When you are the parent of an adolescent whose substance use has become concerning, or the partner of an adult whose drinking is reshaping your life, the clinical questions are often the same. This is a reference for the people watching it happen.
A substantial portion of the people who reach out to my practice are not the patient. They are a parent who has noticed something is wrong with their teenager's drinking or marijuana use. They are a spouse who has watched a partner's wine consumption climb from a glass at dinner to a bottle a night. They are an adult child concerned about an aging parent. The clinical question they are asking is rarely "what should they do." It is "what should I do."
This page is a working reference for parents and partners. The principles below come from years of clinical work with both sides of these family situations. They will not solve the situation. They will tell you what tends to help and what tends to make things worse.
When parents come to me about an adolescent or college-aged child, the patterns that bring them in are consistent: a drop in grades, a change in friend group, behavioral shifts, episodes of intoxication that scared the parents, school discipline events, a DUI, an arrest, or a parent's discovery of substances or paraphernalia. Sometimes the trigger is a single event. More often, it is a gradual deterioration that finally crosses the threshold of tolerable.
For more on what telehealth therapy actually involves for adolescents, including what parents should expect about confidentiality, parent involvement, and outcomes, see our guide on online therapy for teens.
When a partner reaches out to my practice, the clinical situation is usually that they have watched their spouse's drinking gradually escalate over years, have raised concerns multiple times, have been met with defensiveness or minimization, and are now at a point where they are asking what they can do. The honest answer involves both what helps the partner with the substance use, and what helps the partner who is reaching out.
Television depictions have made formal interventions, the staged confrontation by family members, sometimes with a professional interventionist, appear to be the standard response to a family member's substance use. They are not. For most cases, particularly mild to moderate substance use without crisis-level severity, a formal intervention is the wrong move. It produces compliance under duress, it damages relationships, and the resulting treatment engagement frequently does not last.
When a formal intervention is appropriate, which is generally when the severity has reached a crisis point, when the patient is repeatedly refusing all less-confrontational approaches, and when the safety of the patient or family is acutely at risk, it should be designed by a clinician familiar with the case, not based on a generic template. Most of the time, the right next step is a confidential consultation, suggested calmly, framed as information-gathering rather than enrollment.
Parents who are concerned about an adolescent or young adult can schedule a consultation independent of whether the child is ready for treatment. The consultation provides clinical orientation, an assessment of the situation as the parent describes it, and specific guidance on next steps.
Partners of adults with substance use concerns can schedule a consultation for themselves. Whether the spouse engages with treatment or not, the partner often benefits from clinical support and specific guidance on what they can, and cannot, do.
When the patient is in active treatment and family involvement is clinically appropriate, family-system sessions are conducted alongside the individual work. The patient defines the level of family involvement they are comfortable with.
All consultations are conducted via secure telehealth or in person at the Princeton, NJ office. Self-pay, private-practice records. No insurance involvement. PSYPACT-authorized in over 30 states.