At CYF, Eric recalls that he had a "million questions" about why he'd hit bottom. "When I got to CYF, for the first time somebody said: ‘Well, young man, the answer is this: All those questions you have--there's just one answer. It's because you have a disease called chemical dependency.' I was lucky and blessed that I got the message."

Over 25 years, CYF has served about 18,000 young people like Eric with addiction treatment and related services. And steady referrals mean that the 74-bed center routinely operates at 100 percent capacity, with a list of people waiting for the next available opening.

Origins in Pioneer House
Soon after opening its doors in 1949, Hazelden looked for ways to serve diverse groups of people--especially those who might be overlooked when it came to addiction treatment. In 1956, for example, Hazelden opened Dia Linn, a center for women. In the 1970s, it treated people addicted to illegal drugs. In the early 1980s, the focus turned to adolescents.

There was already some activity in this area. Pioneer House, the first treatment center in Minnesota based on Alcoholics Anonymous, welcomed both adults and teenagers. Hazelden acquired Pioneer House in 1981, building on that tradition with three decades of the foundation's own experience in treating alcoholics and other addicts.

"Harry Swift [Hazelden president from 1986-1991] and Pat Butler [Hazelden president from 1952-1971 and board chair from 1971-1989] were the ones who really fostered this opportunity," says Damian McElrath, PhD, the first director of Hazelden's Pioneer House. "Peter Butler [son of Pat Butler] also had a strong relationship with the place. He was at all the meetings, really trying to get people on board outside of Hazelden who would be helpful in promoting a program for young people."

In his book, Further Reflections on Hazelden's Spiritual Odyssey, McElrath notes that the new venture was greeted with skepticism--even from people who trusted Hazelden and had received treatment there. They worried that rebellious adolescents would disrupt the units, especially when forced to keep company with adults.

Hazelden allayed this concern, McElrath writes, by deciding to treat young people with their peers in a separate setting. When New Pioneer House was renamed the Hazelden Center for Youth and Families in 1993, the name change underscored this commitment to youth-specific services.

Founded on respect
Equally important was a basic policy decision--that young people, like anyone else with addiction to alcohol and other drugs, deserve to be treated with dignity.

"I just haven't found any other group like CYF where you can be in so much trouble and yet be treated with such respect," says Eric H. "Their response to your antics can be one of a smile: ‘Hey buddy, cut it out. That ain't gonna fly here.' Their response is not anger-creating, and it's not crazy-creating. It's just the way they are there--inspiring and gracious."

Mary Lou C., whose son gained sobriety at CYF, says that he never lost his dignity at CYF. "I said to his counselor one day, ‘I don't know how you do this job.' And she said, ‘I don't work any harder than the kids work.' To motivate them to open their eyes and to feel safe to do hard work, and for the kids to walk away feeling like they have worth--that's unbelievable in a world that's so quick to condemn."

Creating a national reputation
Today young people from across the country come to CYF, seeing its 15 wooded acres on the north shore of Medicine Lake in Plymouth, Minn., as the first stop to a sober life. They come to a center of excellence that's been treating people ages 14 to 25 in a dedicated setting for 25 years. That's an unusual distinction, says Jim Steinhagen, executive director of CYF.

Another advantage is that CYF has a mental health clinic on site. "Given the fact that 70 to 85 percent of our population comes in with an accompanying mental health diagnosis, we really need to treat the whole person," Steinhagen adds. "Having trained psychologists on staff as part of the treatment team helps us meet our own rigorous standards and give young people the best possible chance of long-term recovery."

Donald Stokes, a counselor in Louisville, Ky., says that he refers clients to CYF because that goal is often met. "The kids who go there and follow their aftercare plans stay sober. All treatment centers provide an aftercare program, but what's different is that when kids come from Hazelden, they want to follow up on their plan. I don't know of any other place that gets the same results."

Integrating services
CYF meets the challenge of addiction with the work of professionals from many disciplines. Each client's individualized treatment plan is developed and administered by a team of addiction counselors, family specialists, physicians, nurses, spiritual care professionals, psychiatrists, psychologists, and recreation specialists. It is delivered in a largely gender-specific environment to ensure that the specific needs of male and female patients are met.

It begins with assessment and at least one night on the medical services unit, where clients are observed by nurses to monitor and treat any physical side effects from their alcohol and other drug use. After that, the overall length of treatment varies. For the inpatient residential program, the average length of stay is four weeks. This includes time for individual counseling, group therapy, lectures, bibliotherapy, and trips to outside AA meetings. In the process, many clients complete assignments related to the first five steps of Alcoholics Anonymous.

Peer interaction is built into the program. Each client's work on Steps One to Three has to achieve approval in a group meeting. Adolescents are experts at spotting pretension, and those who bluff at admitting powerlessness or willingness to surrender will get immediate feedback on those points from their peers.

CYF also offers outpatient treatment. Young people in this program follow the same daytime schedule as clients in residential treatment. In fact, local clients can move between inpatient and outpatient programs, making changes in their treatment plan with minimal disruption.

Students who are in high school can continue their studies during treatment. Two hours out of each weekday are set aside for classes with a certified teacher in English, math, and social studies.

The schedule includes time for recreation and leisure as well. Besides team sports, this includes trips to the local YMCA and cultural events in the community.

"One of our clients' biggest fears is that life is going to be boring without drugs," says Marilyn Milstead, director of clinical services at CYF. "We want to make sure that kids know they can have a good time sober, perhaps doing something they would have never thought of before."

In addition to inpatient treatment, outpatient treatment, and the mental health clinic, CYF offers:

• Extended care for young men who have completed primary treatment but are not ready to return home or move to a halfway house.
• Teen Intervene, a program that provides education, support and guidance for teens who have experienced mild to moderate substance abuse. The program involves parents and aims to prevent future chemical-use problems.
• A long-term continuing care group for local clients.
• A four-day Parent Program for parents and other loved ones.

Meeting the need for treatment
To put the work of CYF in context, consider recent findings about teenagers and young adults and their relationship to alcohol and other drugs.

According to the 2005 Monitoring the Future survey of adolescent drug use, drinking is common among teenagers. Fifty-eight percent of 12th graders report having been drunk at least once; so do 20 percent of 8th graders. In addition, 50 percent of teenagers have used an illegal drug before leaving high school.

Monitoring the Future researchers singled out binge drinking--consuming five or more drinks in a row--as their main public health concern. Acceptance of this practice is widespread: Forty-five percent of 12th graders do not see binge drinking on weekends as a great risk.

These findings are not isolated. One section of the 2004 National Survey on Drug Use and Health (NSDUH) focused on people age 12 to 20 who consumed alcohol. Within this group, about 20 percent were binge drinkers and nearly 6 percent were heavy drinkers (binge drinking on five or more days in the past month).

In a related study, researchers from Harvard School of Public Health reported that 31 percent of college students met the criteria for alcohol abuse, while 6 percent could be diagnosed as alcoholic.

Yet many young people who could benefit from addiction treatment go without it. The 2004 NSDUH revealed that only about 10 percent of Americans age 12 and older who were classified with substance abuse or dependence received services at a specialty facility.

"The majority of services that are available to young people are for adolescent males," says CYF's Steinhagen. "In a dramatically underserved segment of the population, adolescent females are even more underserved. These are facts that we need to consider in terms of our own plans to expand residential youth treatment to another region of the country."

Planning for life after treatment
Treatment plans at CYF extend to life beyond the campus in Plymouth. The next step in a young person's recovery could be extended care, a halfway house, or a high school or college program for students in recovery.

"We certainly used drugs for a lot longer than a few weeks," says Debbie, an HCYF alumna. "And it's going to take us a lot longer than that to learn to be sober. I went to a halfway house for women, and I stayed there for three months. I think it was one of the best experiences I could have had. I learned how to get sober here [at CYF]. But I learned how to stay sober there."

Eric H. took part in the StepUp Program at Augsburg College in Minneapolis, where students in recovery live together and meet regularly for support. Last May, he celebrated his graduation.

"The reputation of CYF is so strong that people are willing to take its alumni not only into halfway houses but also as employees and students," he says. "Why else do you think a college admissions office would be convinced that a group of people with terrible academic records can be major contributors to campus life? Making that case is no small task, and HCYF does it."

--by Doug Toft

Published in The Voice, Summer 2006