The Future of Teen Addiction Treatment
An Interview with Jeff Nalin, Psy.D.
By Meghan Vivo
The field of addiction medicine is growing and changing at a rapid pace. Reaching far beyond medications and 12-Step meetings, modern addiction treatment looks nothing like the institutions and hospitals of the 1900s. As the body of research on substance abuse grows, and as psychiatric and medical professionals seek out new methodologies, treatment of drug and alcohol addiction has become increasingly sophisticated.
Residential treatment for adolescents is an area that has transformed in particularly dramatic fashion in recent years. Facilities that used to offer nothing more than pharmaceutical interventions and weekly group counseling sessions have become obsolete in the face of competition from younger, more innovative programs that incorporate daily individual and group therapy, extensive family systems work, expressive and body-centered therapies like art therapy, acupuncture, and massage, and more.
These modern drug rehab programs are finding newer, more effective ways to treat young people with substance abuse and co-occurring mental health issues, and are raising the bar for everyone in the field of addiction medicine. One example of this new approach to adolescent addiction treatment is a program called Echo Malibu, created when four promising young professionals set out on a journey to revolutionize the way adolescents experience recovery.
The Start of Something New
Dr. Jeff Nalin, a licensed clinical psychologist, certified chemical dependency intervention specialist, and certified youth residential treatment administrator with more than 15 years of experience in the field of addiction, Cole Rucker, M.A., and Alonso Dominguez, a certified 12-Step counselor, met 12 years ago when they joined forces at Los Angeles’ first juvenile drug court program. Together, they improved the lives of gang members and those considered by some to be the “dregs of society” through a unique blend of expressive art therapies, body therapies like acupuncture and yoga, and traditional counseling.
Later, the trio met up with Steve Sager, M.D., a child and adolescent psychiatrist and an attending psychiatrist in the Division of Adolescent Medicine at Children’s Hospital Los Angeles, who has specialized in the treatment of adolescents for over a decade. As these four brilliant minds grew up in the field together, they collaborated to establish an innovative adolescent addiction treatment program of their own in Malibu, California.
All four individuals have dedicated their life’s work to this field, knowing intimately the importance of working with professionals on the cutting edge of addiction science who are always searching for new ideas that lead to a dramatically different approach to treatment.
“When you have the right combination of professionals, you can truly make a difference in kids’ lives,” says Dr. Nalin, the co-founder and executive director of Echo Malibu. “We owe much of our success to our diverse staff of specialists who are at varying stages of their own personal recovery and who serve in a wide range of positions, from master’s level interns to PhDs and MDs. What we all have in common is a passion for this work and a firm belief that magic happens when you give adolescents a voice.”
Dr. Nalin, who has appeared as a chemical dependency treatment expert on CBS News Special Assignment, CNN, and in the anti-drug campaign for the Office of National Drug Control Policy, meets with every adolescent at the beginning of his stay at Echo Malibu to complete a psychological assessment and develop a treatment plan. Some of the students have been escorted to the facility, and most feel their lives are out of control when they arrive. “My goal is to put the control back in their hands and get these kids home as fast as possible. The sooner I get them doing this work without me, the better I’ve done my job,” states Nalin.
Recovery Through Empowerment
Located in the hills of one of California’s most desirable beach towns, Echo Malibu is the manifestation of the belief of these four professionals that adolescent addiction treatment can and should be grounded in empowerment, affirmation, and hope. Echo’s approach is to empower youth with the skills they need to make better choices for themselves.
According to Dr. Nalin, both adolescent treatment and chemical dependency treatment have historically taken a punitive approach of breaking people down and then building them back up. But more than the juvenile justice system, parents, or peers, adolescents are their own worst critics.
“We believe in upgrading a teen’s defenses, not stripping them bare and building them back up,” says Nalin. “It’s important to respect the defenses they’ve created because they saved them at some point. But now that the teen is facing legal problems or family strife, the old go-to behaviors have lived out their usefulness, and it’s time to upgrade by getting interested in life again. Instead of having one go-to option (drugs), they will leave here with 50 options that will grant relief without turning to drugs or other destructive behaviors.”
The concept of supporting and validating young substance abusers is relatively new in the field of addiction. “People laughed at us all those years ago when we started with this approach, but we knew the empowerment model yielded much better long-term results than anything else we’d seen or been affiliated with,” notes Nalin. “As this approach has gained in popularity, the research has followed in support of our theories, and more treatment centers are jumping onboard.”
Giving a Voice to the Next Generation
Integral to Echo Malibu’s approach is the realization that this generation of adolescents will grow into the country’s leaders in a few short years. Rather than tearing teens down and building them into the people others want them to be, Echo takes a fresh approach that helps teens become a better, more insightful version of who they already are.
“The next generation is newer, more creative, more cutting-edge, and will be better than we were if they are given a voice,” counsels Nalin. “They have greater potential than us because they will exist longer and see new things and have new ideas. Instead of envying them for this, we get them tuned back in to all that they have to offer. Our caring, admiration, and respect for these teens trickle down all the way from management to the staff, and on to the students.”
When young people feel good about who they are, they are far more likely to make good choices and fulfill their potential, according to the founders of Echo Malibu. There’s a natural pull in adolescence to explore new activities and interests and to make new connections to life as part of the transition into adulthood. Dr. Nalin and his colleagues observe that even the most put-together adolescents have self-doubt and struggle in some way to define themselves as people. Some stray into trouble, develop bad habits, or try to take shortcuts, but it’s all part of the same, natural process of growing up.
“We don’t judge young people for the path they’ve taken,” states Nalin. “They’re not here because they’re bad people – in fact, to us it’s clear they are here because they’re great people who need help finding a new direction.”
The importance of honoring the ideas and opinions of younger generations became clear to Dr. Nalin during his internship at a hospital where the medical director actively sought out his perspective. The director wisely perceived that Nalin, a young professional who worked night shifts, would have different insights into treatment than an older, managerial daytime worker. Now, in his own practice, Nalin understands that some teens will see him simply as a doctor, and may make a stronger connection to an intern or therapist. Because treatment is about what works for the adolescent, Nalin welcomes healthy bonds of any kind.
“Our approach is to introduce teens to lots of people of all ages, specialties, and styles, and if they connect with one and not the other, that’s great,” says Nalin. “We come from the understanding that we have as much to learn from our clients as they do from us. When you approach teens from a place of genuine openness and humility, rather than approaching them from on high as the mighty addiction experts, the students respond with similar openness.”
Many young people are surprised by this empowerment approach. They’ve attended countless other programs that have broken them down, and are generally far more receptive to the nurturing, compassion-based approach. At Echo, students feel supported by staff members who are friends, not enemies. By the time they leave, they feel ready and scared, which is the desired mix of emotions.
“As they head back into the world, our kids have an honest view of the mountain in front of them, but they also know that if they climb it, they’ll find out who they really are. And that’s a big payoff.”
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