Adolescence Is the Stage of Life in Which We Make the Transition from Relying on Our

MOLDING HEALTHY TEEN BRAINS AT CARLBROOK SCHOOL

The Roles of “Brain 101”, Recovery Maintenance Groups,

Individual Sessions and Family Brain Defense Weekend

As we all know, adolescence is the transition from childhood to adulthood. However, the path is rarely linear. As emerging adolescents struggle to fit in with peers and carve out their own niches, parents and other adults struggle to keep them on track. Sometimes these struggles become too difficult for parents to handle on their own, eroding the adolescent’s future through truancy, defiant opposition to family, illegal behavior and alcohol, tobacco and/or drug use. These are the cases in which Carlbrook School can help.

Carlbrook School is committed to helping its students learn to live meaningful, enjoyable, productive lives free of substance abuse, and to helping its families heal from the wounds that adolescent substance abuse can cause. Toward those ends, Carlbrook contracts with Georgi Educational and Counseling Services (GECS) to provide the following courses, seminars, and other services.

“Brain 101” – Aaron White, Ph.D.

A seminar for Carlbrook students exploring adolescent brain development.

Adolescence is a biological, cognitive and emotional rollercoaster ride. In recent years, it has become clear that extensive changes in the brain are at least partially responsible for widespread changes in behavior common during the teen years. Genes provide the basic blueprints for the adult brain, but the final form of the brain depends on experience, particularly during adolescence. Early in the second decade, the brain begins to shift control away from highly emotional areas toward the frontal lobes, which are involved in rational thought, such as making plans for the future and controlling emotional impulses. The experiences that mold the brain during these years have tremendous staying power – meaning that our adolescent experiences shape and mold the brain in profound ways.

The purpose of “Brain 101” is for students to learn about their brains and the changes taking place within them. The decisions students make, their plans for the future, and the activities they engage in are all discussed in the context of their highly moldable brains. The course stresses that once students reach their late teens or early 20s, it becomes much harder to mold their brains in new ways – meaning that they need to take advantage of their time at Carlbrook to explore who they are and what they want from life and to create the healthiest brains possible before they reach adulthood.

The topic of changing teen’s brains is particularly pertinent to issues like drinking and drug use. Drugs directly affect brain development and the behavioral patterns involved in drug use easily become engrained in the brain, as do the tendencies to turn to drugs to cope with problems, feel good and have fun. The course provides a unique opportunity to get teens thinking about how their decisions directly effect the development of their brains and how to guide their brain development in healthier ways.

The “Brian 101” seminar is four hours long and typically is taught during a single day. It builds upon knowledge of brain structure and function gained during the semester-long Carlbrook academic course, “Brain and Behavior,” which is a graduation requirement for all students. Open and often intense dialogue takes place during the seminar as students explore their own brain function and their plans for keeping their brains healthy after graduation.

Recovery Maintenance Groups – Becky Georgi, Jeff Georgi and Dan Perry

Group sessions for students preparing to graduate from Carlbrook.

As students begin their transition phase at Carlbrook School, there is a natural outward shift in thinking about the future. Students and families begin to anticipate graduation. Anxieties rise and old behavior patterns may begin to surface. During and after regional and home visits, students may encounter situations that bring substance use issues to the forefront. Recovery Maintenance Groups are positioned to use this energy by giving students a forum to address their concerns related to transition, particularly with regards to substance use.

The Recovery Maintenance Groups meet during the last four to five months of a student’s tenure at Carlbrook School. These Groups provides a supportive arena for students to discuss how their pre-Carlbrook drug use may dispose him/her to substance-related difficulties in the future and steps they can take to minimize risks and promote healthy choices. The clear message is abstinence from alcohol, tobacco and other drugs during the students remaining adolescent years. For students who have not had a history of substance use or abuse, the group helps prepare them for the challenges they encounter and to help them make conscious choices about future use with an emphasis on delaying use.

The groups are framed by a Motivational Enhancement model responding to the preponderance of scientific evidence supporting the efficacy of motivation-focused interventions. This approach helps the student keep focused on what he/she wants and how to use the Carlbrook experience to realize that future. It has been noted that “Motivation can be understood not as something that one has but rather as something one does. It involves recognizing a problem, searching for a way to change, and then beginning and sticking with that change strategy. There are, it turns out, many ways to help people move toward such recognition and action.”[1] Motivation is not seen as static but rather is viewed as a dynamic process. It is defined as purposeful, intentional and positive - always directed toward the best interest of the student. Motivation-enhancing techniques are associated with increased probability of continued growth, reductions in consumption, higher abstinence rates, better social adjustment and successful transition to other supportive services.

We emphasize treating the student as an individual. We focus on the student’s strengths rather than on his/her weaknesses. When we discuss use, abuse, and/or dependence, we do not use labels such as “addict” or “alcoholic” because research indicates that such labels do not enhance outcomes. However, as students examine the negative consequences of their past use and/or future involvement in AA or NA, they often find using such labels can be helpful. Motivational approaches build on these ideas. They seek to shift control away from parents and institutions and back to the student without losing sight of the importance of family and institutions. These approaches also recognize that treating substance use/abuse is a cyclical rather than a linear process and that recurrence of brief episodes of use do not necessarily signal failure. This modified interpersonal group model, developed by Jeff Georgi, creates a platform for students to discuss openly their ambivalence about past and future alcohol, tobacco, other drug (ATOD) use and covers a range of topics, which address transitional student and family issues such as:

Helping students examine the consequences of their past and potential use/abuse of ATOD.
Helping students identify how ATOD use conflicts with their Carlbrook values.
Helping students learn to distinguish craving from longing, while providing them with specific craving management techniques.
Teaching students specific distraction techniques and emotional modulation while providing them a context to practice these techniques.
Supporting the student in developing strategies to ask for help.
Helping students examine the potential role of 12-Step support groups.
Helping students challenge the power of social norming.
Supporting students’ continued efforts to build and maintain healthy relationships.
Helping students identify the importance of appropriate nutrition, exercise and sleep.
Practicing mindfulness skills to maintain present awareness.
Helping students to develop strategies to deal with his/her transition to college/secondary school.

Helping students identify the family dynamics into which he/she will return.
Helping students understand their role in the family and learn to deal with parental expectations.

All of the above are presented primarily through the lens of alcohol, tobacco and other drug intervention. However, for students without a pre-Carlbrook history of substance use, this motivational frame and the specific skills can be generalized to a wide range of challenges students will face following graduation.

The Recovery Maintenance Groups are coordinated with the information that is being presented in the “Brain 101” and “Brain and Behavior” courses, providing integrated clinical and academic/educational experiences. Recovery Maintenance Groups usually meet on Friday or Saturday and each session lasts two and a half hours. Each student participates in six sessions in addition to his or her Family Transition Conference. Becky and Jeff Georgi collaborate with the school’s Alumni and Transition Services Department to match student and family needs with community resources; additionally, they are available for consultation with parents, students and faculty as needed. These efforts help to insure that any areas of vulnerability for drug and alcohol use within the family transition plan are adequately addressed. While Becky and Jeff Georgi are not responsible for the transition plan following graduation from Carlbrook School, they work closely with alumni counselors to insure that graduates and their families have established appropriate supports. Continued contact between students and the transition team is achieved through e-mails, phone calls, person-to-person contact and periodic opportunities to return to the school.

These groups are facilitated by Becky Georgi, MS, LPC, LCAS, Jeff Georgi, M.Div. MAH, LCAS, LPC and Dan Perry, MA, LLPC.

Individual Sessions – Jeff Georgi

One-on-one counseling sessions for Carlbrook students.

When an advisor or parent identifies a student who might benefit from greater focus on substance abuse issues related to his/her transition, the student is recommended for individual counseling sessions with Jeff Georgi. This individual work is particularly effective for students who are in a pre-contemplative or contemplative stage of change specific to their planned alcohol, tobacco or drug use following graduation. Motivational Enhancement Therapy (MET) is the primary modality used in these sessions. MET is a therapeutic style that helps students address their ambivalence about transition issues and supports abstinence or delayed use of ATOD. This therapeutic style is directive, goal-orientated, and student-centered, focusing on self-motivation and behavioral change. It is considered a best practice by the Center for Substance Abuse Treatment. These sessions, usually held on Tuesdays or Thursdays, are scheduled by Carlbrook staff in accordance with student’s free periods. Parents are billed separately for a series of four to six sessions, which may be submitted for insurance reimbursement. Parents may request a progress report toward the end of the series.

Family Brain Defense Weekend – Becky Georgi, Aaron White, Jeff Georgi, Dan Perry

A retreat for students and families preparing for graduation from Carlbrook.

As the time that students spend at Carlbrook School draws to a close, it is important to take steps to ensure that the educational and psychological work they done will continue be of benefit to them in life after Carlbrook. As students and parents prepare for the Transition Conference, the Family Brain Defense Weekend (FBDW) is offered to assist in developing a successful transition plan supporting abstinence from alcohol, tobacco and other drug use. The Family Brain Defense Weekend is a psycho-educational experience for Carlbrook families and students addressing such topics as the developing adolescent brain, the impact of alcohol, tobacco and other drugs on the adolescent brain, the power of family systems and effective parenting styles. It begins on Friday evening and ends by mid-day Sunday.

The Family Brain Defense Weekend is not a stand-alone event, but rather is designed by GECS to build upon other GECS Services. FBDW participants are students and families identified by Carlbrook faculty as moderate-to-high risk for future substance use/abuse based on student history. Additionally, families of students not included in this risk group may also be invited. Students are not permitted to attend the FBDW without a parent or legal guardian in attendance for the entire period.

The available research indicates that family therapy is essential in the prevention of adolescent substance abuse; as the family’s functioning changes, the child’s risk for abusing substances may be reduced. The Family Brain Defense Weekend empowers parents and supports students, which leads to family systems that continue the growth experienced at Carlbrook School. Each family will be encouraged to begin to develop its family transition plan in the following areas:

Integrating information provided in “Brain 101” and The Recovery Maintenance Group.
Establishing appropriate and realistic expectations for substance use.
Identifying the ways that families or students may undermine progress.
Defining appropriate use of drug and alcohol screening.
Establishing responses to abstinence and potential future use.
Identifying and utilization of support services, resources including AA, NA and Al-Anon.
Providing a definition of the “recovering family”.

Summary

Carlbrook has a solid reputation as a school capable of helping teens who are off-track get back on-track. This document has briefly reviewed four components of the Carlbrook approach – Brain 101, Recovery Maintenance Groups, Individual Sessions and the Family Brain Defense Weekend. All four strategies are aimed at helping adolescents grow by learning about themselves, while at the same time assisting families in developing strategies to ensure that these students continue growing after they leave the school.

[1] Miller, W.R. “Increasing motivation for change.” In: Hester, R.K., and Miller, W.R., eds. Handbook of Alcoholism, Treatment Approaches: Effective Alternatives, 2nd ed. Boston: Allyn &Bacon, 1995. pp. 89−104.