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Change is a Process, Not an Event

An interview with David Flack, MA, LMHC, CDP

I circled back to Ryther after about 10 years of working in the mental health field and getting more training and now supervise mental health therapists and substance abuse counselors as well as developing new programs for the substance use and co-occurring programs here. My experience is in working with teens and families impacted by substance use, trauma, and mental health challenges.

My first challenge has been and continues to be figuring out a more effective and efficient way to treat teens with both a mental health and substance use disorder. Co-occurring disorders is the term that fits those battling both challenges. In fact, data show that 80-90% of teens in King County who are in treatment for substance abuse also have a mental health disorder. At Ryther, we use a short assessment tool called the GAIN to determine if a teen has a co-occurring disorder. Whether a teen (13 or older) comes in for either a mental health or drug and alcohol assessment, we will know if further assessment and treatment is needed in either area or both, based on the teen’s responses to the GAIN’s 15 questions. Common mental health issues we see here are ADHD, anxiety, depressive disorders, externalizing issues like conduct disorders as well as PTSD as a result of trauma. One of the interesting things I am seeing now that was rare in the past is that there are more teens with co-occurring disorders who are on the Autism Spectrum.

What I am excited about is that we have brought on one of the few evidenced-based treatments for teens with cooccurring disorders – the Seven Challenges. The concept behind it is that change is a process, not an event so we meet teens where they’re at in this process, using journaling, experiential activities and discussion to encourage them to honestly evaluate their life and choices, explore the pros and cons of substance use, develop problem recognition skills, and create effective long-term plans. This treatment approach can be done individually and in a group and we are starting a group at Ryther. To attend, the youth will have to be a client with a diagnosed substance use disorder or cooccurring disorder by us or someone else in last six months. We now provide co-occurring counseling and outpatient substance abuse treatment that is once or twice weekly. We are also working on ways to get parents involved, because we know that outcomes are better when that happens.

If you are concerned about a teen’s mental health and/or substance use, please call our intake line at 206.517.0234.

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