research wise now is that when you do adventures with somebody, right? If you go on family vacation and you, you, you go zip lining the people you do that with, the brain releases dopamine, which is the connector drug, right?
You actually feel closer to those people than if you just sat around and talked. Okay. So for us, with my support staff, the guys who are with these guys every day, the therapist, if we go do these experiences together, we then deeper, which allows us to do the therapy at a deeper level. And so there really is multiple layers that play out when, when you, when you do these adventure based sports and, and what's been really cool is that the brain, you know, mapping and all the stuff that's kind of come out in the last five to seven years has, has really mapped those chemicals in the brain, which now is kind of really affirming what, what we believed all the time. But now they have real resources is, yeah. Like if you want to feel closer to your family, go do an adventure with your family, you're going to feel closer. That's why kids remember vacations where they go and do cool stuff because that's when they felt closest to their families.
BRENDA
Yeah, that's, that's amazing. And I do. I think one of the things that you had said, um, when we were talking and looking for a place for our son was that, you know, a lot of our therapy sessions happen on a ski slope or over a sandwich at a coffee shop or on a boat. And that just made so much sense as the parent of a boy. And I don't have girls, so I can't speak for girls, but I know it's so hard to get these teenage boys to open up sometimes and you know, you can try the driving trick where you're not facing each other and sometimes they open up a little bit. Um, but that whole, that just made so much sense to me to say, yeah, if you're in a chairlift or if you're on the back of a boat, having that conversation is so much easier than sitting in a chair in a therapist office who you don't know. And you know, who doesn't really know you.
DEREK
It's so true. And I try to think about those adolescents as they're asked to engage such difficult things and to talk about honestly, things most adults could never kind of talk about, you know, their own, their own feelings, how they're feeling, their own emotions, their own shame, their own embarrassment, their own beliefs on how this was all supposed to go. And, and, and how we figure out how to connect is, is probably the most important thing. Um, whether it's as parents or as clinicians and providers. Um, it to me is paramount and the whole process is how do we maintain and keep a connected relationship. Um, to me it's, it's by far the biggest thing that I've seen elicit change in somebody else is genuinely how much they feel connected to me or someone else in their life.
BRENDA
Yeah. I would love it if you would talk, it's just been seared into my brain that at one point, you know, you talked about don't focus on the outcome, you know, focus on your relationship, but don't focus on the outcome. And that was kind of a new concept to me. So I'm wondering if you can talk about kind of what that means.
DEREK
Yeah. That plays across a couple of a couple of areas and we've already even talked about that in the sense of the beginning of addiction. You know, it's, it's hard as parents to not have an idea in our heads about what it is we want our kids to do or become or be, you know, and we can, we can go from ranges where that can be pretty, pretty specific all the way down to, Hey, where do I want him to go to college? And you know, I'm a Duke guy and I'd love my kid to go to Duke cause I graduated from Duke. Or you know, that plays across in religion or in politics. I mean, there's a lot of things that as parents, we have this ideal of what our kids could or should or might be. Um, it can be problematic in the sense of putting our kids in that, that, that basket or that outcome, and having a sense specifically in that beginning stage, right.
If we think about, you kind of alluded to this in the sense of if we have a vision about what we think our kids should be, it becomes really easy to dismiss the behaviors that are problematic. My kids got to go to college, my kids dut dut duh, well all of a sudden, I'm now not seeing the drug use or won't even entertain that because that, that gets in the way of this view of what I believe my son should or could do. Um, and this includes your daughters as well. I just use boys cause because that's my world a little. Yeah. So to me that, that's initially that first piece where sometimes it's just even hard to send your kid to treatment because it disrupts what your idea of how that was supposed to be. It would blow your mind how many parents I've had say to me, well, I just, I can envision my kid not having gone to prom this year or you know, not going into the homecoming game. And I have tremendous empathy around that. But it also is super problematic and truly seeing your kiddo where they're really at and as well as your kid, to really be honest with you in the sense of where they're at. Because if, if they have to present different than this ideal, then that can become really a problem.
BRENDA
Yeah. And and I think that it's also hard as the parent to have you have that outcome in mind for your child, but then you also sort of have your own parenting outcome of, you know, what are you going to tell your friends when they say, Oh where's your son? Or where's your daughter? Oh they're like living in another state for a while. You know, it's just sort of like you said, it disrupts your own, you know, personal outcome of what you think that you are going to be doing as a parent.
DEREK
And you know, I want to be empathic to that loss and that there's some sadness around that and some grief and we should all kind of give it its appropriate weight. But we need to be savvy in how we see that because outcome then becomes really problematic in how we address addiction. Um, because what I found is kids will go really, really far out of their way to turn that outcome up on its head, right. Once. Sometimes it's just in the sense of I don't want to deal with what that might look like for my parents or myself if I had to really face, I'm not going to college cause I'm not even graduating high school because I've been addicted to drugs. Right. Just for, for an adolescent or a family to accept that can be heartbreaking as compared to just the fact that they're dealing with the drugs.
Right? Which is heartbreaking in and of itself. But to add those layers to it can become really problematic. And so oftentimes in treatment it's, it's really pushing families to let go of those outcomes because you have zero control over that. And as a matter of fact, the more you try to control that outcome, it ends up hurting the one thing you have the most control over, which is how do you connect to your kid and how do you keep and maintain a loving, connected relationship even as they're struggling. And what I found is that the more we can focus on containing and keeping that relationship because it's the one thing as a parent you can control, the more we give up the outcomes and, and allow the adolescent or young adults who really kind of figure that out on their own. And so that process of doing that I think does at times take a therapist to help you navigate that.
Sometimes it does take support groups or people who've been through it to say, wow, like be really careful here cause your need to have your kid go to prom may really put him more at risk than he really needs to be. Like he may just need to learn how to not do drugs this month. Um, and so having an outside perspective help you get clear on that can, can ultimately make all the difference as well. Um, and so yeah, letting go of outcomes, letting go of how it's supposed to be or should be or, or was supposed to happen, can, can really change what you feel and connection to your kid. Um, and, and learning how to really just have that radical acceptance of this is where my child's at and, and my biggest influence will be just how much they feel. I care and love them right now as compared to what they need to be is in all the work I've done. The most profound thing and longterm change.
BRENDA
Yeah, that's true. It's really true about what you do and don't have control over. I think that's probably as a parent, one of the most frustrating things is that you really at a certain age and, and we can maybe talk about for just a second age of consent, and how that plays into to this whole thing. But, to know that you do have control over the relationship where you don't have control over what they're going to hang out with or, or anything like that, it's, um, it's a good reminder. And you do, you need somebody from a less emotional standpoint, somebody who's not as emotionally invested in your child to be able to tell you that because you kind of lose, you lose the ability to see the forest for the trees when it's your own child. And I think that's a helpful part of, you know, especially when our son was, was there with you and to have somebody who wasn't me as the mother who, you know, we're so crazy emotionally attached to our kids to be able to have that separation and say, listen, this is, you know, from a more, , constructive point of view or from a little bit less emotional, I guess it is just so helpful because it, it does, it sounds crazy.
And somebody listening might say, what are you talking about? You want your kid to go to the prom, but they're doing drugs. But that really does happen because you lose focus and you lose sight. And I think too, you just, um, you just don't know the severity of what's going on and, and it's until you realize, my child's life is in danger. I've got to do something about this, that you can play games with yourself, thinking about prom or thinking about college and, um, and really let that get in the way of your child's safety.
DEREK
It's so uncomfortable. It can be almost an identity crisis in some ways to have to reframe that or to let that go. And, and I, and so I'm super empathic around it. And, and yet it's so, such an important part of this process, that it's one that I don't ever find doesn't happen. It's almost universal at whatever levels in working with families and, and, and it's a constant process of reevaluating that, giving the the power back to your child, not trying to control and trying to engage in and it's hard to do that when it's a little easier to do it when they're safe and in a safe environment, it's a lot harder to do that when your child decides to, to go do some dumb stuff or get go back into that lifestyle, that to allow it to happen. It's, it's so counterintuitive. Um, but in the end may be the most important.
BRENDA
So that, so kind of focusing on, on an outcome is, is definitely something that parents do to trip themselves up and their child. Are there other things that you see, sort of mistakes that you see parents making or, or things that you talk to parents about that can sort of help either maybe when the child is still at home or especially once they're in treatment, um, that parents do that you think, Oh, I would love to be able to tell them this.
DEREK
Yeah. Yeah. I think, I think one is, is comparison. Um, you know, even within the context of, of your own kids, you know, for instance, I have a parenting style. My, my oldest daughter is super over-achieving, never have to talk to about school or, or grades or, you know, chose the right friends, you know, did all this social stuff and really landed really, really pretty well. Um, whereas my boy, my is completely opposite. I have to, I have to continuously re-examine how I parent him because if I tried to parent them the same way parents and my daughter, it's, it's really just not gonna work. I think parents get stuck sometimes in comparing those two kiddos. Um, and not taking a look at their own parenting style and saying, well, the kid has to kind of shift or comparing themselves to the way their parents parented.
Well, my parents did it this way, so I'm going to do it that way. Or my parents did it this way, so I'll never gonna do it that way, which can be just as problematic. So I think comparing kids to an ideal, comparing them to other siblings, comparing them to you, you yourself can be super problematic. Really working towards just that radical acceptance of this is my kiddo, this is what he brings to the table. How do I adjust my parenting to work with the kiddo as compared to my kid needs to fit into this box. Um, and that can be super hard for sure.
BRENDA
Yeah. And even just, you know, in the high school environment now, there's so much pressure on these kids to go to college and, you know, some kids just are not cut out for that or just not ready for it, you know? So if you're the parent of one of these kids who's struggling and maybe they're in truancy program and it's so sort of painful and embarrassing and difficult not to compare your child and say, well, how come my kid's not applying to that school or my kid's not, you know, rushing this fraternity or sorority. Um, so just even kind of externally looking around and saying, man, you know, how come my kid's not doing that? Um, it's, yeah, it's so distracting and so sort of just destructive.
DEREK
Oh, for sure. Yeah. I think about that in the sense of if we just look at college, and this is be a little side, a little tangental, but if we, if we look at just this idea of going to college, the idea of going to college for a lot of parents is if I can get my kid out to go to college, they're going to educate themselves and they're going to get a good job and they're going to be okay in this world, right? Whatever that means being okay. But kind of the mindset around it ultimately is that that if I can get them to hit this benchmark or you know, we know research wise, if you get a college degree, you make more money in and you're going to be better off in a lot of ways it's lazy parenting really, that, that somehow this thing is going to allow my kid to be successful if I can just get him to do that thing.
Um, where, where the truth of the matter is, yeah. Overall if you go to college, but, but there's so many more things that play out in the context of parenting and, and what causes someone to be successful or be a healthy adult that, that really their education is just such a poor, uh, measuring stick. Um, and, and it becomes kind of a, an easy way out in validating did I do a good job or not? To me it's just so low on the totem pole of what truly causes or help someone be a successful, healthy adult where, how or if they go to college. And, and that's probably true across a lot of things we could look at in the sense of, you know, religion or politics or, you know, sports stuff. You know, I mean, the way we've, yeah, we've embraced sports.
It's just, it's just absurd in some levels. So to me, I think it's just, let's stop comparing. Let's stop creating this outcome that, that really isn't that great of a measuring stick. And let's get back to really just connecting and being savvy. Like really, can you as a parent parent your oldest different than your youngest? Do you have enough insight to an end? Do you try to say, well, listen, I really have to approach this kid different because he's just wired a little differently and the way he sees the world is a little different. Maybe just because he's the third is compared to the second. And, and so that's one thing I would ask parents to look at for sure is, is can you adjust your parenting and stop comparing your kids?
BRENDA
Yeah. And, and I think also, in addition to that sort of, there's a tendency to want to just put your, kind of, put your head in the ground, and look down and, and just sort of brush things off to teenage experiment, you know, experimentation. Because it's, it's difficult to deal with. Um, it's the hardest thing I've ever dealt with. And I think you mentioned it, that today the risk of doing that is even greater because of things like, you know, opioids that are so available and benzos and fentanyl for sure. I think, you know, if you're a parent and you're putting your head down saying, Oh, my kid's at a party, but you know, they're popping some pills, that's just what they do. Those pills are very likely not what they are stamped, what's stamped on them. Um, so I think that just being able to have the courage to address it and say, Hey, I need to get some help in my corner. Um, because the, the risk is just so, so high today.
DEREK
Oh, it's like nothing we've ever seen. It's, it's something that even as a profession or as an industry has evolved so quickly and it has got, it got so out of hand so fast that we didn't, we don't even know or weren't prepared in the sense of what that would look like. Um, and so, so it is something that yeah, we need to up our game and yeah, I would, I would definitely love to see parents take a serious, you know, who my kids going to at a party is what they're doing on their ACT scores. Like I'd love to see a shift in that curiosity about, about who they're connected with, how are they connecting, how do they feel connected and, and a push towards learning skills around that as much as getting them tutors to do better on the ACT. I think if we can match some of that, we, we could help some of this a little bit.
And I, and I'm not saying that negatively, like, or, or is it because, because that has been and was for a long time what really helped with upward mobility. It's just shifted and, and the costing of college. And, and what kiddos are going through right now, it's just we just need more savvy parenting. We need a shift in what, what those priorities are to, to kind of match. And if we do that we're going to be fine. Like we'll, we'll be able to navigate this with, with young people and, and we'll be able to work through a lot of it, but we gotta be really open to shifting some of that fairly quickly.
BRENDA
Yeah. I think, you know, parents today, whether you asked for it or not, you have a tougher job because you're not just dealing with, and I say just cigarettes, but we're kind of at that point, right? Where it's like you're not just dealing with, you know, some beer and a cigarette at a party on or a football game on a Friday night. You're talking about, you know, pills that there's a 90% chance that that pill has got a deadly amount of fentanyl in it. And you know, you have to step up. Like we, we've been given no choice now as parents to have to have conversations. I think that that previous generations and even 10, 15 years ago didn't have to have because of the substances that are just, you know, floating around and ending up in our kids' hands. Yeah, yeah.
DEREK
100%. It's a different deal in that way. I, I think in the difficulty of it, we also are blessed in, in that we have some technology and we have some education and insight that that really changed that our parents never had. There really never was, I mean our parents didn't have access to podcast or, you know, some of the cool stuff that, that, that we have access to being able to text your kiddo is, you know, I think, I think we sometimes get really afraid of technology, but to me it's, it's one of the greatest things and being able to stay connected to our kids that, that we've ever seen. And so if we can use technology, if we can use some of the resources we have, w we'll be able to navigate this and parents will be able to navigate it. As difficult it is, is I'm as hopeful as I've ever been in, in the fact that we can really help young people and parents and young parents figure out how to do this better than maybe previous generations even had a chance of.
BRENDA
Yeah. Yeah. That's actually, I was going to ask you what kind of, what, what are you looking at in, in your industry and what are you getting excited about as far as, you know, treatment or, or what's going on with adolescents.
DEREK
Yeah. I would start with technology, I think, I think technology, specifically, you know, the internet, cell phones, texting, I think social media. I think it's gotten a severe, bad rap, I think. I think there are areas to be concerned for sure. But I also think it literally can and will change how we, we help young people navigate life. Um, it's going to allow for information and resources to go to places that, that we could never do before. You know, the highest risk for suicide in our country are in rural communities. Um, it's where there's a lack of resources. And so native Americans, you know, Alaskan Americans and Inuit tribes, uh, rural counties, which the West is full, you know, the West has some of the highest rates of suicide because we have the most rural out-of-place, like the lack of resources.
So in major cities where we have good mental health resources, suicide rates are going down, addiction is going down. Um, so, so with resources, with professionals, we're, we're really winning in a lot of areas. It's where we don't have those resources where we're struggling. And so with technology, we're going to be able to, I'm going to be able to do a session with a kid in the middle of, of Dushane, Utah, right? Where that kid maybe, never would have got resources or supports before. Um, and they're going to have access to information through social media about suicide, about depression, about drug use that they never had before. You know, in any other time in our history, if there was a fentanyl outbreak, we never would've been able to have the communication we have right now in letting kids know about the problem of it. It could have been a disaster if he didn't have that. And so, as much as some of these things are going to cause some problems, it's also, it's also going to change how, how the very application of mental health services are, are happening. And so I'm really excited about that. I'm excited to see what, what Instagram and Snapchat and, and Facebook can do for mental health treatment. Cause I think it could be as profound as anything we've ever seen.
BRENDA
Yeah, that's, that's good to hear. Cause I think as, especially as parents, I think of teenagers and tweens, a lot of times social media is kind of the bane of our existence, right? It's like, Oh, if they could just get off that stupid device. But, um, but there is, like you said, the good side of that is that there, there is good information out there and the more that we can get that out to the kids and to parents and um, you know, and be able to help people that normally wouldn't be able to find that is super, super valuable. So. Wow. Well, this has just been so amazing. I think we could probably talk for four more hours, but are there any books or podcasts or other resources that you would sort of recommend to a parent who might be starting to notice some things or is dealing with a child who's either actively in addiction or, or in treatment? Anything that kind of pops to your mind that you would recommend?
Yeah, I mean, I definitely think there, there are some wonderful resources in addiction. Um, there's two or three, and it's just escaping my head, Spiegel out of UCLA, his stuff on adolescent brain and addiction and the mind is brilliant. There's a great book called Enlightenment Now, this is, this is probably more of the, uh, it's by Pinker, Steven Pinker, I believe. It's really just kind of about the nature of, of the world as a whole. It's a super hopeful book really about, and it talks a little bit about adolescent addiction and, and mental health and the mental health crisis in our country. How real is it? Um, I, I do like Evoke wilderness program. They've got an amazing parent resource. Dr. Brad Reedy has put together some phenomenal podcasts that I think could keep parents kind of really engaged for a long time, but some really good resources and he's written a book, it just escaped my head right now. But it'd be a great resource. Yeah. Could be a great resource for sure.
BRENDA
Awesome. That's so great. Yeah, we'll put all in the show notes so people can access those there. So. Well, thank you again and again. I can't even tell you how much this has been helpful to me, but also, I know a lot of parents are going to get a lot out of it. Um, I think there's a lot of questions that people are afraid to ask that we've probably answered here. So it was wonderful and I can't thank you enough.
DEREK
You're absolutely welcome. I appreciate the invite and, I have just enjoyed our relationship and love your son and, and if I can be any help in the future, let me know.
BRENDA
I will. Thanks.
DEREK
Alright my friend.