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Substance Misuse Counseling 101 for Parents

Understanding some basic principles of substance misuse counseling will help you as parents develop an approach to intervening with your child.

Substance misuse is a problem that involves the interaction among physical, emotional, social (friends), and environmental (family, school) variables. In the course of our normal daily interaction with our kids, we’re usually aware of any physical, social, and environmental issues. Since children are often not able to articulate their emotional struggles well, we need to look at their behaviors as possible signs of conflict.

People use drugs for reasons. And our behavior, no matter what age, reflects choices we make based on how we think and feel. Also, as humans we tend to move towards rewarding activities and away from uncomfortable activities. Problems with drinking and drug use are associated with the harmful choices we make, often as ways of helping us feel better in the short run. Chemically, alcohol and drugs offer available options ways to self-medicate the uncomfortable feelings of daily life.

For example, a common example of uncomfortable feelings in teenagers is associated with their struggle with self-esteem. Children tend to blame themselves and feel excessive guilt for a loss or trauma in their life and often feel shame about having such feelings. Avoiding these feelings by not talking is like burying them, making children more vulnerable for ill-advised choices for relief.

Using ICE

In my work with clients I explore making healthy choices with them regardless of their age. With parents of teens and preteens, I encourage parents to follow these guidelines for being proactive with their children to lower the risk of drinking or drug abuse: Information, Communication, and self-Examination.


  • Accurate information is the best ammunition to counter the risk of problems associated with substance abuse. Arming yourselves with facts about alcohol and other drugs as well as about your child’s development will keep you ahead of the curve and help you stay in touch with your child’s potential risk.
  • Emphasize facts, not opinions. Certainly your opinion matters, but the idea here is to be a reliable resource for non-judgmental information for your kids. Offer your opinion, don’t force it on them. It’s likely they already know it by observing you.


  • Listening to what children have to say is often a more important communication skill than what you say to them. Talking about general current events and pop culture will give you an opportunity to hear their views and attitudes without them feeling “interrogated.”
  • Set and do your best to establish clear rules about drug, alcohol and tobacco use. Discuss substance use often and emphasize that you prefer that they not use alcohol and other drugs, but realize that you can't prevent them from experimenting. Rather you can nonjudgmentally and unemotionally (not always easy!) discuss the harms associated with use and encouraging conversations on how to reduce the risks associated with their drinking or getting high, if they choose to do so.
  • Engage in regular family activities such as eating meals together, “movie/game night”, and family meetings.
  • Emphasize and provide, safe, sober transportation,
  • Help children develop resistance skills. Discuss with them specific ways to counter pressure from peers to take part in risky behavior.
  • Reward healthy choices and activities.


  • We often forget that we were once teens. Take a look at your own childhood for clues about what parenting approaches worked and what didn’t work for you and adapt those guidelines for today’s lifestyle.
  • How do you cope with stress? What coping strategies do you use? How manageable is your family’s schedule? The answers here are usually transparent to your child; honesty is required if you expect respect and trust back from her. 
  • Examine your own substance use/abuse and model healthy, responsible behaviors. For example, never drink and drive; don’t use illegal drugs.
  • Seek help for yourself if you become aware of your own substance se problem.
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