How Residential Programs Help Teens with Co-Occurring Disorders

According to SAMHSA, “the coexistence of a mental health and a substance use disorder is referred to as a co-occurring disorder.” Teens who struggle with co-occurring disorders often require specialized treatment that focuses on treating both addiction and underlying mental health problems [1]. Treating co-occurring disorders is complex and requires a blend of approaches such as evidence-based therapies, psychiatric care, and social support. Residential treatment is usually recommended for co-occurring disorders because it provides teens with around-the-clock care in a safe, structured, and sober environment. Read on to understand how residential treatment programs support teens in recovery from co-occurring disorders and what makes them effective.

Understanding Co-Occurring Disorders in Teens

Adolescence is a vulnerable time for both substance abuse and developing a mental health problem. Over 60% of teens in substance abuse disorder treatment also struggle with a co-occurring disorder [2]. Teens are at a unique risk of co-occurring disorders due to the sensitive stage of development. They are more likely to take risks, and experiment with drugs and alcohol. And most mental health disorders begin to emerge around the age of 14 [1]. It is not clear which one always appears first. Having a mental health disorder increases the risk of developing an addiction, but addiction can also cause symptoms of mental health problems such as depression or anxiety. As teens continue abusing drugs or alcohol, the symptoms of both disorders worsen—trapping them in a cycle that can be hard to break without professional intervention.

Common Co-Occurring Mental Health and Substance Abuse Disorders

Some co-occurring mental health disorders are more common than others. According to the National Institute on Drug Abuse, below are some of the most common comorbidities with substance abuse [2].

• Depression: 20-25%
• Anxiety: 20 to 40%
• Trauma and PTSD: Approximately 75%
• Bipolar Disorder: 60%
• Personality Disorders: 34.8% to 73%

Signs and Symptoms in Adolescents

Warning signs of co-occurring disorders in teens are not always easy to recognize and vary greatly depending on the addiction and mental health disorder. For example, a teen who has anxiety and drinks alcohol will have different symptoms than a teen with bipolar disorder who abuses stimulants such as cocaine. However, some common signs that may indicate a teen is struggling with substance abuse or co-occurring mental health problems include:

• Social isolation
• Drastic shifts in mood or personality
• Irritability, aggression, or violent outbursts
• Sudden academic decline
• Risky behavior that threatens themselves or others (reckless driving, unprotected sex, vandalism, theft, etc)
• Self-harm or suicidal thoughts
• Finding drugs, alcohol, or paraphernalia on them or in their belongings
• Coming home visibly high or drunk
• Intense cravings for substance of choice

What Is A Residential Treatment Facility For Teens?

A residential treatment facility is a behavioral healthcare center that provides around-the-clock care to treat substance abuse and/or co-occurring mental health problems. Residential programs are considered the highest level of care and are recommended as a first line of treatment for co-occurring disorders. However, for mild to moderate mental health challenges, residential treatment is often not necessary. During residential treatment, teens will live at the center with peers their own age who are also in recovery. They will participate in daily therapy sessions such as CBT, DBT, and trauma therapy. Residential programs also engage teens in structured group activities such as art, music, dance, sports, and adventure outings like hiking or camping. These help manage cravings for drugs and alcohol and develop essential skills such as teamwork, collaboration, resilience, and communication.

Why Residential Treatment Programs Are Effective

Residential treatment programs are effective because they provide high structure and support in a safe and substance-free environment. Residential programs help teens build daily routines that positively contribute to their recovery and mental health. Living in a residential center for treatment also lowers the risk of teens being influenced by peers or situations where they are likely to relapse. Other key components of residential treatment that make them effective for co-occurring disorders are therapy sessions, psychiatric care, recreational activities, and aftercare services.

Evidence-Based Therapy

Access to mental health therapies is a core piece of residential treatment for co-occurring disorders. These are essential for successful treatment outcomes and help teens reframe negative thoughts that drive substance abuse and develop positive coping skills for their mental health. Standard substance abuse treatment also uses therapy, but this is to treat symptoms of addiction and often follows a 12-step approach. Therapy in a co-occurring disorder treatment program is tailored to the individual mental health needs of teens. Common therapies used in residential programs to treat co-occurring disorders include:

• Cognitive Behavioral Therapy (CBT) is one of the most widely used mental health therapies. CBT helps teens break negative thinking patterns, set treatment goals, and build healthy coping strategies.
• Dialectical Behavior Therapy (DBT) was originally developed to treat Borderline Personality Disorder but is effective in treating co-occurring disorders, especially in teens who have experienced trauma. DBT focuses on distress tolerance, interpersonal skills, and mindfulness.
• Trauma-Focused Therapies such as EMDR, trauma-focused CBT, and Internal Family Systems (IFS) are all examples of therapies focused on helping teens process trauma, reduce emotional distress, and explore triggers that cause substance abuse.

Psychiatric Care

Medication management is highly effective when combined with behavioral therapies and positive social supports. Most residential programs have a licensed psychiatrist on-site who can prescribe mental health medication and adjust doses as necessary. Common medications prescribed for co-occurring disorders include antidepressants, anti-anxiety medication, and antipsychotics.

Recreational Activities

Structured recreational activities help teens form connections with other peers in treatment and provide them with a positive outlet for stress. These activities can help distract teens from cravings for drugs or alcohol and teach them how to have fun while sober. Common recreational activities teens may participate in during residential treatment include:

• Hiking
• Camping
• Kayaking
• Basketball
• Art projects

Aftercare and Transition Services

An effective residential program supports teens and their families even after treatment is finished. Aftercare services help teens transition smoothly to their communities, prevent relapse, and increase long-term recovery success. These services may include enrolling teens in a partial hospitalization or intensive outpatient program, providing academic support, and connecting them to a peer network.

Co-Occurring Residential Treatment for Teens in Texas

Clearfork Academy residential facility is a licensed, 24/7 supervised, and structured treatment program helping teens recover from substance abuse and mental health disorders. We provide around-the-clock care and support to teens on their journey toward sobriety. We strive to provide parents with mental health education and offer evidence-based treatments such as CBT, DBT, and EMDR. Contact our admissions team today to see how we can support your family.

Sources

[1] Co-Occurring Disorders and Other Health Conditions. 2024. SAMHSA. [2] Common Comorbidities with Substance Use Disorders Research Report. 2020. National Institute of Drug Abuse.