Teen Co-Occurring Disorder Treatment in Utah

It is not unusual for a young person to experience more than one mental or behavioral health concern at the same time.

A teenager with depression may also struggle with anxiety. A young person with trauma may begin using alcohol or drugs to escape painful memories. Another teen may experience ADHD along with depression, substance use, or serious behavioral concerns.

When a mental health disorder occurs alongside a substance use disorder, the conditions are commonly called co-occurring disorders or a dual diagnosis. SAMHSA defines co-occurring disorders as the presence of at least one mental health disorder and at least one substance use disorder.

The term “co-occurring conditions” may also be used more broadly when a young person has two or more mental health or medical concerns, such as:

Depression and anxiety
ADHD and depression
Trauma and substance use
Bipolar disorder and anxiety
OCD and depression
A mental health disorder and chronic pain

These conditions can interact with one another. Depression may increase substance use, while substance use may make depression more severe. Anxiety can interfere with treatment, and untreated trauma may contribute to risky behavior.

Effective teen co-occurring disorder treatment looks at the full picture rather than treating one concern while ignoring the other.

At New Beginnings Behavioral Health & Wellness, children, adolescents, teens, and families receive individualized treatment for a range of mental and behavioral health concerns. Available services include residential treatment, partial hospitalization, intensive outpatient treatment, individual therapy, group therapy, family therapy, psychiatric care, medication management, and educational support.

What Are Co-Occurring Disorders?

Co-occurring disorders are two or more conditions that affect a person at the same time.

In formal behavioral health treatment, the term usually refers to the combination of:

A mental health disorder
A substance use disorder

For example, a teenager may experience major depression and an alcohol use disorder. Another young person may have PTSD and regularly misuse marijuana or prescription medication.

Mental health and substance use concerns may occur together for several reasons:

A young person may use substances to cope with emotional pain.
Alcohol or drugs may trigger or worsen psychiatric symptoms.
Both conditions may share risk factors, such as genetics, trauma, chronic stress, or early exposure to substance use.
The conditions may develop separately and then begin affecting one another.

SAMHSA explains that mental health and substance use disorders can share underlying causes. Substance use can also produce mental health symptoms, while some people use alcohol or drugs in an attempt to manage distress.

Co-occurring disorders can affect:

Mood
Judgment
Sleep
School performance
Family relationships
Friendships
Physical health
Safety
Legal behavior
Ability to complete responsibilities
Response to treatment

An assessment should consider every major emotional, behavioral, medical, and substance-related concern.

Dual Diagnosis vs. Co-Occurring Disorders

The terms dual diagnosis and co-occurring disorders are often used to describe the same situation.

Dual Diagnosis

Dual diagnosis usually means that a person has:

A mental health disorder
A substance use disorder

For example:

Depression and alcohol use disorder
Anxiety and cannabis use disorder
PTSD and prescription drug misuse
Bipolar disorder and stimulant use disorder

Co-Occurring Disorders

Co-occurring disorders is generally the preferred and broader clinical term for mental health and substance use disorders occurring together.

Families may also hear providers use “co-occurring conditions” when a young person has more than one mental health concern, such as depression and anxiety. However, SAMHSA’s formal definition focuses on the combination of a mental disorder and a substance use disorder.

Regardless of the term used, the important question is whether the treatment plan addresses all conditions affecting the teenager.

What Is a Substance Use Disorder?

A substance use disorder develops when repeated alcohol or drug use causes significant problems with health, responsibilities, behavior, relationships, or safety.

A teenager does not need to use a substance every day to have a serious problem.

Possible substances include:

Alcohol
Marijuana or cannabis products
Prescription pain medication
Prescription stimulants
Sedatives
Opioids
Cocaine
Methamphetamine
Hallucinogens
Inhalants
Nicotine products
Other drugs

Signs of a possible substance use disorder may include:

Using more than intended
Trying unsuccessfully to stop
Spending significant time obtaining or using substances
Experiencing strong cravings
Missing school
Neglecting responsibilities
Continuing despite family conflict
Using in dangerous situations
Developing tolerance
Experiencing withdrawal symptoms
Giving up important activities
Continuing despite physical or emotional harm

SAMHSA describes substance use disorders as recurrent alcohol or drug use that causes clinically significant impairment, including health problems, disability, and failure to fulfill major responsibilities at home, school, or work.

Only a qualified professional can diagnose a substance use disorder.

Common Co-Occurring Disorders in Teens

Many combinations of mental health and substance use disorders can occur during adolescence.

Common examples include:

Depression and alcohol use
Depression and marijuana use
Anxiety and alcohol use
Anxiety and prescription drug misuse
PTSD and substance use
ADHD and substance use
Bipolar disorder and substance use
Personality disorders and substance use
OCD and substance use
Conduct problems and substance use
Self-harm and substance use
Suicidal ideation and substance use

A teenager may also experience several mental health conditions at once.

Examples include:

Depression and anxiety
ADHD and depression
PTSD and anxiety
OCD and depression
Bipolar disorder and anxiety
Trauma and attachment concerns
Depression and an eating disorder

The presence of several conditions can make symptoms harder to understand. A behavior that looks like defiance may be connected to trauma, substance use, depression, or a combination of concerns.

Depression and Substance Use

A teenager with depression may use alcohol or drugs to escape sadness, numbness, guilt, hopelessness, or low self-esteem.

Substances may seem to provide temporary relief. However, they can make depression more severe and interfere with healthy coping.

Possible warning signs include:

Social withdrawal
Loss of interest
Low energy
Hopelessness
Changes in sleep
Changes in appetite
Declining grades
Secretive behavior
Increased substance use
Self-harm
Suicidal thoughts
Statements about not caring what happens

Substance use can also make it more difficult to determine whether symptoms are caused by depression, intoxication, withdrawal, medication, or another condition.

Both concerns should be evaluated.

Anxiety and Substance Use

A teenager with anxiety may use substances to feel calmer, more confident, or less afraid in social situations.

A young person might use:

Alcohol before social events
Marijuana to relax or sleep
Prescription medication without medical guidance
Nicotine to manage stress
Other drugs to escape constant worry

Substance use may provide temporary relief but can worsen anxiety over time.

The young person may begin believing they cannot attend school, socialize, sleep, or handle stress without using a substance.

Treatment should help the teenager develop healthier ways to manage fear and anxiety while also addressing the substance use.

Trauma, PTSD, and Substance Use

Trauma can affect a young person’s emotions, memory, sleep, relationships, and sense of safety.

A teenager may use alcohol or drugs to:

Avoid painful memories
Reduce nightmares
Feel emotionally numb
Manage fear
Fall asleep
Fit in with peers
Escape shame or guilt
Reduce physical tension

The substance use may become a way of coping with trauma symptoms.

However, intoxication can increase risky behavior, vulnerability, conflict, and exposure to additional traumatic experiences.

Trauma-informed treatment recognizes the young person’s experiences without excusing harmful or unsafe behavior. Treatment should build safety and coping skills before expecting the teenager to discuss painful events in detail.

ADHD and Substance Use

Teenagers with ADHD may struggle with:

Impulsivity
Planning
Organization
Frustration tolerance
Decision-making
Completing responsibilities
Considering long-term consequences

These difficulties may increase vulnerability to experimentation or risky substance use.

A teenager may also misuse stimulants in an attempt to improve academic performance, lose weight, remain awake, or feel more focused.

Treatment should distinguish between:

Properly prescribed medication use
Medication misuse
Sharing medication
Taking larger doses
Using someone else’s prescription
Using substances to manage untreated symptoms

Parents should tell the treatment team about all prescribed medications, supplements, alcohol use, and drug use.

Bipolar Disorder and Substance Use

Bipolar disorder involves serious changes in mood, energy, sleep, activity, and judgment.

During a manic or hypomanic episode, a teenager may:

Sleep very little
Feel unusually confident
Make impulsive decisions
Use alcohol or drugs
Drive dangerously
Spend money recklessly
Engage in unsafe relationships
Ignore consequences

During depression, the teenager may use substances to escape hopelessness or emotional pain.

Substance use may make mood symptoms more difficult to diagnose and stabilize. It can also interfere with medication and increase safety concerns.

A careful psychiatric and substance use evaluation is important.

Personality Disorders and Substance Use

Young people with emerging personality-disorder symptoms may struggle with emotional intensity, impulsivity, unstable relationships, anger, identity concerns, or fear of abandonment.

Alcohol or drugs may be used to:

Reduce emotional pain
Manage emptiness
Fit into a social group
Respond to rejection
Increase confidence
Escape shame
Act on impulsive urges

Substance use can increase emotional instability, relationship conflict, self-harm, and suicidal behavior.

Treatment may need to address emotional regulation, relationships, impulsivity, safety, and substance use at the same time.

Eating Disorders and Co-Occurring Conditions

Eating disorders commonly occur alongside:

Anxiety
Depression
OCD
Trauma
Substance use
Self-harm
Suicidal ideation

A young person may misuse substances to suppress appetite, change weight, increase energy, or manage emotional distress.

Eating disorders can also cause serious medical complications.

New Beginnings’ residential program is not suitable for youth whose primary diagnosis is an eating disorder. A child requiring medical stabilization, supervised meals, or specialized nutritional rehabilitation should receive care from a qualified eating-disorder provider.

Dual Diagnosis Symptoms in Teens

Co-occurring disorders can be difficult to recognize because the symptoms often overlap.

Parents may notice emotional, behavioral, social, academic, or physical changes.

Possible emotional symptoms include:

Increased depression
Severe anxiety
Frequent irritability
Emotional outbursts
Rapid mood changes
Hopelessness
Shame
Low self-esteem
Paranoia
Emotional numbness
Unusual fear
Suicidal thoughts

Possible behavioral symptoms include:

Increased secrecy
Lying about activities
Breaking rules
Running away
Stealing money
Using substances alone
Using before school
Driving while impaired
Becoming physically aggressive
Engaging in risky sexual behavior
Missing appointments
Refusing treatment
Neglecting responsibilities
Self-harming
Getting into legal trouble

Possible social symptoms include:

Withdrawing from family
Leaving longtime friends
Joining a new group suddenly
Spending time with peers who use substances
Ending healthy activities
Increased family conflict
Unstable relationships
Losing interest in sports or clubs
Avoiding supportive adults

Possible school-related symptoms include:

Falling grades
Missing assignments
Truancy
Sleeping during class
Losing motivation
Repeated discipline
Suspension
Dropping activities
Difficulty concentrating
Leaving school during the day

Possible physical symptoms include:

Changes in sleep
Changes in appetite
Unexplained weight changes
Bloodshot eyes
Unusual smells
Poor coordination
Slurred speech
Shaking
Frequent illness
Headaches
Stomach problems
Neglected hygiene
Unexplained injuries
Changes in energy

Families may also find:

Empty alcohol containers
Vape devices
Drug paraphernalia
Missing medication
Small plastic bags
Unexplained pills
Hidden cash
Unfamiliar chemical smells
Messages about buying or using substances

One sign does not confirm a disorder. A repeated pattern should lead to a professional assessment.

Why Teenagers Hide Substance Use

A teenager may hide alcohol or drug use because they:

Fear punishment
Feel ashamed
Do not believe the use is serious
Want to protect friends
Fear losing independence
Believe the substance helps them
Worry about entering treatment
Do not trust adults
Fear disappointing their family
Are experiencing cravings
Are unable to stop

SAMHSA notes that substance use disorders can be difficult to identify because people may continue functioning in some areas and hide their alcohol or drug use.

Parents should focus on safety and assessment rather than trying to force an immediate confession.

Self-Medication and Teen Substance Use

Self-medication occurs when a person uses alcohol or drugs in an attempt to manage emotional or physical symptoms.

A teenager may say:

“Marijuana is the only thing that helps me sleep.”
“I drink so I can talk to people.”
“The pills help me stop thinking.”
“Using is the only time I feel normal.”
“It helps me forget what happened.”
“I need it to calm down.”

The young person may sincerely believe the substance is helping.

However, substance use can:

Worsen psychiatric symptoms
Create dependence
Increase impulsivity
Affect memory
Interfere with medication
Reduce motivation
Increase family conflict
Lead to legal concerns
Increase overdose risk
Make diagnosis more difficult

Treatment should provide healthier tools for managing the symptoms the teenager has been trying to escape.

Causes and Risk Factors for Co-Occurring Disorders

There is no single cause of co-occurring disorders.

Several biological, psychological, family, and environmental factors may contribute.

Genetic and Biological Factors

A family history of mental illness or substance use disorders may increase a young person’s vulnerability.

Genetics do not guarantee that a teenager will develop either condition. Family history is one part of a larger picture.

SAMHSA identifies genetic vulnerability as one factor that may contribute to both mental health and substance use disorders.

Trauma and Chronic Stress

Trauma and ongoing stress can affect emotional regulation, relationships, judgment, and the ability to feel safe.

Possible experiences include:

Abuse
Neglect
Domestic violence
Community violence
Bullying
Sexual abuse
Sudden loss
Family separation
Parental incarceration
Serious illness
Unstable housing
Repeated conflict
Discrimination

A young person may develop depression, anxiety, PTSD, behavioral concerns, or substance use after these experiences.

SAMHSA identifies early exposure to stress and trauma among the factors shared by mental health and substance use disorders.

Peer Pressure

Adolescents may experiment with alcohol or drugs because they want to:

Fit in
Avoid rejection
Seem mature
Gain social confidence
Join a romantic partner
Enter a peer group
Escape bullying
Avoid being seen as different

A teenager already experiencing anxiety, depression, low self-esteem, or family conflict may be especially vulnerable to peer pressure.

Treatment can help the young person develop boundaries, decision-making skills, and healthier social connections.

Family Conflict

Family conflict does not automatically cause co-occurring disorders.

However, ongoing yelling, violence, instability, substance use in the home, or inconsistent boundaries can increase stress and make recovery more difficult.

Family treatment may address:

Communication
Conflict patterns
Safety
Trust
Boundaries
Substance access
Parent responses
Family routines
Support after treatment

Parents should not be blamed for their child’s condition. Family participation is intended to build support and improve recovery—not assign fault.

School and Academic Pressure

Academic stress may contribute to:

Anxiety
Depression
Sleep loss
Stimulant misuse
Alcohol or marijuana use
Avoidance
School refusal
Feelings of failure

A teenager may use substances to stay awake, relax, escape pressure, or cope with falling behind.

Treatment may need to include educational support and coordination with school staff.

Access to Alcohol, Drugs, or Medication

Easy access can increase the risk of experimentation and misuse.

Substances may come from:

Friends
Family members
Unlocked medication
Online sources
Parties
Older peers
Social media contacts
Alcohol stored at home

Parents should secure prescription medication, monitor quantities, dispose of unused medication, and limit access to alcohol.

Untreated Mental Health Conditions

A teenager may begin using substances before receiving treatment for depression, anxiety, trauma, ADHD, or another condition.

The substance may appear to improve symptoms temporarily. Over time, use may become a separate disorder.

Early mental health evaluation and treatment may help reduce the need to rely on unsafe coping methods.

How Co-Occurring Disorders Are Evaluated

A complete assessment should evaluate both mental health and substance use.

The evaluator may review:

Current emotional symptoms
Current substance use
Age at first use
Types of substances
Frequency and amount
Reasons for using
Previous attempts to stop
Cravings
Withdrawal symptoms
School functioning
Family relationships
Friendships
Trauma history
Medical history
Current medications
Previous diagnoses
Previous treatment
Legal concerns
Self-harm
Suicidal thoughts
Aggression
Overdose history
Family history
Strengths and protective factors

Information may also be gathered from:

Parents
Teachers
School counselors
Pediatricians
Therapists
Psychiatrists
Previous treatment providers
Other caregivers

The teenager should have an opportunity to speak privately with the evaluator. Honest information is important for developing a safe treatment plan.

Mental Health and Substance Use Screening

Screening tools may be used to identify possible concerns.

A screening is not the same as a diagnosis.

Screening may focus on:

Depression
Anxiety
Trauma
Suicide risk
Alcohol use
Drug use
Medication misuse
General emotional or behavioral symptoms

A positive screening result should lead to a more complete assessment.

Both conditions should be evaluated because substance use may hide mental health symptoms, and psychiatric symptoms may hide the seriousness of substance use.

Substance-Induced Mental Health Symptoms

Alcohol or drugs can sometimes cause symptoms that resemble a mental health disorder.

Possible symptoms include:

Anxiety
Panic
Depression
Paranoia
Hallucinations
Mood changes
Irritability
Sleep problems
Poor concentration
Aggression
Suicidal thoughts

Symptoms may occur during intoxication, withdrawal, or after repeated use.

A qualified professional must determine whether the teenager has:

A primary mental health condition
Substance-induced symptoms
A substance use disorder
Several conditions occurring together

Diagnosis may require observation over time and information about when symptoms began.

Integrated Treatment for Adolescents

Integrated treatment addresses mental health and substance use within one coordinated plan.

The treatment team does not treat depression first and postpone substance use until later. It also does not focus only on stopping substance use while ignoring trauma, anxiety, or another psychiatric concern.

Integrated care may include:

Mental health assessment
Substance use assessment
Individual therapy
Family therapy
Group treatment
Psychiatric care
Medication management
Substance use education
Coping-skills development
Relapse-prevention planning
Safety planning
Educational support
Case management
Continued-care planning

SAMHSA reports that integrating screening and treatment for mental health and substance use disorders supports better quality of care by treating the whole person.

Individual Therapy

Individual therapy gives the teenager a private setting to discuss emotional symptoms, substance use, relationships, trauma, and treatment goals.

A therapist may help the young person:

Understand the connection between conditions
Identify substance-use triggers
Recognize emotional triggers
Build coping skills
Develop healthier routines
Reduce impulsive behavior
Address trauma safely
Improve problem-solving
Challenge unhealthy beliefs
Strengthen motivation
Prepare for high-risk situations
Create a relapse-prevention plan

The therapist should avoid treating every problem as only a substance-use issue or only a mental health issue.

Cognitive Behavioral Therapy

Cognitive behavioral therapy helps young people understand how thoughts, emotions, and behavior affect one another.

A teenager may think:

“I cannot handle anxiety without using.”
“Everyone already expects me to fail.”
“One drink will not matter.”
“Nothing will ever improve.”
“I can stop whenever I want.”
“Using is the only way I can sleep.”

A therapist may help the young person:

Identify inaccurate thinking
Consider consequences
Challenge hopeless beliefs
Recognize triggers
Develop alternative actions
Practice refusing substances
Manage stress
Create safer routines
Prepare for setbacks

New Beginnings describes its treatment philosophy as collaborative, client-centered, and based on cognitive behavioral theory. Its interventions focus on unhealthy thought patterns, underlying emotional concerns, and replacing harmful behavior.

Motivational Interviewing

Motivational interviewing is a collaborative approach that helps young people explore their own reasons for change.

A teenager may feel uncertain about stopping substance use. They may understand the consequences while also believing the substance helps them.

A therapist may explore:

What the teenager likes about using
What problems it has caused
How use affects personal goals
What the teenager wants for the future
What changes feel possible
What support is needed
What concerns the young person has about treatment

The goal is not to argue or shame the teenager. It is to help them recognize differences between current behavior and personal goals.

Families should ask whether the treatment provider offers motivational interviewing or another adolescent substance-use intervention.

Emotional Regulation and DBT Skills

Some teenagers use substances to manage emotions that feel too intense.

Emotional-regulation and dialectical behavior therapy skills may help young people:

Recognize emotions
Tolerate distress
Reduce impulsive behavior
Use mindfulness
Manage anger
Communicate needs
Handle rejection
Reduce self-harm
Survive a crisis without using
Develop safer relationships

These skills may be especially helpful when substance use occurs with self-harm, suicidal thoughts, borderline personality symptoms, trauma, or severe emotional instability.

The availability of formal DBT programming should be confirmed directly with the treatment provider.

Group Therapy

Group therapy allows young people to learn skills and receive support in a structured setting.

Groups may focus on:

Coping skills
Stress reduction
Substance-use education
Emotional regulation
Healthy relationships
Communication
Anger management
Problem-solving
Peer pressure
Relapse prevention
Accountability
Building healthy routines

New Beginnings provides clinician-led group therapy through its intensive outpatient services. Its groups may address behavioral health needs, interpersonal relationships, stress reduction, coping skills, and changing unhealthy behavior.

New Beginnings’ public program information does not identify a specialized substance-use group or dual-diagnosis track. Families should confirm whether the available group services match the teenager’s substance-related needs.

Family Therapy

Co-occurring disorders affect the entire family.

Parents may experience:

Fear
Anger
Guilt
Confusion
Exhaustion
Loss of trust
Worry about overdose
Concern about legal trouble
Uncertainty about boundaries

Family therapy may help families:

Understand both conditions
Improve communication
Reduce blame
Set clear boundaries
Recognize warning signs
Reduce access to substances
Respond to relapse
Rebuild trust
Develop safety plans
Support medication use
Prepare for transition home
Coordinate continued care

New Beginnings provides family therapy designed to support positive family interactions and the constructive integration or reintegration of the young person into family life.

Psychiatric Care and Medication Management

A psychiatric evaluation may be needed when substance use occurs with:

Depression
Anxiety
Bipolar disorder
ADHD
Trauma
OCD
Psychosis
Severe sleep problems
Suicidal ideation
Another psychiatric condition

Medication may be considered as part of the treatment plan.

The prescribing professional should know about all alcohol, drug, supplement, and medication use. Combining substances with psychiatric medication can create safety concerns and make it difficult to understand treatment response.

New Beginnings’ psychiatric services include diagnostic interviews, medication prescribing, monitoring medication effects, dosage adjustments, crisis intervention, and pre- and post-hospitalization consultation.

Parents should not begin, stop, or change a teenager’s psychiatric medication without guidance from the prescriber.

Relapse-Prevention Planning

A relapse-prevention plan identifies situations that may increase the risk of returning to substance use or harmful behavior.

The plan may include:

Emotional triggers
Social triggers
High-risk locations
Peer influences
Warning signs
Coping strategies
Supportive adults
Treatment contacts
Safe activities
Medication plans
School support
Steps to take after a lapse
Emergency instructions

A lapse does not mean the young person has failed or that treatment is useless.

It is a signal that the treatment plan, supervision, coping skills, or level of care may need to change.

Families should respond quickly rather than allowing shame to prevent the teenager from returning to treatment.

Treating Mental Health and Substance Use Together

Treating only one condition may create several problems.

When only the mental health condition is treated:

Substance use may continue worsening symptoms.
Medication may not work as expected.
The teenager may remain exposed to unsafe situations.
Substance use may interfere with therapy.
Relapse may lead to another mental health crisis.

When only substance use is treated:

Depression may remain untreated.
Trauma symptoms may continue.
Anxiety may drive the teenager back to using.
Suicidal thoughts may be missed.
The young person may lose their main coping method without gaining a safer one.

Integrated care addresses the relationship between the conditions.

Levels of Care for Co-Occurring Disorders

The correct level of care depends on:

Substance being used
Frequency and amount
Risk of withdrawal
Overdose history
Psychiatric symptoms
Suicide risk
Aggression
Medical stability
Family supervision
School functioning
Previous treatment
Ability to remain safe at home

A young person may move between levels as needs change.

Weekly Outpatient Treatment

Weekly outpatient treatment may be appropriate when:

Symptoms are manageable
Substance use is limited
The teenager can remain safe
School attendance can continue
Family supervision is available
The young person is participating in treatment

Services may include:

Individual therapy
Family therapy
Psychiatric care
Substance-use counseling
Medication management
Drug or alcohol testing when clinically appropriate
School coordination

A higher level of care may be needed if symptoms continue or safety declines.

Intensive Outpatient Treatment

An intensive outpatient program, or IOP, provides more structure than weekly therapy while allowing the teenager to remain at home.

IOP may be appropriate when:

Weekly therapy is not enough
The young person needs several sessions each week
Residential care is not required
Family participation is important
The teenager can remain safe at home
School involvement should continue
The young person is stepping down from a higher level

New Beginnings’ IOP offers individual, group, and family therapy for concerns including depression, anxiety, bipolar disorder, trauma, high-risk behavior, anger, relationship problems, ADHD, and parent-child conflict.

The public IOP description does not specifically list substance use disorder treatment. Families should provide complete information about alcohol or drug use so admissions can determine whether New Beginnings is an appropriate setting or whether specialized dual-diagnosis services are needed.

Partial Hospitalization for Co-Occurring Conditions

A partial hospitalization program, or PHP, provides intensive treatment during the day while the young person continues living at home.

PHP may be appropriate when:

Weekly therapy or IOP is not enough
Daily structure is needed
The young person can safely return home
Parents can provide supervision
Residential care is not required
The teenager is transitioning from hospital or residential care

New Beginnings’ Journey Program serves qualifying youth ages 9 through 17 with serious emotional disturbances.

Services include:

Individual psychotherapy
Group therapy
Family therapy
Medication management
Case management
Accredited online education
Educational enrichment
Physical and social activities
Cultural programming
Structured therapeutic support

The program allows young people to remain at home while receiving intensive treatment and educational support.

The Journey Program is not publicly described as a specialized substance-use or detoxification program. Admissions must determine whether a teenager’s substance use can be safely managed within the program.

Residential Treatment for Co-Occurring Disorders

Residential treatment provides 24-hour structure and supervision in a nonhospital environment.

Residential care may be considered when:

Lower levels of care have not worked
Mental health symptoms seriously affect daily life
The teenager needs 24-hour supervision
Family relationships are in crisis
School attendance has stopped
Risky behavior continues
The child is transitioning from hospital care
Treatment providers recommend residential placement

New Beginnings operates a 16-bed, coeducational residential program in Draper, Utah, for qualifying youth ages 11 through 17.

Licensed clinical staff provide therapeutic services, while youth mentors provide 24-hour supervision and support. The program also includes educational, recreational, cultural, therapeutic, and community-service activities.

However, New Beginnings states that its residential program is not suitable for active and high-risk drug users.

A teenager who requires:

Medical detoxification
Withdrawal management
Specialized substance-use residential care
Medication for opioid use disorder
Continuous medical monitoring
A primary addiction-treatment program

should receive care from a facility equipped to provide those services.

Admissions must review the type and severity of substance use, current safety, diagnoses, treatment history, and medical needs before accepting a young person.

Detoxification and Medical Stabilization

Some substances can cause serious withdrawal symptoms when use is stopped.

A teenager should not be expected to detox alone at home without professional guidance when there may be physical dependence or medical risk.

Medical evaluation may be needed when the young person:

Uses substances frequently
Has withdrawal symptoms
Has a history of seizures
Uses opioids
Uses sedatives
Mixes several substances
Has experienced an overdose
Has serious medical conditions
Is pregnant
Is confused or severely ill

New Beginnings does not publicly identify itself as a medical detoxification center.

Families should seek emergency or specialized medical care when withdrawal, overdose, or intoxication creates immediate danger.

Inpatient Psychiatric Treatment

Inpatient psychiatric treatment is provided in a hospital or psychiatric hospital.

This level may be necessary when the young person:

Has attempted suicide
Has a current suicide plan
Is experiencing severe psychosis
Is dangerously aggressive
Cannot care for basic needs
Is severely intoxicated
Has experienced an overdose
Requires emergency psychiatric stabilization
Cannot remain safe at home

Hospital care focuses on immediate safety and stabilization.

After discharge, the young person may move to residential treatment, PHP, IOP, specialized substance-use care, or weekly outpatient treatment.

New Beginnings is not an emergency department or inpatient psychiatric hospital.

Immediate Safety Notice

Call 911 or go to the nearest emergency department if a teenager:

Is unconscious
Is difficult to wake
Has stopped breathing normally
Has experienced an overdose
Has a seizure
Is severely confused
Has attempted suicide
Has a current plan to harm themselves
Has a plan to harm someone else
Is experiencing severe psychosis
Is dangerously intoxicated
Cannot be supervised safely

Do not leave the young person alone during an active safety crisis.

Provide emergency professionals with all known information about the substances, medications, quantities, and time of use.

An admissions call should never replace emergency medical or psychiatric care.

Educational Support During Treatment

Co-occurring disorders can affect:

Attendance
Concentration
Memory
Motivation
Assignment completion
Classroom behavior
Relationships with teachers
Relationships with classmates
Academic confidence
Graduation progress

A teenager may fall behind because of:

Depression
Anxiety
Intoxication
Withdrawal
Hospitalization
Treatment appointments
School suspension
Truancy
Poor sleep
Family conflict

New Beginnings helps qualifying clients continue their education while receiving behavioral health treatment.

New Beginnings is not a school. Families may choose accredited online education through the Canyons School District while New Beginnings staff provide learning support.

Educational support may help young people:

Continue earning credits
Complete assignments
Rebuild study habits
Reduce anxiety about falling behind
Improve organization
Prepare to return to school
Balance academics and treatment
Develop realistic educational goals

How Parents Can Help a Teen With Co-Occurring Disorders

Parents cannot force long-term recovery, but they can create conditions that support safety and treatment.

Helpful steps may include:

Learn about both conditions
Take substance use seriously
Avoid shaming the teenager
Ask direct questions
Secure alcohol and medication
Monitor changes in behavior
Participate in family therapy
Communicate with providers
Support treatment appointments
Follow safety recommendations
Set consistent boundaries
Avoid covering up serious consequences
Monitor access to money and vehicles
Encourage healthier friendships
Take suicidal statements seriously
Care for your own mental health

Parents should not ignore substance use because the young person has a mental health condition.

They should also not assume every difficult behavior is caused by alcohol or drugs.

Both areas need assessment.

How to Talk to Your Teen About Substance Use

Choose a calm and private time.

Focus on specific behavior rather than labels.

You might say:

“I have noticed that you are missing school, staying away from longtime friends, and coming home smelling like marijuana. You also seem more depressed. I am concerned about both your substance use and your mental health, and we are going to arrange an evaluation.”

During the conversation:

Remain calm
Use specific examples
Avoid yelling
Avoid calling the teenager an addict
Ask open questions
Listen to the answers
Explain safety concerns
Avoid arguing about every detail
Set clear boundaries
Explain the next step
Follow through

The teenager may deny using or become angry.

The family does not need a full confession before arranging an assessment.

What Parents Should Avoid Saying

Shaming statements may cause the teenager to hide symptoms more carefully.

Try to avoid:

“You are ruining your life.”
“You are just like your addicted relative.”
“You have everything, so you have no reason to be depressed.”
“This is only a phase.”
“You are a bad child.”
“You are embarrassing our family.”
“Why can’t you just stop?”
“You clearly do not care about us.”
“Your mental health is only an excuse.”
“You will never change.”

Instead, try:

“I am concerned about your safety.”
“You are not in trouble for telling the truth.”
“Both your mental health and substance use matter.”
“We will get an assessment.”
“You do not have to handle this alone.”
“I care about you, and this boundary will remain.”
“Recovery may take time, but help is available.”

Setting Healthy Boundaries

Compassion does not require allowing unsafe behavior.

Family boundaries may include:

No driving after substance use
No substances in the home
No sharing medication
Supervised medication
Restricted access to vehicles
Limits on cash
Treatment attendance
Drug or alcohol testing when recommended
Communication about location
Safe behavior toward family members
Following the crisis plan

Consequences should be:

Clear
Predictable
Related to the behavior
Delivered calmly
Appropriate for the teenager’s age
Consistent with the treatment plan

Parents should avoid making threats they cannot enforce.

Family Enabling and Co-Occurring Disorders

Enabling occurs when family members protect a young person from the natural or appropriate consequences of harmful behavior.

Examples may include:

Lying to school staff
Giving money without knowing how it will be used
Replacing missing medication without asking questions
Allowing unsafe driving
Hiding legal problems
Excusing aggression
Avoiding treatment because the teenager becomes angry
Repeatedly rescuing the child from predictable consequences

Parents usually enable because they are frightened and want to protect their child.

Family therapy can help caregivers distinguish between supportive help and actions that allow unsafe behavior to continue.

Potential Benefits of Integrated Treatment

No program can guarantee a specific result.

Progress depends on:

Diagnoses
Substance use severity
Medical stability
Treatment history
Family involvement
Participation
Medication response
Peer environment
School support
Continued care

Possible short-term goals include:

Improving safety
Completing a full assessment
Reducing substance use
Stabilizing psychiatric symptoms
Building trust with providers
Identifying triggers
Improving sleep
Creating a crisis plan
Developing coping skills
Reengaging with family
Returning to school responsibilities

Possible long-term goals include:

Maintaining recovery
Managing mental health symptoms
Developing healthier relationships
Improving family communication
Reducing legal and school concerns
Strengthening emotional regulation
Building refusal skills
Developing a stable daily routine
Recognizing early warning signs
Preparing for future stress
Following a continuing-care plan
Building hope and personal goals

Recovery may include setbacks. A return to substance use or mental health symptoms means the treatment plan should be reviewed—not that the young person is beyond help.

Helping a Teen Who Refuses Treatment

A teenager may resist treatment because they:

Do not believe they have a problem
Fear losing friends
Believe substances are helping
Fear withdrawal
Feel ashamed
Distrust adults
Fear hospitalization
Worry about school
Do not want medication
Have had a negative treatment experience
Feel hopeless about change

Parents can help by:

Listening to specific concerns
Avoiding long arguments
Connecting treatment with the teenager’s goals
Explaining what the assessment involves
Offering appropriate choices
Remaining firm about safety
Being honest about privacy
Avoiding insults and labels
Involving trusted professionals
Following emergency guidance when necessary

You might say:

“I understand that you do not believe treatment is necessary. I am concerned about your depression, your substance use, and your safety. We are going to complete an assessment and listen to the recommendations.”

A teenager does not need to agree with every concern before being evaluated.

Why Families Contact New Beginnings

New Beginnings Behavioral Health & Wellness offers several levels of care for children, adolescents, teens, and families.

Available services include:

Residential treatment
Partial hospitalization
Intensive outpatient treatment
Individual therapy
Group therapy
Family therapy
Psychiatric evaluation
Medication management
Crisis intervention and triage
Case management
Educational support
Recreational and enrichment activities

New Beginnings treats a range of mental and behavioral health concerns, including depression, anxiety, bipolar disorder, trauma, ADHD, anger, attachment concerns, high-risk behavior, relationship problems, and parent-child conflict.

New Beginnings’ public website does not identify a dedicated substance-use disorder, medical detoxification, or formal dual-diagnosis program.

Its residential program is not suitable for active and high-risk drug users.

Families should provide complete and honest information about alcohol and drug use during admission. The admissions team can determine whether New Beginnings may be appropriate for the teenager’s mental and behavioral health needs or whether a specialized co-occurring-disorder provider is required.

Begin Teen Co-Occurring Disorder Treatment in Utah

Families do not have to wait until substance use leads to overdose, arrest, expulsion, hospitalization, or a complete family crisis before asking for help.

A comprehensive assessment can help determine:

Which conditions are present
How the conditions affect one another
Whether medical care is needed
Whether withdrawal is a concern
What level of treatment is appropriate
Whether psychiatric medication should be reviewed
How parents can support treatment
What school services may be helpful
Whether specialized substance-use care is required

Contact New Beginnings Behavioral Health & Wellness in Draper, Utah, to discuss your child’s symptoms, diagnoses, substance use, and treatment history.

Call 801-282-6953 and select Option 1 to speak with admissions.

Be prepared to discuss:

Your child’s age
Current diagnoses
Current mental health symptoms
Types of substances used
Frequency of use
Date of most recent use
Overdose history
Withdrawal symptoms
Current medication
Previous treatment
Recent hospitalization
School concerns
Family concerns
Legal concerns
Aggression
Self-harm
Suicidal thoughts
Recommendations from current providers

An admissions call does not replace emergency care.

Call 911 or go to the nearest emergency department when a teenager is experiencing an overdose, severe intoxication, dangerous withdrawal symptoms, suicidal intent, psychosis, or another immediate safety emergency.

Frequently Asked Questions About Teen Co-Occurring Disorders

What are co-occurring disorders?

Co-occurring disorders are the combined presence of a mental health disorder and a substance use disorder.

For example, a teenager may have depression and an alcohol use disorder or PTSD and a cannabis use disorder.

What is a dual diagnosis?

Dual diagnosis is another term for having a mental health disorder and a substance use disorder at the same time.

The term co-occurring disorders is often preferred because a young person may have more than two conditions.

Can two mental health disorders co-occur?

Yes.

A teenager may experience depression and anxiety, ADHD and depression, trauma and anxiety, or another combination of mental health concerns.

However, the formal SAMHSA definition of co-occurring disorders refers specifically to mental health and substance use disorders occurring together.

What are common dual diagnosis symptoms in teens?

Warning signs may include depression, anxiety, mood changes, secrecy, declining grades, new peer groups, missing medication, drug paraphernalia, changes in sleep, neglected hygiene, legal trouble, aggression, self-harm, and suicidal thoughts.

Why do mental health and substance use disorders occur together?

A teenager may use substances to manage emotional distress. Alcohol or drugs may also trigger mental health symptoms.

Both conditions may share risk factors such as genetics, trauma, stress, and environmental exposure.

What does self-medication mean?

Self-medication means using alcohol or drugs in an attempt to manage symptoms such as anxiety, depression, trauma, insomnia, or emotional pain.

The substance may provide temporary relief while worsening the underlying condition over time.

Can marijuana worsen mental health symptoms?

Marijuana can affect mood, motivation, concentration, anxiety, judgment, and perception.

The effects vary based on the person, product, amount, frequency, age, and existing mental health concerns. Families should report all cannabis use during an assessment.

Can prescribed medication become part of a substance-use problem?

Yes.

A teenager may misuse their own prescription, take larger doses, combine it with other substances, or use another person’s medication.

Parents should supervise medication when misuse or safety concerns are present.

How are co-occurring disorders diagnosed?

Assessment may include interviews, mental health screening, substance-use screening, medical history, psychiatric history, school information, family input, medication review, and questions about safety.

Both areas should be evaluated before treatment recommendations are made.

Why should both conditions be treated together?

One condition can worsen the other.

Integrated treatment helps the care team understand the relationship between psychiatric symptoms and substance use and create one coordinated plan. SAMHSA supports integrated screening and treatment as a whole-person approach.

What therapy is used for co-occurring disorders?

Treatment may include cognitive behavioral therapy, motivational interviewing, family therapy, group therapy, emotional-regulation training, trauma-informed care, psychiatric treatment, substance-use counseling, and relapse-prevention planning.

The specific plan depends on the teenager’s diagnoses and needs.

Are parents involved in treatment?

Family involvement is often important.

Parents may participate in family therapy, safety planning, medication supervision, relapse-prevention planning, progress reviews, school coordination, and transition preparation.

Does medication treat co-occurring disorders?

Medication may be used to address depression, anxiety, bipolar disorder, ADHD, psychosis, or another psychiatric condition.

Medication does not replace substance-use treatment when a substance use disorder is present.

Does my teenager need detoxification?

Medical detoxification may be needed when stopping a substance could cause serious withdrawal or when the teenager has significant physical dependence.

A medical professional should determine whether detoxification is required.

Does my teenager need residential treatment?

Residential treatment may be considered when lower levels of care have not worked, the young person needs 24-hour structure, or symptoms seriously affect safety and functioning.

The chosen residential program must be equipped to address the severity of both conditions.

Does New Beginnings provide substance-use treatment?

New Beginnings’ public website does not describe a dedicated substance-use disorder, detoxification, or formal dual-diagnosis program.

The residential program is not suitable for active and high-risk drug users. Admissions must determine whether New Beginnings can safely meet the teenager’s needs.

Can New Beginnings treat related mental health concerns?

New Beginnings treats qualifying youth with depression, anxiety, bipolar disorder, trauma, ADHD, anger, attachment concerns, high-risk behavior, relationship problems, and other mental or behavioral health needs.

What levels of care does New Beginnings offer?

New Beginnings offers residential treatment, partial hospitalization, intensive outpatient treatment, individual therapy, group therapy, family therapy, psychiatric care, medication management, case management, and educational support.

Program fit depends on the young person’s age, diagnoses, safety, treatment history, substance use, and required supervision.

Can my child continue school during treatment?

New Beginnings supports qualifying clients with continuing their education.

Families may choose accredited online education through the Canyons School District while New Beginnings staff provide learning support.

Can teenagers recover from co-occurring disorders?

Yes.

With appropriate integrated treatment, family support, psychiatric care, substance-use services, educational assistance, and continued planning, young people can improve their functioning and develop healthier ways to manage stress.

Recovery may take time and may include setbacks, but a setback does not mean the teenager cannot continue making progress.