What Kind of Counseling Should I Seek for My Adult Child?

What kind of counseling should I seek? Our 22-year-old daughter was arrested New Year's Eve for driving while intoxicated and fleeing the scene of an accident. She'd sideswiped another vehicle and kept driving. Fortunately, no one was hurt or injured, but the thought of what could've have happened to her or others is gut-wrenching. Her irresponsible behavior is not new. It started when she turned 18, broke up with her longtime boyfriend, made new friends, and started experimenting with drugs. Since then, she damaged a rim/tire because of reckless driving, totaled two vehicles (one of which we believe was due to her drinking, but since she didn't call the police and had her car towed by a friend, we'll never know!), engages in risky behavior which exceeds that of others her age (in my opinion), and more recently has started dancing at a strip club. Her father and I are worried sick that the next call we get will be to tell us she's missing or dead. I want to get help for myself to learn how to better deal with her and my own anxiety about it all, but I don't know what to look for in a therapist. There are so many specialties to choose from, and I'm not even sure what her problem is. I've wondered if she's bipolar, has some kind of personality disorder, suffers from multiple addictions, or if she just needs help learning how to cope with feelings of self-worth. GoodTherapy.org seems like a great resource, if I only knew what to look for. I feel completely overwhelmed with my daughter and her problems and the many types of therapists. Please. Point me in the right direction! —Perplexed Parent
Dear Perplexed Parent,

First, thanks for writing. Second, I’m sorry to hear about your travails; I can only imagine the exhausting and frightening roller-coaster you have been riding. Finally, this may or may not surprise you, but even as a therapist I can relate to your question, “What kind of therapy is best?” I recently read an article by a newly licensed and overwhelmed therapist who said there are something like 200-plus “modalities” for therapists to choose from. It seems every other day someone is inventing a new approach to this, that, and the other. One research study says this approach is solid, the next one says the opposite. No wonder you’re confused!

Fortunately, clarity can be found, because ultimately any good therapist—in my experience—is there to answer the question, “What is most helpful or healing for this particular person at this particular time?” Nearly all research studies come to the common conclusion that a safe and trusting therapeutic relationship is central to a helpful treatment. If someone has a viscerally strong response for or against one of my recommendations, my job is not to call this “resistance” but rather to listen, explore, and learn what’s going on.

So, point one: Is the therapist you’re talking to listening to you, as an individual, not a generic “anxious client” or “parent of an addicted child,” etc.?

In general, human beings prefer certainty to ambiguity, but offering too much certainty as a therapist is misleading and maybe even unethical. No one has a “lock” on what to do for sure. Now, practical suggestions can be helpful and reassuring. A common “tip” a therapist might offer someone in your situation might be to attend Al-Anon meetings. It certainly couldn’t hurt to try the program. There is much to be gained, even if it ultimately isn’t a good fit. (I’ll return to Al-Anon in a minute.) Other suggestions, such as “Take care of yourself” or “Don’t enable the addicted person” or “Detach with love” are a little more problematic, because although they might sound good, but what do they mean for you and your loved one, in this particular case, with whatever circumstances are happening at that time?

What if a person grew up in a family where setting certain types of boundaries, or stating one’s needs or limitations, drew traumatizing emotional fire? Are they being weak for not “speaking up” or “asserting their needs”? Trauma tells us something is still prohibited or dangerous, in the present, since we are wired for self-protection and safety above all. This is where self-help gives way to psychology, to empathic understanding and exploration of a person’s experiences, beliefs, and needs. Some parents may tell me, “Not giving my addicted child money feels like I’m killing them.” It would be easy for me to wave this off and urge them to withhold—“Hey, it’s for their own good”—but, again, that might be overly simplistic.

I would certainly recommend that you seek a therapist who has experience working with families and parents of addicted children, someone who can empathize and offer suggestions that make sense for you and your circumstances. A sense of safety and trust is essential.

I would certainly recommend that you seek a therapist who has experience working with families and parents of addicted children, someone who can empathize and offer suggestions that make sense for you and your circumstances. A sense of safety and trust is essential. One litmus test is, can you give the therapist feedback on what is or isn’t helpful and how does the therapist handle it? If they become defensive or claim it’s all your “resistance,” I say move on sooner rather than later.

Other factors you’ll want to look for: experience with addiction as it affects families; knowledge of treatment options (including local or community support groups besides or in addition to Al-Anon, and an understanding of Al-Anon, come to think of it!); and a patient but persistent curiosity about your experience. If it seems like a lot to ask, it may be; but to be honest, so what? Addiction is a merciless, complicated issue (some prefer to say “disease,” others don’t); it takes a lot from people and asks a lot from families, so it stands to reason people in therapy will, at least some of the time, need a lot from their therapists. It comes with the territory.

I also suggest you try at least two or three therapists to get a sense of different styles and so forth. This is not uncommon, and it makes a lot of sense.

Finally, a word on Al-Anon. Some swear by it, others say “stay away at all costs.” I think any rigid position is potentially harmful. I think trying it is a good idea. (It is also good role modeling for your child, who may not be so keen on attending meetings at first but may ultimately find them essential.) Try a few different meetings; attending one and disliking it is common, but no two meetings are the same and some fit better than others. Some are turned off by the spiritual talk, others aren’t. I suggest you take what you like and leave the rest. At the least, it allows people in your position to share their experience in a communal setting, offer practical ideas on what has worked and what hasn’t, and may possibly provide support for those, like you, who are overwhelmed and beleaguered. Addiction is a hurricane, and everyone in its path suffers.

I think it is terrific that you are seeking support. That shows a humility and inner wisdom that should be nurtured and supported by the right provider. Sometimes, what people need most is a sense of hope. There is no shame in seeking or wanting this. Yes, sugarcoating or fantasy can be dangerous, but so can hard-edged “realism,” since the truth is we just don’t know what will happen from one day to the next. It is a day at a time for all of us, therapists included.

Thank you for writing, and best of luck to you in your search.

Kind regards,
Darren