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Section 11
Confrontation Strategies in Adolescent Addiction: Monitoring Skills

Question 11 | Test | Table of Contents | Addictions
Social Worker CEU, Psychologist CE, Counselor CEU, MFT CEU

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On the last track, we discussed the four ‘C’s of confrontation in an intervention with a chemically addicted teenager. These are choices, consequences, contracts, and control.

On this track, we will discuss learning the three essential confrontation skills. These are monitoring skills, giving feedback, and consequating. We will also discuss the "Simple Chart" technique for assisting the parents of addicted teens with these three confrontation skills.

Three Essential Confrontational Skills

#1 - Monitoring
In my experience the first skill for parents to learn is monitoring. As you are aware, when the parents of chemically addicted teens put their teenager on a contract, as we discussed in the last track, they must be willing to monitor and record their teen’s behavior. In my experience, the best way to approach this is to have the parents make a simple chart and attach it to the teen’s contract.

Diane and Richard put their sixteen-year-old son Sam on a simple contract after Sam came home from a party at 4am, severely intoxicated. I asked Diane and Richard to try the "Simple Chart" technique with Sam. As part of his contract, Sam was required to be home by 10 pm on school nights, and by 12 on weekends. He was also required to attend all of his classes at school.

I helped Diane and Richard make a chart  for Sam on which each day of the week was listed across the top, and each behavior was listed down the left hand side. Diane and Richard then checked off each day of the week each behavior was performed. In addition, I asked Diane and Richard to assign a 10 point value to each behavior. At the end of each week, I had Richard and Diane total up the number of points Sam had earned.

Both Sam and his parents would then be aware of exactly what was happening on a daily basis. Sam knew what was expected of him, and Diane and Richard had a written record of Sam’s behavior. I encouraged Richard and Diane to record Sam’s behavior as it happened, and to not rely on their memory of what had happened the previous day.

As you may have experienced now, monitoring using the "Simple Chart" also helps parents avoid snoopervision. I encourage the parents of chemically addicted teens to respect their child’s privacy, and not to go through their teen’s rooms and belongings unless his or her behaviors have become self destructive. As you are well aware, if the teen has become self-destructive, their need for privacy becomes secondary to the need to keep them safe.

#2 - Feedback
I find that the next essential confrontation skill is feedback. At the end of each week, I had Diane and Richard tell Sam how many points he had earned, and describe the behaviors that had caused him to lose points. Based on the points Sam earned during the week, Richard and Diane were able to tell him whether he had kept his contract, and whether he had earned the privileges described in it.

For example, during one week Sam broke curfew twice, and missed school one day. Richard stated to Sam, "Son, you earned 90 out of 120 points this week. You came home late smelling like alcohol on Thursday and Saturday, and you missed school on Friday. As we discussed, you need 100 points per week to use the car on weekends."

As you are aware, using this type of point system allows the parents to be objective about determining whether or not the contract is being kept. I encouraged Richard and Diane to not only give feedback about Sam’s behaviors, but about their feelings. I practiced feeling statements using the phrases when you, I feel, and because with both Richard and Diane in our sessions.

For example, Diane stated, "Sam, when you skip school, I feel worried, because you may not graduate." I also reminded Diane and Richard that they should never confront Sam when he was drunk or high, as he may not remember the feedback the next day.

#3 - Consequating
In addition to monitoring and feedback, I find that the third essential confrontation skill is consequating. Consequating refers to what parents should do when the teenager does not meet the terms of their contract. Part of consequating is to allow natural consequences to occur, and to enforce logical consequences, as we discussed on the last track.  I find that this entails establishing rules in the home, backing up local laws and school regulations concerning alcohol and other drug use, and above all, being consistent.

As you may have experienced, consequating keeps parents from becoming permissive, and gives them a sense of strength and control. In my experience, chemically addicted teens also benefit, as they gain a sense of security in always knowing beyond a doubt what the consequences of their actions will be. I often hear from parents who are concerned that their teen will not like them during the consequating process. As you know, a chemically addicted teen may even come to hate their parents for a while.

I tell parents not to be surprised by the angry response, and to not back down. I find that by consequating with consistency, parents give their chemically addicted teen what he or she needs most; a parent who can be counted on, who means what he or she says, who can be trusted, and who clearly cares.

On this track, we have discussed learning the three essential confrontation skills. These are monitoring skills, giving feedback, and consequating. We have also discussed the "Simple Chart" technique for assisting the parents of addicted teens with these three confrontation skills.

On the next track we will discuss the professional’s role in an intervention with a chemically addicted teenager, as well as the six steps to preparing for an intervention. These are, choosing a group leader, going over the data on the teen’s behavior gathered by the intervention group, deciding speaking order and seating arrangements, decide on a location for the intervention, choose a person to act as the teen during the rehearsal, and the rehearsal itself.

Peer-Reviewed Journal Article References:
Nadel, E. L., & Thornberry, T. P. (2017). Intergenerational consequences of adolescent substance use: Patterns of homotypic and heterotypic continuity. Psychology of Addictive Behaviors, 31(2), 200–211.

Rusby, J. C., Light, J. M., Crowley, R., & Westling, E. (2018). Influence of parent–youth relationship, parental monitoring, and parent substance use on adolescent substance use onset. Journal of Family Psychology, 32(3), 310–320.

Webb, J. A., Bray, J. H., Getz, J. G., & Adams, G. (2002). Gender, perceived parental monitoring, and behavioral adjustment: Influences on adolescent alcohol use. American Journal of Orthopsychiatry, 72(3), 392–400.

What are the three essential confrontation skills? To select and enter your answer go to Test.

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