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Competency 3: Treatment Strategies for Working with Clients with an FASD

Adolescents

Treatment Plan Development

It is important to remember that adolescents are not miniature adults, especially adolescents with an FASD, who may function socially and emotionally at a much younger age. The treatment process must incorporate the nuances of the adolescent's experience. In developing treatment plans for adolescents with an FASD, it is important to consider cognitive, emotional, and social limitations, as well as risk factors that led to their substance abuse. Many youth with an FASD have grown up in less than ideal environments, facing parental substance abuse, economic deprivation, abuse, and multiple foster care placements. These situations can increase their risk of alcohol abuse.

It is generally believed that traditional forms of therapy such as “talk therapy” are not the most effective with adolescents with an FASD. Their cognitive deficits prevent them from developing insight or applying lessons to their real lives. However, with creativity and flexibility, a treatment plan can be developed that includes techniques counselors are familiar with and comfortable with, adapted to fit the needs of youth with an FASD.16

Stethescope

Many of the principles for working with adults apply to adolescents in terms of their ability to function in a group setting. Individual counseling may be needed to avoid some of the issues that arise in youth with an FASD who lack social skills and find group settings confusing or overwhelming. Talk therapy can be modified to incorporate role playing, practice dialogues, play therapy, art therapy, and other methods that can draw on many of the strengths seen in youth with an FASD.

Information on treating adolescents with an FASD and alcohol problems is scarce, but some ideas can be found in existing programs. For example, a program at Keystone Treatment Center in South Dakota addresses issues typically seen in these youth and suggests a protocol. These principles may be helpful in developing treatment plans.

Adolescents with an FASD show hyperactivity, are easily distractible and restless, have poor impulse control and poor judgment, are easily influenced by other people, have difficulty in learning from past experiences, and are uninhibited. They do not recognize dangerous situations and tend to trust anyone. They have memory problems, lack flexibility, and cope poorly with change. Many are genetically predisposed to addiction and many are forced into chemical dependency treatment. The average patient at Keystone with fetal alcohol problems has an I.Q. from 65 to 85. They socially function at the level of a 7- to 9-year-old child.17

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