Program Aids Self-Esteem of Teen Addicts : Emphasis Placed on Parents, Education at Phoenix House

Cindi Gladwell said she started smoking marijuana and drinking beer in sixth grade. A year later, she was also using cocaine and LSD. The soft- spoken Irvine girl seldom attended school, preferring instead to hang out with friends in Los Angeles.

She argued with her mother about the Ds and Fs she got in school. They fought, too, about her leaving home for days, making her mother sick with worry that she might be lying dead in some alley.

“When my mom talked to me about our not getting along, I’d just walk out of the house,” recalled Cindi, who is 14. “Nothing she said made any difference to me. I told her she couldn’t stop me from doing whatever I wanted.”

Cindi said she rebelled and turned to drugs because she had low self-esteem and wanted to escape problems she blamed on her parents’ divorce.

She now lives at the Phoenix House drug rehabilitation center in Santa Ana. In another month she will be completing the yearlong program.

“It’s been hard here,” she said. But she’s learned that drugs aren’t the solution to the problems of adolescence.

The therapy for Cindi and the 34 other drug-addicted teens she lives with in a converted school is far different from that of the youngsters who entered the first Phoenix House in New York City in 1967.

“The most striking thing we’ve had to change about our treatment strategy has come about because kids are using drugs at an earlier age,” said Dr. Mitch Rosenthal, founder and president of the Phoenix House Foundation.

Once Believed Incurable

“Years ago it was felt that drug addiction was incurable,” Rosenthal said during a stop last week at the Santa Ana Phoenix House, which also serves 65 adults in a separate section. He later visited branches in Venice and Escondido.

“But we now know that drug addiction is a very treatable problem. Adults who’ve used drugs 10 years or more can receive the right kind of care and live drug free for the rest of their lives.”

The New York City psychiatrist was equally optimistic about treating the growing number of teen drug abusers. However, he acknowledged, “we have to handle their educational deficits as well as their emotional problems.”

“Because kids are beginning to use drugs at 10 or 13, by the time we see them at 14 or 16, they’ve lost a lot of time from their educations,” he said.

“For years, these kids have been in school in body only, or they’ve been cutting classes a good part of the time. We’ve set up schools where we try to get the kids to make up two years of education in the year they’re in our residences,” Rosenthal said.

Phoenix House is marking its 20th anniversary this year. Thirty-thousand people have passed through its doors, Rosenthal said. Today, 70% of them lead drug-free lives, based on periodic follow-up studies of all the program’s graduates.

Rosenthal credits this success to lengthy psychological therapy. “Those (adolescents) here for the full 12 months of residential treatment have a success rate in excess of 85%,” he said.

“Those who leave against our advice (midway through therapy) have a success rate that falls below 25%. And those who are here for just a month have no success.”

Because “time in treatment is the crucial variable,” Rosenthal said graduates of many short-term rehabilitation programs all too often slide back into drug dependence after their release when they encounter emotional difficulties. They haven’t had enough time to develop the psychological skills to cope with the stresses of everyday life, Rosenthal said.

Phoenix House’s guiding philosophy, he said, “is not about abstinence (from drugs). We’re really trying to give someone an understanding of his or herself and teach them (through individual and group therapy) healthy ways to deal with the pain, loneliness and fear that causes them to turn to drugs.”

Graduates regain their self-esteem. This gives them the confidence to confront problems rather than run away from them through drugs, Rosenthal said. Participants also learn to overcome difficulties through continual self-evaluation, compromise and communication.

From its New York headquarters, the organization operates what Rosenthal says is the country’s largest residential drug treatment program for adolescents and adults.

The program, composed of a network of six centers in New York and four in California, houses 1,200 people. Since the first California Phoenix House opened in Santa Ana in 1979, other facilities have sprung up in Venice and San Diego and Stanislaus counties.

Phoenix House is one of about 100 residential “therapeutic communities” in the country. “It’s one of the very best,” said drug treatment pioneer Dr. Herbert Kleber, a professor of psychiatry at Yale University Medical School.

Kleber, who also serves as the director of the 900-patient Substance Abuse Treatment Unit of the Connecticut Mental Health Center, said in a telephone interview from his New Haven office that he had high praise for Phoenix House because of a success rate that’s been independently documented and its willingness to implement new ideas.

Recently, Phoenix House’s therapeutic program has been expanded to include the teen’s family. The move also was partly prompted because parents pick up the tab for the program’s $30-a-day cost, based on their ability to pay. (The sliding fee plan is subsidized by funds from county, state and federal grants. Donations come from corporations, foundations and individuals, Rosenthal said.)

“To understand why a kid uses drugs and to keep him from doing so in the future,” he said, “you’ve got to take a good look at his relationship with his parents, brothers and sisters.

“Kids, like adults, tell you things that put the best light on their behavior. But when you put him in a room with other family members, you get the whole story. You get a better understanding of the kid’s character and his real pattern of drug abuse.

“But just as important, you get a good feel for how the kid’s addiction has ruptured family relationships.

“Parents, particularly, feel their trust has been betrayed. They’ve been lied to, had possessions stolen, checks forged and even been physically abused.”

This was the situation that Troy Garver, 17, said he faced with his parents when they sent him to Phoenix House 8 1/2 months ago. He had already been through two monthlong drug rehabilitation programs.

“But I couldn’t stay clean,” Troy said. “In programs like that you’ve got to be really motivated to make changes. I wasn’t.”

The Yorba Linda youth also said 30 days wasn’t enough time to break patterns of behavior developed over years. “I was here for three months before I developed the desire to be in school,” Troy said.

Since he was 13 he had lived in a daze of alcohol, marijuana, methamphetamines, cocaine and LSD, he said. He also lied to his parents and rarely went to school, finally failing 11th grade. A natural athlete, he lost interest in water polo and golf.

“I was a lifeguard at a (country club) swimming pool,” the muscular youth recalled. “I was so spaced (on drugs), I don’t know what I would’ve done if one of the little kids had started to drown.”

Responsibility to others and himself, Troy said, is something that he’s only now developing. He credits much of this change to the therapy sessions at Phoenix House with his father, a retired policeman now in sales, and his mother, the owner of a clothing store.

“When I came here my parents didn’t trust me at all,” he said. “They’d put all this trust in me when it looked like I was willing to turn my life around (by enrolling in the two 30-day hospital drug programs). But when I got out, I’d burn them again.”

Troy’s and Cindi’s feelings of low self-esteem and conflicts with parents don’t seem much different from those of other teens, Rosenthal later acknowledged. He said he didn’t know why teens like Troy and Cindi become addicted and others don’t.

“These days the availability of drugs is so great that it’s very hard for any adolescent not to use drugs at some point,” he said. “There’s no single reason why a kid with problems moves from drug experimentation to drug dependence.”

Troubles with family, friends and school play a role. “Still, we see kids from understanding families that are psychologically savvy. But the kids don’t feel so good about themselves. They turn to drugs to handle everyday problems.

“There is no way any parents, no matter how enlightened they are, can give their children immunity from drug abuse. Once addiction occurs, the only thing parents can do to minimize the problem is to identify it early.”