Service To Others May Help Addicted Adolescents Overcome Fear Of Social Humiliation

Maria Pagano, PhD Case Western Reserve University School of Medicine Department of Psychiatry, Division of Child Psychiatry Cleveland, OHMedicalResearch.com Interview with:
Maria Pagano, PhD
Case Western Reserve University School of Medicine
Department of Psychiatry, Division of Child Psychiatry
Cleveland, OH

MedicalResearch: What is the background for this study?

Dr. Pagano: Socially anxious adolescents quickly figure out that alcohol and drugs can provide ease and comfort in social situations that are anxiety provoking.  Reaching for a substance to change how you feel can quickly become a knee-jerk reaction, can develop into an addiction, and robs youths of learning how to tolerate interpersonal differences and uncomfortable feelings, developing emotional maturity, and cultivating self acceptance.

Adolescents who fear being criticized by their peers are likely to not speak up in group therapies during treatment, which can limit their benefit from treatment.  There is a lot of healing that comes sharing your insides with others. Socially anxious patients may not get this healing nor let others really get to know who they are and give input to their lives

Higher peer helping in AA during treatment means getting active in low intensity tasks like putting away chairs, or making coffee at a 12-step meeting.  It is less about needing peer assistance or expecting praise or recognition from giving service.  It is more about adopting the attitude of “how can I be helpful?”

MedicalResearch: What are the main findings?

Dr. Pagano: Almost half of patients entering adolescent residential treatment suffer from a persistent fear of social humiliation that began years before they started to experiment with alcohol and other drugs.  Getting active in service in the 12-step program cuts of return to the drink-trouble cycle in half, and particularly benefits youths with social anxiety.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Pagano: Professionals should encourage and help facilitate patients’ participation in service activities at the start of treatment and monitor their engagement as one would exercise throughout treatment.  We do a disservice by limiting their service participation or considering service as an activity for those who graduate from treatment.

There are many real-world applications of the findings from this study.  Adolescents would benefit from knowing that most people feel like they do not fit in and that it is a lifelong journal to get comfortable in your own skin. Parents, teachers, and other positive adults in the lives of adolescents can provide education about this and the role alcohol and other drugs can play in providing initial comfort and long-term cost.  Using alcohol and drugs to fit in or be the life of the party can develop into a habit and ultimate an addiction.  Learning to tolerate feeling different and letting other people have their opinions about you takes practice, but it gets easier.  Play-role practicing with safe friends or adults who pretend to dismiss or view the adolescent negative is another real-world application that can help an adolescent develop this muscle.

Citation:

Social Anxiety and Peer Helping in Adolescent Addiction Treatment

Alcoholism: Clinical and Experimental Research

Volume 39, Issue 5, May 2015, Pages: 887–895, Maria E. Pagano, Alexandra R. Wang, Brieana M. Rowles, Matthew T. Lee and Byron R. Johnson

Article first published online : 14 APR 2015, DOI: 10.1111/acer.1269

MedicalResearch.com Interview with: Maria Pagano, PhD (2015). Service To Others May Help Addicted Adolescents Overcome Fear Of Social Humiliation