Each young person’s capacity for resilience and healthy development can be compromised by an unresolved personal issues and potentially problematic behaviours.

Each young person and their family experience the impact of these issues and behaviours in a unique way. However, it is possible to identify particular issues and experiences that underlie and shape the problems that many youth AOD clients have with substance use.

They are:

• Childhood abuse and neglect
• Past and current sexual assault
• Exposure to violence (domestic and other)
• Family breakdown
• Complicated grief
• Physical health complaints (particularly involving persistent pain)

These issues and experiences are often the source of significant trauma for youth AOD clients. Trauma can stem from a single event or multiple events that compound over time. The experience can be dehumanising and terrifying and often includes betrayal by a trusted person or institution.

The associated loss of safety can be experienced repeatedly, inducing powerlessness, hopelessness and fear. It can also result in a person being in a constant state of alert. These effects can damage self-concept, relationships with others and cause recurring feelings of shame, guilt and rage. Traumatic stress is closely associated with difficulties in regulating impulses and emotions.

It is understandable that the effects of trauma and the other issues and experiences mentioned can be the source of considerable distress and are directly related to:

• Substance use problems
• Mental illness and a range of mental health problems
• Problems with anger and aggression
• An antisocial orientation and offending behaviour
• Self-injury
• Persistent suicidality

There are complex interrelationships between each of these issues and behaviours (including substance use) and all have potential to compromise the well-being of young people and their families. When the issues and the problems associated with particular behaviours become overwhelming and/or intolerable crisis situations can develop. This has the potential to undermine young people’s stability, the quality of their relationships and their options for constructive participation.

Daley and Chamberlain (2009) contend that the multifaceted and systemic issues experienced by youth AOD clients cannot be addressed independently or by focusing on the substance use alone. While it might be ideal for one or all of these problems to be resolved, circumstances might dictate that it is not possible. In such cases, interventions may be more usefully focused upon creating conditions that support the agency of the young person to restore, establish and maintain as much control as possible over their health and well-being, rather than fixing their problems (even though at times this will be the result). It is also noted that when issues or behaviours are out of control, a crisis situation might develop.

At the most basic level, the maintenance or restoration of some form of stability in living conditions and emotional state is required is a client is to deal effectively with underlying issues and associated behaviours.