How Do You Turn Troubled Teens Around?

Photo illustration by The Phoenix Spirit

Imagine you are 14 years old. Your parents blast you with venomous comments when they are in a drug stupor, or they disappear for days. Or maybe they push you to go to school when you are so depressed and scared that you wish you could die. You only go because the fentanyl is there waiting for you. It’s the one thing you know you can count on to get out of this hole.

Imagine you are the parent of a 16-year-old and everything you try to do to keep that child healthy and safe seems to backfire on you. You’re tired of the lies, the ER visits after the cuttings, the calls from the school. For a moment you may even feel complete disgust for this child of yours and then sink into shame over that.

Who is going to care enough to turn these situations around?

Only a handful of local treatment programs roll out the red carpet for such teens. One is tucked inside Fairview’s massive health system. Another, Lakeside Academy operated by Minnesota Adult & Teen Challenge, was just cited by Newsweek as one of the top treatment programs in the country.

It takes love

Staff at Fairview’s adolescent treatment program stand ready with an enthusiastic welcome for young people dealing with both addiction and mental health difficulties. Program Manager Nicole Herlofsky is quick to say how much she loves kids like this.

“They’re fun and they’re funny and they’re irreverent,” she says, with a lighthearted laugh. “It’s the best job.”

She and her staff treat adolescents with both addiction and mental disorders in both inpatient and outpatient programs. Some patients may be from fine families, never giving their parents much concern until they get lured into drug use by friends and get hooked. Others may have been cycling through living on the street, in shelters, on a friend’s couch, or in jail, or stuck in destructive and abusive home environments. For some of these teens, everyone in their lives has given up on them — or come darn close to it. They enter treatment with a host of emotional and behavioral problems intertwined with their addiction.

Herlofsky and her staff are undaunted.

“The thing about adolescents is they still think that they’re going to change the world,” she says, even when their living situation seems hopeless. “They have all of these dreams and all of these goals. And many of them are going to achieve those things.”

To help them realize such a promising future takes massive amounts of patience, planning, and partnering. The first step is to get the young person physically stabilized. It may take days and the right mix of medication treatment to get the drugs flushed out of their system.

“I think one of the most concerning things that we’re seeing, particularly in Minneapolis, Saint Paul and the immediate suburbs, is the explosion of fentanyl and opiates,” says Herlofsky. “Kids have that brain development stage where they think that nothing bad’s gonna happen to me, and they’re using fentanyl and overdosing on fentanyl at alarming rates. So that’s why the medication-assisted treatment piece becomes really important, because we have to figure out a way to keep these kids alive long enough that we can treat them and help them get better.”

Meet core needs for stability

Once the teens enter treatment, full-time psychiatric staff see these patients throughout each week. Therapists and other staff also meet with them for extended periods every day. They pour on the love and acceptance these youth are desperate for, while helping them build skills for living a healthy life.

In the residential program supervised by Luke Bushman, the staff also partner with many local organizations and agencies to establish a stable and healthy environment for them when they leave treatment. A place to live. Food. Clothes. County support services.

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“Sometimes,” says Bushman, “it is the county taking custody, or it’s a grandparent.”

“I think the most important work honestly that we do is within the family,” says Herlofsky. “We’re working on helping the parents with kind of basic parenting skills, about what is normal adolescent development and what behaviors do you need to address as a parent, helping them hold kids accountable. Reestablishing structure in the home that often by the time we see them has kind of gone out the window in terms of rules, expectations, appropriate consequences, those kinds of things. We work a ton on communication and how to have conflict safely and effectively at home.”

Sometimes they work with divorced parents who, she says, “can’t or won’t coparent together, and that poses significant challenges. So oftentimes we’re starting with two family sessions a week with each one of the parents, with the goal of trying to eventually merge that and get them to, at a very basic level, parent on the same page with some similar expectations.”

Stop the pain

“They’re painfully aware of the ways they’ve let everybody down. They’ve been using alcohol and drugs to get relief. They get stuck and get lost.”Not every patient is in such dire straits. Ava, an A student and “over-achiever,” according to her mother, chose to enter treatment after she got tired of lying to her parents. She was hiding her fentanyl use, which came about, she says, “from hanging out with the wrong group of friends.” Her school performance got sloppy. All she could think about was getting her next fix, she says. She skipped going to work and got caught in lying about that. She also felt ill equipped to handle her emotions. “I would cry, break down sobbing,” she says, and fentanyl brought her relief.
In Fairview’s treatment program, she learned how to notice her emotions building up and how to calm herself. “I don’t cry that much now,” she says. She’s been sober for 10 months.

Ava’s mother noticed a big change in her daughter.

“When she first came out, her confidence level – she was fearless,” her mother recalls. “That’s still there.” And she believes that Ava is done with fentanyl. “One thing she has never wavered on is her commitment to sobriety. Those friendships have fizzled.”

Ava and her parents sing the praises of the staff at Fairview. “Everyone was so nice,” Ava says. “They saved my life.”

Surround them with a family spirit

At a sprawling former Girl Scout camp among farmlands near Buffalo, Minnesota, you can almost smell the culture of kindness at the barbeque “Family Day” event at the lakeshore. The family in this case is the community of people who make up Lakeside Academy, which include 29 teenage boys and a passel of compassionate, fun-loving staff.

A biker pulls up, a woman once a troubled teen herself, now on staff. She gets a quick hug from a couple of the teenage boys as a group of them are drawn like flies to admire her set of wheels. Another boy is showing off a garter snake. Other boys shoot hoops nearby, and a few more are pulling out bows loaded with soft “arrows” to pelt at each other. They look nothing like a bunch of kids whose lives have been marked by a history of failure and rebellion that brought them to Lakeside.

This Christian-based school and treatment program draws students from around the country. They stay for 6-12 months.

Most of them come in “resistant,” says Lakeside’s director Jeff Jensen. Any adult who tries to talk to them is likely to be cussed out and hear, “This is stupid, I don’t have a problem,” according to Jensen.

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It takes a while to make a dent in this hostility. The boys are generally not interested in talking to a counselor about their “feelings” from across a desk. At Lakeside, those conversations are more likely to happen while the student is on a walk with a counselor or tending to the horses and goats in the barn, making a birdhouse or restoring a canoe in the woodshop, or rebuilding an engine in the welding shop. Or out in the garden, on a boat, in the art room, or in the gym.

Show them respect

What they find at Lakeside is people who quickly show they are genuinely interested in what the boys want. Jensen and his staff learn what that is from their collaborative, strengths-based approach to treatment.

Jensen’s eyes seem to mist over as he talks about how much these boys are hurting and how they are eager to be respected and understood. All the pressure they’ve been getting to shape up back home has alienated them, shut them down, he says.

“They want good relationships with their parents. They don’t want to do poorly in school,” say Jensen. “They’re painfully aware of the ways they’ve let everybody down. They’ve been using alcohol and drugs to get relief. They get stuck and get lost.”

Jensen’s staff work to create a safety net for these troubled teens. They ask the boys about their goals and then toss out questions like, Is the way you’re behaving getting you that? How can we help you get what you want? “We respond to defiance with love,” he explains.

Instead of responding to being cussed out by telling the boys to watch their language, Jensen says, they are more likely to respond with a warmhearted, “I’m sorry if what I said offended you. What can I do to make things better for you?” Boys used to being scolded are taken aback by this demonstration of care and respect. They soon learn the staff are indeed on their side.

Build emotional skills

“Most of them don’t have any capacity for emotional regulation,” Jensen says. “We give them those skills early on.” The boys learn how to notice the pressure building up in their bodies before it explodes. Self-soothing techniques become a new skillset for them. They learn to “step back,” take a walk, find another outlet for their feelings, throw cold water on their face, and other strategies to keep their brain’s amygdala from being hijacked by the intense emotions. They learn to notice how things turn out better for them when they do these things. They see themselves meeting their goals.

The boys attend an onsite school with transferable credits and special education teachers. The rest of their days are filled with group and individual meetings with members of their “care team,” and there is plenty of time for skateboarding, disc golf, time in the water, or other favorite activities.

Feed their spirit

“Spiritual care is part of their stay as well. They aren’t pressured to believe anything, says Jensen. “That wouldn’t work,” he says. But, he adds, what most of the students do latch onto is finding some meaning and purpose in their lives. “They learn a message of love, of redemption,” he says. “They learn they don’t have to be defined by their past.”

Pat Samples, is a Twin Cities freelance writer, writing coach, and somatic coach. Her website is

Last Updated on September 7, 2023

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