You may have heard that your son or daughter needs to “hit rock bottom” or “has to want help,” in order to get better. And therefore any attempts to otherwise convince him or her to enter treatment is wasted breath. The fact of the matter is our loved ones are often interested in getting help — but we may not always know what to listen for.

If your loved one expresses even a little willingness to engage with treatment — whether it’s a consultation, attending an AA or NA meeting, or going to more intensive programs — it can be all the invitation you need to begin the conversation. While the hope is that your loved one will readily and quickly agree to treatment, don’t despair if he or she says no or wants to think about it. There will inevitably be other opportunities to raise the subject again. Managing your expectations around engaging and staying in treatment are a part of good self-care.

Note: It’s important to do your homework before suggesting treatment so that you know what programs are suitable, have openings and what means of payment will be accepted. 

Listen for “Change Talk”

So, how does a willingness to get help reveal itself? It usually comes in the form of “change talk.” Change talk is any time your loved one voices a concern over the way things are, or expresses a desire to improve his or her life in some way. Do any of these examples of change talk sound familiar?

“I’m really feeling depressed that I don’t have a decent job.”

“I think I really upset Jack [a friend] last night when he thought I had one too many.”

“I want to move out and have my own place.”

“I wonder if I should go back to school.”

When a loved one expresses change talk, take notice and help him or her connect the dots. Compassionately explain how their substance use is related to their concerns in the present and their hopes for a better future.

Consider the following contrasting dialogues between a parent (P) and young adult (YA) who is struggling with substance use, can’t get a job and wants to be independent.

YA: I really want to move out and have my own place.

P: How many times have I heard that? You need to get a decent job.

YA: Yeah, I know, but no one’s hiring.

P: You mean no one is hiring that doesn’t want a drug screen. When are you going to figure out that employers don’t want stoners? If you’d only get your act together and stop smoking, your life would be so much better. You know, you really ought to go to rehab.

YA: That’s ridiculous! It’s not that bad.

P: Not that bad? You’re stoned right now. You’d better figure it out pretty soon because your father isn’t going to put up with you not contributing and you’re going to find yourself out on your ear.

YA: I have to go. There’s no point in talking to you about anything.

 
Now consider the following exchange which begins with very similar change talk.

YA: I really want to move out and have my own place.

P: I know you’ve wanted your own place for quite some time. What do you think is holding you back?

YA: I can’t get a decent job that pays enough.

P: What have employers told you when you’ve applied?

YA: They all want drug screens. That’s BS in my opinion. I mean why should they care that I smoke some weed and do a little cocaine now and then.

P: So, you want a good job and your goal is to move out, but your drug use is getting in the way.

YA: Yeah, that about sums it up.

P: What are your thoughts about getting a consultation to see what kind of help might be available to cut back, or quit for at least a while so that you can get a better job?

YA: I don’t know… maybe.

P: Why don’t you think about it and let’s talk about it again in a day or so.

YA: Ok.

What can we take away from these conversations?

There are several key differences to note. The second exchange remains a respectful conversation without becoming confrontational by using techniques like open-ended questions that lead the young adult to reach his or her own conclusions. The parent likely knows that drug use is at the root of their child’s unemployment, but draws it out of him or her without belittling or judgment.

And the timing of this kind of conversation is important. While it’s useful to let a loved one’s change talk open the door to this type of conversation, it’s counterproductive to do so when they’re under the influence, racing out the door, overly tired or might otherwise feel interrupted.

Note that in the second conversation, the parent suggests “getting a consultation” rather than demanding, “You have to get treatment” or “You have to go to rehab.” Treatment comes in a range of options and it’s helpful for your loved one to have some degree of input and choice. This could be at the level of treatment (for example, your loved one may agree to attend an intensive outpatient program, but won’t agree to residential treatment) or within a treatment level (for example offering that a loved one could make a choice to attend ABC outpatient program or XYZ outpatient program.)

In addition, even though abstinence may be the ultimate goal, it can also be effective to suggest that a loved one consider treatment in order to “cut back” on substance use. Once in treatment, they’ll have an opportunity to examine whether they can moderate and still meet personal goals.