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- SMART Recovery
- Focuses on self-management and recover-training to treat the overall issue of addiction.
- Works to build and maintain motivation, cope with urges, manage thoughts, feelings, and behaviors, and live a balanced life.
- Accessible in-person and online.
- Has groups specifically for young adults in recovery.
- Has groups for family and friends of those dealing with addiction.

SMART Recovery. (2022). SMART Recovery- About Us. SMART Recovery. Retrieved October 6, 2022, from https://www.smartrecovery.org/about-us/

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History:
- Parental divorce at age six
- Lives with mother, stepfather, and two younger brothers
- Spent weekends with father, but not close
- Forced to live with his father for the summer
- Was working as a sex worker to earn money for drugs and stealing pills from his father
- Finally agreed to help his father build a house and began mending relationships with his father, mother, brothers, and, eventually, his step father
- Began romantic relationship with next-door neighbor Alyssa
- Stopped using substances about 2 months ago but indicated he would still take his father's pills and count them when he had cravings
- Father died of terminal cancer one month ago
- Grief has led to increased desire to begin using substances again

Strengths:
- Family supports
- Supportive significant other
- Educational setting and communal supports
- Resiliency and motivation to recover
- Interests: Music and art

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These feelings, no matter how painful, are part of living. Today, we are alive- not anesthetized, not sedated, not passed out. Take control of your feelings and through action you can change. Today, as everyday of sober living, we have a choice. - Ann D. Clark

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The best time to plant a tree was 20 years ago. The second best time is now.
- Chinese Proverb

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1. The National Association for Alcoholism and Drug Abuse Counselors (NAADAC)- Resources for classes, books, regularly published magazines, and links to more resources. https://www.naadac.org/resources

2. Substance Abuse and Mental Health Services Administration (SAMHSA)- Tips for Teens fact sheets about different drugs in informative graphics. These are free to download.
https://store.samhsa.gov/?https://store.samhsa.gov/?f%5b0%5d=series:5567

3. The Institute for Research, Education, & Training in Addictions (IRETA)- Resource library with great free resources such as webinars, infographics, and treatment guidance.
https://ireta.org/resource-library/

4. National Institute on Drug Abuse (NIDA)- Resources for parents and educators that have a lot of publications, videos, and resources to use and/or share with clients.
https://nida.nih.gov/research-topics/parents-educators

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One aspect I think will be important in this client's recovery is the support systems he has that many teenagers with substance abuse do not have. Sam has a mother who truly cares about him and is working towards understanding him better. He has two younger brothers who look up to him whom he enjoys spending time with. Sam's stepfather had been distant and unkind in the past, but is making a true effort to mend the relationships in his family and be present in their lives. Sam's girlfriend is aware of his substance abuse history, was present for the drastic changes that recently occurred in his life, and is willing to help him in any way she can. Finally, Sam had a unique opportunity to form a true relationship with his father prior to his death and was able to experience a lot of healing and closure for past issues that lead to his drug use. I think Sam would be an interesting client because he has so much support behind him, but also the factor of grief due to the recent death of his father. This grief could either push him to use again to numb the pain or to remain in recovery to make something of his life like his father wanted. Though this case would be complicated because of the grief, Sam's support system could provide the compassion, understanding, and accountability he would need to be a teenager in recovery.

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In thinking about this client, I believe he is very capable of entering and maintaining recovery, but I can't help by think of the future implications as well. Given that Sam began his substance use at age 12 and is now entering addiction recovery at age 16, what will his life look like down the line? Like at 21 when his peers begin drinking legally or when he's 26 and already 10 years clean- what will that mean to him? He may say to himself one day, "I was a kid when I abused drugs and now that I'm an adult and have been clean for so long, I can handle it now." Maybe for him that will be true, but likely it would lead him back down the path of addiction combined with all the negative feelings that are tied to relapse. I think this might be important to consider with teens in recovery while in therapy. Asking them to address what their life might look like in the future and how they will face the challenges of recovery is important especially because many people don't begin their recovery journey during their teen years. Everyone is different and we cannot predict the future, but I think it's important to consider the likely challenges are client's will face and discuss healthy ways to cope with those challenges.

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- Know which model/ theory you're using and why.
- Be aware of yourself and any countertransference that emerges.
- Utilize supervision.
- Seek out research, resources, and certifications to continue learning how to best help your clients.
- Set realistic expectations for your client in your mind- know not everyone is truly ready for recovery, relapses are very common in addiction recover, and lying is a common problem-solving strategy used by clients.
- Believe in yourself and take care of yourself.

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Frances Jensen, MD at Children's Hospital Boston in 2011 on the teenage brain and addiction.

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Why the biopsychosocial model of addiction applies to Sam

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Diversity, Multicultural, and Social Justice Considerations

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Diversity, Multicultural, and Social Justice Considerations

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- Currently, no social barriers impleading recovery
- Considerations that may be relevant in the future:
--- Client identifies as bisexual which could lead to discrimination (particularly if his history of a sex worker comes to public light)
--- Client began using substances at age 12 and is entering recovery at age 16- the stigma surrounding addiction may become relevant in his recovery journey in the future.

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- Young age combined with length of use may make recovery more difficult due to biological factors affected during development.
- Dislike of talking and sharing emotions with people.
- The grief being experienced due to his father's recent death.

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- Motivation to change and not use drugs to avoid feelings.
- Strong family support.
- In a healthy romantic relationship.
- Recent experiences with his father have helped him heal from a lot of past resentment and pain and has changed his perspective on what's important in life .

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Demographics:
- A- 16 years old
- D- No developmental disabilities
- D- No acquired disabilities
- R- No religious affiliation
- E- White
- S- Upper middle-class
- S- Bisexual
- I- No indigenous heritage
- N- California, USA
- G- Cis-gender male

Presenting Problem:
- Substance Use including tobacco, marijuana, inhalants, and prescription pills including Vicodin and Morphine.
- Began using at age 12 and uses because
he "likes how it feels not to feel."

Diagnosis:
- Other Substance Use Disorder
- V code- Uncomplicated Bereavement