As I continue with my internship, my most recent challenge has been with a client who is progressing in the wrong direction, and I believe this is because she has been able to hide her addiction from me so well. This troubles me most because of her age, and I can’t help but wonder what else she’s hiding from me, but more importantly, what is she hiding from herself? She is already in trouble with the law, and I fear her refusal to open up to anyone is going to prove to be her biggest mistake.
This client hasn’t been honest with me, which means she is not being honest with herself. My heart breaks for her parents, as they struggle to find answers to a disease no one has answers about. Why the lying? Why does a sixteen-year-old use substances to the point where she is almost going to be expelled from an alternative school? Why did she break the law? Many people are involved with this one girl. There is a probation officer, the school administration, school social worker and myself.
We all see potential in this girl, but she doesn’t see anything but adults trying to control her. She is angry to the point of losing all sense of reality and needing to be restrained at school sometimes. She has not undergone testing to rule out any other DSM-V diagnosis (besides substance use) so we are not sure if her anger is a result of symptoms of withdrawing from drugs or something purely emotional.
At this point, we have all agreed she needs to go to a residential facility to get away from her social network, using substances and to “reboot” her life. This is critical in finding out if her behavior problems are a result of substance use or something else. But she refuses right now. She promised all of us she would go in January.
We all felt like we needed some kind of proof she would go in January, and with her taking more risks than ever, we made her a deal to come to our I.O.P. group three times a week and see me as usual once a week. Counseling is going to increase until she goes to residential from one hour a week to seven hours. She was not happy, but she knew this was the only option. If she didn’t agree to this, she would be going to residential.
My supervisor asked me how I felt about this difficult client. I told her I felt very challenged by her, and more than ever, I’m compelled to find a way to get to her and to help her. Logically, I know there is not an easy, clear answer for this client. But my hope is in the next few weeks we will know more than we know now. I have changed my approach with her, and I do not tread lightly, nor will I take all control away from her. I told her I am not here to control her life, I am here to help her move in the right direction, because the road she is traveling on will not lead her towards anything good.
Does she believe me? Does any of this mean anything to her? Does she trust me?
I don’t know.
During the end of our last session I gave her a pile of value cards. For the next few sessions we’re going to make plans based on her values. My hope is for her to see her actions don’t match her values or in other words, the life she wants. We will also take a more psychodynamic approach and look into her past.
Will I be able to make a difference? Will she shut down on me? Does she think she wants the life she’s building right now?
I’m not sure, but I am sure I’m going to my best to re-direct her. And in the process, my hope is to somehow help her face her pain, so she can begin to start building a better life for herself.
Shari Brady is a counselor-in-training at PEER Services, Inc., an agency located in suburban Chicago, dedicated to the treatment and prevention of substance use disorders. She is also an award-winning author who has a passion for adolescents and the struggles they face. You can read more about her and her books at sharibrady.com.