Introduction
Despite increasingly effective prevention and treatment efforts on the part of parents, schools, and treatment programs, teen substance use continues to pose a challenge. Educators and school staff—especially guidance counselors, school social workers, and school psychologists—are in a unique position to identify substance use and related disorders in students and provide support and direction for teens and their parents. In many ways, school counselors are first responders, standing on the frontlines in the effort to educate and address substance use issues.
The Helping Relationship
At the foundation of all therapeutic services is relationship. The most effective prevention and intervention efforts are rooted in trust, empathy, and consistent care. School staff are often among the most consistent adult presences in a teen’s life and can become critical anchors of support. Simply showing up, listening, and maintaining an open line of communication may be more impactful than it seems.
Recognizing Warning Signs of Substance Use
It’s important for school staff to be attuned to the potential signs of substance use. While no single behavior confirms use, patterns and clusters of signs may warrant further attention.
- Physical Signs: fatigue, red or glassy eyes, sudden weight changes, unexplained injuries.
- Behavioral Changes: sudden decline in academic performance, frequent absences or tardiness, defiance or rule-breaking, increased risk-taking.
- Emotional Indicators: mood swings, irritability, apathy, unexplained sadness or anxiety.
- Social Signs: withdrawal from friends or activities, secrecy, changes in friend/peer group, rumors or reports from peers.
Building a Safe, Nonjudgmental Space
When concerns arise, the way we approach students matters deeply. Begin with rapport, approaching the student with curiosity and compassion. It is both ethical and helpful to emphasize confidentiality, explaining the limits of privacy in school settings. Using open-ended questions can help to elicit important information from students, promoting more communication.
Basic Assessment Practices for School Counselors
Brief screening tools like the CRAFFT, which assesses for substance use disorders in adolescents and young adults aged 12 to 21, can help structure a conversation and identify risk. While it can be filled out by the adolescent, it is short enough to administered conversationally using the following prompt: “I ask these questions of many students to help get a sense of what support might be helpful.”
Additional Key Questions
Along with validated screens, gently exploring use patterns, motivation, and consequences can also help determine whether more help is needed:
- “Have you ever felt you needed to cut down on your use?”
- “Has your use ever gotten in the way of school or relationships?”
- “Has anyone ever expressed concern about your use?”
Assess for Co-Occurring Issues
Substance use issues do not exist in a vacuum. Pay attention to signs of anxiety, depression, trauma, or stress at home. Gaining a holistic picture of a young person’s deficits and strengths can guide more effective referrals and support planning.
Documentation and Consultation
While specific guidelines vary from school to school, generally it is vital to document all observations and do so in a way that is factual, without resorting to assumptions or interpretation. The goal is not diagnosing a substance use issue but determining whether a formal assessment is indicated. Always consult with your supervisor or administrator and, if needed, external professionals. Even if you are not authorized to share identifying information, you can still discuss general observations and patterns that can help in determining whether further intervention is recommended.
Alerting Parents and Supporting Treatment
Except in rare occasions of abuse, neglect, emancipation, and older minors seeking treatment independently, it is vital to alert parents of suspected issues with the goal of facilitating assessment and potentially treatment. Once a referral is made and treatment initiated, programs like the New York Center for Living will likely want to sign the necessary consent forms to facilitate coordination in support of the young person and their family. Effective collaboration across all parties is strongly correlated with good outcomes.
Referral to the New York Center for Living
If you would like to refer a family to our program, it is vital to approach them with respect, partnership, and clarity. Here are some sample talking points:
- “We want to make sure your child has access to the right support.”
- “The New York Center for Living is a specialized outpatient program in NYC that works specifically with adolescents and young adults.”
- “They offer comprehensive, developmentally attuned care for substance use and co-occurring mental health concerns.”
From there, you or the family can contact the Center directly at 212-712-8800 or info@centerforliving.org.
Final Thoughts
Early intervention can change a life. School counselors, psychologists, and social workers have a profound role—not only in identifying risk, but in offering hope. Referrals are not about blame—they’re about support, healing, and care. When we act early and partner with specialized programs like the New York Center for Living, we give young people a better chance at recovery, resilience, and the future they deserve.
Recognizing & Responding to Student Substance Use (One-Pager)
A Guide for School Staff
Why This Matters
Teen substance use remains a challenge. As educators, you’re often the first to notice signs and can play a crucial role in early intervention. Your relationship with students makes you a key support in preventing long-term harm.
Warning Signs to Watch For
- Physical: Fatigue, red/glassy eyes, weight changes, unexplained injuries
- Behavioral: Drop in grades, frequent absences, rule-breaking, risk-taking
- Emotional: Mood swings, apathy, irritability, anxiety or sadness
- Social: Withdrawal, secrecy, changing peer groups, concerning rumors
Best Practices for School Counselors
- Build Trust: Use open-ended questions; explain confidentiality limits.
- Screening Tool: Use the CRAFFT to guide conversation.
Prompt: “I ask these questions of many students to understand what support might help.”
Sample Questions:
- “Have you ever felt the need to cut down on your use?”
- “Has your use impacted school or relationships?”
- “Has anyone shown concern about your use?”
Look Deeper: Consider anxiety, depression, trauma, or family stressors.
Document Objectively: Stick to facts—avoid assumptions.
Consult Freely: Talk with your supervisor, administrator, or external experts when needed.
Working with Families
Approach with empathy and partnership.
Say:
- “We want to ensure your child has the right support.”
- “The New York Center for Living is a specialized outpatient program for adolescents and young adults.”
- “They offer expert care for substance use and co-occurring issues.”