THE SEVEN

CHALLENGES

MANUAL

Robert Schwebel, Ph.D.

THE SEVEN
CHALLENGES
MANUAL

Robert Schwebel, Ph.D.

ISBN 1-890164-22-4
Copyright 2004 by Robert Schwebel, Ph.D.
This book may not be reproduced, in whole or in part, without written permission. Inquiries may
be addressed to Viva Press, P.O. Box 57621, Tucson, AZ 85732.
This manual has been written to help practitioners understand The Seven Challenges; its clinical
approaches, published materials, and implementation issues. Agencies and practitioners can
purchase and use The Seven Challenges materials in their practice. However, agencies and practitioners cannot implement The Seven Challenges Program or announce that they are providing
the program without training and authorization from Dr. Schwebel.
For information regarding The Seven Challenges Training, contact Robert Schwebel, Ph.D.,
c/o Viva Press, P. O. Box 57621, Tucson, AZ 85732; or by email, [email protected];
or by phone (520) 748-2122.
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The Seven Challenges Manual 2004 Robert Schwebel, Ph.D.

About this Manual

ABOUT THIS MANUAL

The idea of manualizing treatment is appealing because it helps ensure fidelity of
treatment that is, that counselors are delivering the intended approach to clients.
Manuals offer a careful description of how to implement and conduct a certain
approach to counseling. They serve as a good training resource. They spell out the
techniques to be employed and how to implement them. Manualizing also benefits
researchers who can feel confident that they are studying a unitary approach to treatment that has some degree of consistency across practitioners. The ideal outcome of
research is validated technology identifying effective programs that can be replicated. Clients, providers, and payers want to be confident that a treatment approach
works.
One problem with manualizing is that the counseling process involves a specialized,
interpersonal relationship that cannot be translated into simple mechanics. When
counseling is manualized to the point of telling counselors what to say and do at each
session, it provides standardization and consistency, but at an enormous cost. Good
counseling must be responsive to clients needs, emotions, and thought processes. Too
much is compromised or lost when the whole process is rigidly guided by pre-determined protocol.
This manual has been written to help practitioners implement The Seven Challenges
Program with great confidence in the fidelity of their treatment. It is designed to
supplement, but not replace Seven Challenges Training. The manual spells out in
clear detail the philosophy and strategy of the program. It explains the health decision-making process inherent in The Seven Challenges, and clarifies the meaning of
each of the challenges. It presents the basic Seven Challenges Counseling Approaches.
It explains how to introduce and orient youth to The Seven Challenges Program, and
how to use Seven Challenges materials, including The Seven Challenges book, and the
nine Seven Challenges Journals. It explains how to give feedback to help young people
in journaling, one of the important elements of the program. Further, it defines
working sessions in adolescent drug treatment, explaining how to avoid widelyplayed games such as Try to make me quit or Try to prove that Ive been harmed
by drugs and other variations of these games all of which are wasteful diversions
from meaningful work.
This manual offers model statements about how to introduce and discuss various
issues. It suggests ideas about content for group sessions. It discusses some of the nuts
and bolts of the program such as settings in which it can be used, time requirements,
types of groups, size of groups, length of group sessions, composition of groups, issues
related to individual and family sessions, and more. It examines important group
start-up issues, such as how to win group consciousness. It presents material about
helping clients who are required to be drug free (perhaps by courts or schools), but
may not be ready to successfully become drug free. It also provides help to supervisors
in terms of issues that frequently arise in implementing the program. However, this
manual does not micro-manage what counselors say and do on a daily basis. Rather it

The Seven Challenges Manual 2004 Robert Schwebel, Ph.D.

iii

About this Manual

provides the framework for implementing the Seven Challenges Program, with help
and guidelines for use of the materials and for the counseling sessions. But the counseling must be personalized and individualized. Counseling is different from psychoeducational sessions that can be fully prescribed, and from the implementation of a
program of rigid, mandated protocols.
With this manual and training in The Seven Challenges, counselors can get a good
start on delivering The Seven Challenges Program in an effective way. Not everyone,
however, will be doing the exact same thing each day. The program requires individual initiative by counselors, and draws upon their clinical skills. It also requires that
counselors incorporate some distinct techniques that can add to their repertoire of
skills. These skills are not mastered in one training session or by reading a manual.
They are cultivated and refined over years of experience. Complemented by training,
this manual will help get people started in delivering effective Seven Challenges drug
counseling services to youth.
Agencies and practitioners who are not implementing the Seven Challenges Program
can still purchase and use Seven Challenges materials. They should also be able to
mine this manual for a wealth of information about state of the art substance abuse
treatment for adolescents, including a discussion of important theoretical issues and
effective clinical approaches.
Robert Schwebel, Ph.D.
Tucson, Arizona
April 2004

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The Seven Challenges Manual 2004 Robert Schwebel, Ph.D.

Table of Contents

ABOUT THIS MANUAL.....................................................................................................iii

CHAPTER ONE: INTRODUCTION TO THE SEVEN CHALLENGES .....................................1
Purpose of the Program....................................................................................................3
Start Where Youth Are At .............................................................................................3
Trust and Relationship Building Come First....................................................................3
Support Adolescent Development ...................................................................................3
Cognitive / Emotional Decision-Making Model..............................................................4
The Health Decision-Making Model ................................................................................4
Holistic Vision ..................................................................................................................5
An Empowerment Model: Solving Co-Occurring Problems and Teaching Life Skills ....5
Redefining the Role of the Drug Counselor ....................................................................6
Inspiring Hope..................................................................................................................6
Thinking about Change ...................................................................................................7
Behavioral Success ............................................................................................................8
Cultural and Gender Issues ..............................................................................................8
CHAPTER TWO: PUBLISHED MATERIALS.......................................................................11
Books, Journals, and Other Printed Material .................................................................13
CHAPTER THREE: METHODS ..........................................................................................15
Core Components ..........................................................................................................17
Readings ....................................................................................................................17
Journals .....................................................................................................................18
Counseling / Educational Sessions ...........................................................................18
CHAPTER FOUR: THE MAD RUSH FOR ABSTINENCE ....................................................21
Pressure for Immediate Abstinence................................................................................23
Fakers.........................................................................................................................23
Flee-ers (Those Who Flee).........................................................................................24
Fighters......................................................................................................................24
Followers ...................................................................................................................25
Slowing Down the Change Process: The Long Road to Success ...................................25
The Stages of Change .....................................................................................................26
Abstinence Based? Disease Model? Harm Reduction?...................................................28
Insisting Upon Abstinence .............................................................................................29
CHAPTER FIVE: UNDERSTANDING THE SEVEN CHALLENGES ......................................31
The Seven Challenges Process........................................................................................33

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Table of Contents

Challenge One................................................................................................................33
Challenge Two ................................................................................................................34
Challenge Three .............................................................................................................35
Challenge Four ...............................................................................................................36
Challenge Five ................................................................................................................37
Challenge Six ..................................................................................................................38
Challenge Seven .............................................................................................................40
Going Through The Seven Challenges ..........................................................................40
CHAPTER SIX: THE SEVEN CHALLENGES COUNSELING APPROACHES........................43
Substance Abuse Counseling as a Specialty Field ..........................................................44
Key Considerations in Adolescent Drug Counseling ....................................................44
Challenge One Clinical Skills.........................................................................................45
Undoing Negative Expectations ...............................................................................45
Introducing Ourselves to Youth ...............................................................................45
Introducing the Program ..........................................................................................46
Increasing Trust.........................................................................................................46
Redefine Success in Smaller Increments...................................................................46
Challenge Two Clinical Skills.........................................................................................48
Ten Reasons to Encourage Discussion of Drug Benefits ..........................................48
What About Glamorization? ....................................................................................50
Are You Saying It Is OK to Use Drugs?.....................................................................51
Challenge Three Clinical Skills ......................................................................................52
Avoid Argumentation ...............................................................................................52
The Rebuttal Cycle....................................................................................................53
Give Up In-the-Face Power.......................................................................................54
Confronting Denial in the Seven Challenges: Getting to Harm.............................54
Challenge Four Clinical Skills ........................................................................................58
Validation..................................................................................................................58
From Validation to Constructive Criticism and Support.........................................59
Taking Responsibility for Ones Own Behavior .......................................................60
Challenge Five Clinical Skills .........................................................................................60
Choices......................................................................................................................60
Discrepancy...............................................................................................................61
Future Harm..............................................................................................................61
Hope and Optimism .................................................................................................62

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Deferred Gratification...............................................................................................62
Challenge Six Clinical Skills...........................................................................................62
A Real Decision to Quit ............................................................................................62
Returning Home to a Family or Community Where Drugs Are Used ....................64
Challenge Seven Clinical Skills ......................................................................................64
Taking Action............................................................................................................64
Relapse Prevention....................................................................................................65
Using Work from Earlier Challenges in Relapse Prevention ...................................66
Lifestyle Action .........................................................................................................66
CHAPTER SEVEN: IMPLEMENTATION ............................................................................69
How to Introduce The Seven Challenges Program to Youth ........................................71
Seven Challenges Sessions..............................................................................................71
A Working Seven Challenges Session Defined ..............................................................72
Planning and Preparing for Counseling Sessions ..........................................................74
Teaching Life Skills .........................................................................................................74
Relate Activities, Discussions, and Problem-Solving Sessions
to The Seven Challenges ................................................................................................75
Ongoing Orientation to the Seven Challenges .............................................................76
Nuts and Bolts for Groups..............................................................................................77
Group Size.................................................................................................................77
Length of Group Session ..........................................................................................77
Group Composition..................................................................................................77
Starting Seven Challenges Groups ...........................................................................78
Positive Introduction to the Program ......................................................................78
Positive Introduction of Counseling Roles ..............................................................79
Wearing Two Hats.....................................................................................................80
Whats Expected of Group Members in a Working Group......................................80
Guest Status: Time to Adjust and Check Us Out .....................................................81
Group Rules ..............................................................................................................81
Confidentiality..........................................................................................................82
Seven Challenges Services ..............................................................................................83
Orienting Parents to The Seven Challenges ..................................................................84
Family and Multi-Family Services ..................................................................................85
Parent Education ............................................................................................................86
Parent Involvement........................................................................................................86

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Intensive Outpatient Program........................................................................................87

Time Required to Complete the Program ......................................................................88
Training in The Seven Challenges .................................................................................88
CHAPTER EIGHT: HOW TO USE SEVEN CHALLENGES MATERIALS:
BOOKS, JOURNALS, AND POSTERS ...............................................................................91
Introducing The Seven Challenges Readings to Youth .................................................93
How Are the Readings Used? .........................................................................................95
Introducing The Seven Challenges Journals to Youth ..................................................95
Basic Journal Information ........................................................................................95
Model Statement for Handing Out Journals ............................................................97
Who Sees the Journals? ............................................................................................98
Overcoming Resistance to Journals: Building Interest, Excitement
and Involvement in the Journaling Process ............................................................98
Reading Problems ...................................................................................................100
CHAPTER NINE: REVIEWING AND RESPONDING TO JOURNALS ...............................101
Responding to Journals ................................................................................................103
Writing Emotional / Relationship Comments in Journals ....................................104
Writing Cognitive / Intellectual Comments in Journals .......................................105
Special Concerns Regarding Face-to-Face Follow-up .............................................108
Concerns about Defacing the Journals ........................................................................109
Moving Through the Program .....................................................................................109
Frequently Asked Questions about the Journaling Process .........................................110
Diplomas.......................................................................................................................113
CHAPTER TEN: WORKING ON TWO LEVELS WHEN THE COURTS, COMMUNITY,
JUVENILE CORRECTIONS, OR SCHOOLS REQUIRE IMMEDIATE ABSTINENCE ...........115
Requiring Abstinence / Readiness for Abstinence .......................................................117
Treatment......................................................................................................................119
The Courts, Probation, and Other Authorities ............................................................121
Rethinking Expectations ..............................................................................................122
Probation Officers Wearing a Second Hat ...................................................................122
Progress and Setbacks ...................................................................................................123
A Single Standard with Individualized Responses .......................................................124
Drawing the Line..........................................................................................................124
CHAPTER ELEVEN: TRY TO MAKE ME QUIT AND OTHER GAMES ..........................127
Go Ahead, Try to Make Me Quit ..............................................................................129
Try to Make Me Quit in Group Sessions ..................................................................130

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An Example of Two Players Playing Try to Make Me Quit......................................131

How to Avoid Games ...................................................................................................131
When Group Members Challenge Other Group Members Who Are Playing
Try to Make Me Quit.................................................................................................133
Self-Disclosure...............................................................................................................133
CHAPTER TWELVE: SEVEN CHALLENGES GENDER ISSUES .........................................137
Gender Responsive Considerations..............................................................................139
Seven Challenges for Girls ...........................................................................................139
Implications for Girls with Regard to The Seven Challenges................................139
Challenge One and Girls ........................................................................................140
Challenge Two and Girls ........................................................................................141
Challenge Three and Girls......................................................................................141
Challenge Four and Girls........................................................................................141
Challenge Five and Girls ........................................................................................141
Challenge Six and Girls ..........................................................................................142
Challenge Seven and Girls .....................................................................................142
Skill Building for Girls ............................................................................................142
Seven Challenges for Boys ...........................................................................................142
Implications for Boys with Regard to The Seven Challenges ................................143
Challenge One and Boys ........................................................................................143
Challenge Two and Boys ........................................................................................144
Challenge Three and Boys......................................................................................144
Challenge Four and Boys........................................................................................144
Challenge Five and Boys ........................................................................................145
Challenge Six and Boys ..........................................................................................145
Challenge Seven and Boys......................................................................................145
Skill Building for Boys ............................................................................................145
CHAPTER THIRTEEN: SUPERVISION ISSUES ................................................................147
Fidelity of Implementation and Treatment .................................................................149
Program Implementation .............................................................................................149
Agency Issues ..........................................................................................................149
Counselor Issues .....................................................................................................150
Clinical Issues Specific to The Seven Challenges Counseling Approach ....................152
Orienting Youth to the Program and Continually Integrating
the Clients Work with The Seven Challenges Process..........................................152
Confusion about Counselor Role ...........................................................................152

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Relationship Skills...................................................................................................153
Too Focused on Drug Use .......................................................................................153
Discussion of Drug Benefits....................................................................................154
About the Harm from Drugs ..................................................................................154
Applying Pressure to Quit.......................................................................................155
Validation and Compassion ...................................................................................155
Decision-Making .....................................................................................................156
Relapse Prevention / Lifestyle Change ...................................................................156
Use of Seven Challenges Materials...............................................................................157
Introduction to Materials .......................................................................................157
Readings ..................................................................................................................157
Responding to Journals ..........................................................................................158
Deficits in Group Skills.................................................................................................158
Working Sessions ..........................................................................................................159
Activities .......................................................................................................................160
APPENDIX ONE.............................................................................................................161
Sample Treatment Note for The Seven Challenges
APPENDIX TWO............................................................................................................165
Sample Treatment Goals for the Seven Challenges
ENDNOTES....................................................................................................................173

The Seven Challenges Manual 2004 Robert Schwebel, Ph.D.

INTRODUCTION
TO THE
SEVEN
CHALLENGES

The Seven Challenges Manual 2004 Robert Schwebel, Ph.D.

The Seven Challenges Manual 2004 Robert Schwebel, Ph.D.

Introduction to The Seven Challenges

PURPOSE OF THE PROGRAM

The Seven Challenges Program is designed for adolescent (and young adult)
substance abusing and substance dependent individuals to motivate decisions and
commitments to change. Once such decisions and commitments are made, the
program guides young people toward success in implementing the desired changes.

START WHERE YOUTH ARE AT

Although we might wish that young people would enter treatment eager and ready to
quit using drugs, most come under duress, often dragged in by parents, schools, the
courts, or the juvenile correctional system. We have to begin where the young people
are at (usually resistant and reluctant to change) not where we wish they might be,
or might pretend to be (fully and honestly prepared to quit using drugs).

TRUST AND RELATIONSHIP-BUILDING COME FIRST

The Seven Challenges is a relationship-based program. Counselors start with an understanding that young people generally come to treatment against their will, or at best
with little enthusiasm about the experience. Many youth are accustomed to lying to
adults. They are also accustomed to being around adults with whom, if they told the
truth, they would only get into more trouble. Most youth expect that counselors will
try to control them and make them quit using drugs. Some may have had previous
negative experiences in treatment. Many may be quite angry or defensive about these
experiences. Unless counselors proactively address this negative expectation about
counseling, most young people will remain predisposed to resisting adults or faking
it. With The Seven Challenges, trust and relationship building come first, and remain
important issues throughout the program. Our aim is to create a climate in which
young people feel safe to talk openly and honestly about themselves and their drug
use. Unless trust is built in a counseling relationship, there will be little likelihood of
positive outcomes. Good relationships lead to retention in counseling, and retention
correlates with success.1 We also know that many young people in drug treatment
come from high-risk environments. Forming relationships with an adult who cares is
one of the key predictors of resilience. That is, youth who connect with adults who
care about them are much more likely to fare well than those who do not.2

SUPPORT ADOLESCENT DEVELOPMENT

Adolescents need developmentally appropriate drug treatment. During the adolescent
stage of life, young people are faced with the developmental tasks of defining their
own independent identities, learning systematic logical thinking, and preparing for
adult roles. It makes little sense to try to dictate and control their behavior. Most
youth would simply rebel. Instead, adults should help young people learn to make
their own wise decisions. We need to help them develop logical abilities, and then
apply these thinking skills to their lives. Because we live in a drug-filled society, when

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Introduction to The Seven Challenges

young people forge independent identities and prepare for the future, they must
determine where they stand in relationship to drugs. This is an inescapable challenge.
The Seven Challenges Program gives young people an opportunity to do this a
chance to think about the impact of their drug use upon their current lives, and its
potential impact upon what lies ahead in adulthood. In that way, we work with development, rather than against it.

COGNITIVE/EMOTIONAL DECISION-MAKING MODEL

As trust builds in the counseling setting, the Seven Challenges Program helps young
people look at their lives and consider where their drug use fits with what has happened in the past, what is happening now, and what they would like to see happen in
their future. Counselors help youth through the difficult and sometimes lengthy
process of thinking through drug and lifestyle decisions for themselves.
Young people consider:
why they are using drugs
what they like about drugs
how they harm themselves and others by using drugs
how their continued use might affect their future if they do not change.
Humans do not want to be controlled. Research about psychological reactance3 has
confirmed that no one wants to be backed into the corner and forced to behave in
certain ways. People need to feel that they have choices. When backed into corners,
they get defensive and attempt to assert their liberty. (Ill show you: No one tells me
what to do.) The urge toward self-determination is especially acute in adolescents
who are developmentally charged with forming independent identities. Young clients
need an opportunity to make their own informed choices.
The Seven Challenges incorporates a cognitive/emotional, decision-making process.
The program does not attempt to dictate behavior or coerce young people. Rather it
helps them learn to think for themselves, consider all relevant information, and then
make their own wise decisions. Relevant information includes awareness of the emotional issues that influence human decision-making the emotions we may seek and
those we want to avoid or minimize.4 With adolescents in particular, it is important to
show confidence in their competency and to support their sense of self-efficacy, as in
You can do it.5

THE HEALTH DECISION-MAKING MODEL

In the Seven Challenges Program, young people are given an opportunity to reflect upon
their drug using behavior within the framework of a health decision-making model.
Using drugs or not and the extent of drug use by those who indulge are health
decisions. People are deciding what they choose to put in their bodies. Drug use has

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Introduction to The Seven Challenges

important implications for physical and emotional health.

People make health decisions by weighing the costs versus the benefits of the
behavior under consideration. We do this, for example, when we decide whether or
not to wear seat belts: On the one hand, seatbelts are cumbersome and uncomfortable,
and rarely needed. On the other hand, they are required by law and can be life-saving
in an accident. (In fact, 75% of the population use their seat belts regularly.) Another
example of a health decision is about eating junk food, which is high in calories,
fat, and cholesterol, but may taste good, be readily available, and have great mouth
feel. People compare the relative value of the benefits and the costs. Similarly, people
make health decisions about drugs. They weigh what they like about drugs (the benefits) against the harm and potential harm (the costs).
Clear, informed thinking is required for good decision-making. This type of thinking
is not likely to take place in contentious relationships in which people are arguing
with one another. Too often drug treatment of adolescents can degenerate into a
battle of wills with counselors trying to convince their young clients to quit, and the
clients defending their drug use. That is one reason why relationship building is a
crucial priority in The Seven Challenges.

HOLISTIC VISION
Drug use is not a stand-alone, peripheral behavior in an adolescents life. People use
drugs for a reason to try to satisfy personal desires and needs. A holistic program not
only must address the drug use, but also the reasons for using. In The Seven
Challenges Program, young people identify the desires and needs they are satisfying,
or attempting to satisfy, through their drug use. They may be using alcohol and other
drugs to avoid or cope with stress, tension, boredom, anxiety, fear or other feelings.
They may use them to moderate their anger or release it, or to self medicate against
negative emotions. Young people sometimes use drugs to temporarily forget painful
life experiences, such as child abuse or other trauma, or to silence self-doubts or selfdeprecating thoughts. Sometimes drugs are used to escape from reality instead of facing it or to quell various uncomfortable feelings. Sometimes drugs are used simply
for pleasure or fun.
When self understanding increases when young people see why they are using drugs
they have an opportunity to think about alternatives to drug use. They can learn healthy,
drug-free ways to meet these same needs and satisfy desires. One way to tip the balance
toward healthier decisions about using drugs is to provide healthy, drug-free options.

AN EMPOWERMENT MODEL: SOLVING CO-OCCURRING PROBLEMS

AND TEACHING LIFE SKILLS
The Seven Challenges Program does not narrowly focus on drug seeking and drug
taking behavior. It goes further and provides young people with an opportunity to
identify and solve co-occurring, underlying psychological problems that motivate

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Introduction to The Seven Challenges

their drug use. This includes supporting them in their efforts at resolving trauma
issues. Co-occurring problems are the norm with drug abuse, and these problems must
be addressed in a comprehensive drug treatment program.
The Seven Challenges also places a strong emphasis on teaching social, psychological
and emotional life skills, so that individuals can learn new, positive ways to cope with
life, meet their needs, and satisfy their desires. In the program, young people learn
problem solving skills, communication skills, anger management skills, social/relationship skills, self-control skills, thinking skills, and relaxation and stress reduction skills.
Clients are given opportunities to resolve trauma issues and overcome a variety of psychological problems that may plague them.6
Solving co-occurring problems and learning life skills empowers young people to meet
their needs in healthy ways, without drugs. It puts them in a position from which
they could choose, of their own accord, to give up drugs, but still have other ways to
attain satisfaction, pleasure, and happiness in life.

REDEFINING THE ROLE OF THE DRUG COUNSELOR

Young people who believe that counselors are striving to make them quit using drugs
will see counselors as antagonists. They will see counselors as trying to take something
away from them their drugs. Drugs may be the only way some young people can
envision satisfying their own needs. Counselors in The Seven Challenges Program must
redefine their role. We are not here to take something away. We are on your side. We are
your problem-solving partners. Were here to help you think about your options and to give
you more options. When you have learned new ways to meet your needs and considered your
options, you may choose of your own accord to give up drugs. But that will be for you to
decide.

INSPIRING HOPE
People dont make changes in their lives if they think their lives will get worse. They
make changes when they believe that their lives would improve. That is why it is so
important to empower young people to feel that if they choose to give up drugs, they
will have better lives. They would be giving up the benefits they derive from drug use.
In exchange, however, they would stop the physical, psychological, and social harm
caused by drugs, and find other ways to satisfy their personal needs.
By way of illustration:
A person who is seriously depressed and uses drugs to self medicate is unlikely to
choose to quit using unless there is some hope of overcoming the depression.
Without this hope, quitting drugs would be seen as stopping the harm from the
drugs, but leaving this person feeling miserable.
A person who has a serious anger problem, uses drugs to moderate the anger, and

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Introduction to The Seven Challenges

is frightened of being explosive when not self-medicating would be quite reluctant

to choose to stop using drugs unless: (1) this person acquired skill in problem solving (to prevent angry situations from occurring); or (2) learned other ways to manage the anger; or (3) knew he or she would have an opportunity to learn anger
management skills in the near future.
Victims of physical or sexual abuse who self medicate with drugs would be reluctant to quit using drugs unless they felt they could resolve the trauma and cope
with their thoughts and feelings about it.
People such as those described above, who feel pessimistic or hopeless about their
future, need to believe that things could get better before they would be willing to
stop coping the way they have been coping by using drugs.
Many young people who abuse drugs have already been discouraged about life and
may have a sense of powerlessness and hopelessness. The Seven Challenges promotes
and teaches skills to create a better life, but also works to promote optimism and
hope. This includes conveying a sense of personal power that people can make
changes and make their lives better. This sense of optimism is reinforced as young
people are empowered to learn various life skills in The Seven Challenges Program.

THINKING ABOUT CHANGE

After young people reflect upon their lives, including their use of drugs, The Seven
Challenges Program offers them an opportunity to think about making changes:
what it takes to change
what they might gain and lose by changing
which changes they might want to make
how they would go about making such changes
what they need to do so they feel that they could successfully make the desired
changes
We know that most young people do not enter drug programs wanting to change,
ready to change, or even able to change their drug use behavior. They are in the
earlier stages of the change process. First they need to recognize the problem, then
consider making changes, then make decisions about changing, then prepare to
change, and finally, make the desired changes. Important psychological research by
Prochaska, Norcross and DiClemente7 has identified six stages of change in overcoming problem behaviors and discussed the implications of their findings in terms of
matching appropriate interventions to an individuals particular stage. The application
of the stages of change research to work with adolescent substance abusing youth is
discussed in more detail later in this manual (pages 26-28). The Seven Challenges
Program is designed to match the intervention to the clients stages of change.

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Introduction to The Seven Challenges

BEHAVIORAL SUCCESS
When young people make decisions and set goals for themselves (about their drug use
or their lives), they need help and support in initiating and maintaining new behavior. The Seven Challenges Program supports them and guides them toward successful
implementation of the changes they pursue.
The Seven Challenges Program provides Lifestyle Action Groups (see Seven Challenges
Services, pages 83-84) for young people who are committed to making changes in
their lives. These groups are focused on following through on decisions. In the groups,
young people get support in making any behavior changes they have chosen to make
such as learning anger management, learning to cope with stress in positive ways,
etc. For those who commit to stopping their use of alcohol and other drugs, a specialized part of the Lifestyle Action Group teaches state of the art relapse prevention
skills, which is incorporated in work in Challenges Six and Seven.
When youth have decided to become drug free, individuals and agencies that implement The Seven Challenges may want to use community resources such as 12-steps
programs, Smart Recovery, or other recovery groups to supplement Seven Challenges
work. Appropriate support should be available to all youth who want to overcome
problems of drug abuse and drug dependence. Spiritually minded youth who accept
the ideas of (1) admitting powerlessness over their drug use and (2) surrendering to a
higher power should be encouraged to attend 12 step groups.
Until recently, drug treatment tended to be defined as either pro 12-steps, or against
it. The Seven Challenges offers a different perspective. Whereas a 12-step program is
designed for people who are motivated to make significant changes in their lives, we
know that most youth enter drug treatment in the very early stages of change. Most
are far from ready to make informed, internally motivated, and committed decisions
to quit using drugs, and are poorly prepared to succeed even if they were to make
such decisions. The Seven Challenges starts working with youth in these earlier stages.
It is only after considerable effort and significant progress has been made that young
clients are ready to swing into the action stage. Although The Seven Challenges is not
a 12-step program, it is not opposed to it. When young people are ready to stop using
drugs, 12-step programs are one of a number of viable options for additional support.
Youth in The Seven Challenges Program who want to take the spiritual approach to
maintaining abstinence should have access to 12-step groups. Other youth should be
oriented to the 12-steps, whether they accept the principles of it or not, because it is a
universally available support group in their communities.

CULTURAL AND GENDER ISSUES

The Seven Challenges Program and materials were developed while working with
and with the input of a culturally diverse group of youth. An effort has been made
to put substance abuse in a social and cultural context. People use drugs, at least in
part, in response to their circumstances and environment. The Seven Challenges

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Introduction to The Seven Challenges

Program is designed to help young people understand and explore the context of
their drug use. Often, serious environmental risk factors correlate with drug use (for
example: child abuse and other trauma, poverty, and families experiencing high levels
of stress). Clients need help in understanding this. By teaching life skills and encouraging positive relationships, the program builds resilience within clients to cope with
these stressors, and offers an opportunity to strengthen and reinforce
protective factors.
The Seven Challenges Program was developed in clinical settings with both boys
and girls. As such, it could be considered gender neutral, with both sexes equally
represented. However, there are special considerations when using this program with
either sex. Gender responsive considerations are discussed later in this manual (pages
137-145).

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PUBLISHED
MATERIALS

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Published Materials

BOOKS, JOURNALS, AND OTHER PRINTED MATERIAL

The Seven Challenges Program incorporates the use of the 120-page book, The Seven
Challenges, which is a collection of readings for youth; the nine Seven Challenges
Journals designed for counselor/youth interaction; The Seven Challenges Poster; and
The Seven Challenges Diplomas. Resources for counselors include the books: The
Seven Challenges Activity Book and this publication, The Seven Challenges Manual. A variety of other printed materials have also been developed to assist in implementation of
the program, such as a sample treatment note, a list of treatment goals, and information about implementation in different settings.
The Seven Challenges and the nine Seven Challenges Journals are available in Spanish.
They were translated by a native Spanish speaker, in collaboration with the author of
the program to ensure fidelity of meaning.
Explanations about the use of this printed material are included in this manual. Seven
Challenges Training is required to maximize benefits of the published material, to
fully implement the program, and for an individual or agency to announce that they
are doing The Seven Challenges Program.

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METHODS

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CORE COMPONENTS
Youth are guided through The Seven Challenges Program by a combination of:
Readings in The Seven Challenges
Journaling in the Seven Challenges Journals
Educational/counseling sessions in one-to-one and/or group settings
Family or multi/family sessions, when feasible and appropriate
To successfully implement the program, staff must be thoroughly familiar with The
Seven Challenges published material; know how to introduce the program and the
materials to youth; know how to give feedback to youth who write in the journals;
know how to promote openness and talk with, or counsel, young people to empower
them, without eliciting defensiveness and without getting hooked into power struggles; and be able to integrate the topics or content of counseling sessions with The
Seven Challenges process. They must be prepared to work in a holistic manner with
youth. On the one hand, this means being informed by a basic understanding of drug
information (widely available elsewhere; not included in this manual).8 On the other
hand, this means being able to teach problem solving skills and various life skills,
which are also essential to this program.
The extent to which the full power of this program is utilized will depend to a large
extent on the clinical skills of those who use it. Among these are specialized Seven
Challenges Counseling Approaches that maximize impact of The Seven Challenges
Program. These approaches are introduced in this handbook, and taught in Seven
Challenges Trainings.
The Seven Challenges Program has been implemented in a wide array of treatment
settings (outpatient, intensive outpatient, inpatient, residential, day treatment, partial
care programs, and in-home). It has also been used in public and private schools,
juvenile probation departments, and public and private correctional facilities.
READINGS
The Seven Challenges reader is based on the experiences of young people who have
been successful in overcoming alcohol and other drug problems. (This is why the text
is written in the first person plural We format.) This book of readings expresses
their point of view. What these youth had in common was that they all were willing
to challenge themselves to think honestly about their lives and their use of drugs.
That is why the book and the program are called The Seven Challenges. Readings are
an important part of the program, providing ideas and inspiration to help young
people look at their own lives. The book is divided into seven chapters, one for each
challenge. This book and other materials are all written in very simple, easy-to-read
language.

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Methods

JOURNALS
The Seven Challenges Journals are a valuable and powerful tool to help young people
look at their lives and drug use, to support them in making important decisions about
their future, and in following through with positive changes in their lives. Young people write in the nine journals, one at a time, and receive extensive feedback from
counselors. When youth have answered all questions in a journal, they pass them to
their counselors who read the journal and respond with their own comments. Each
journal goes back and forth between the client and counselor several times before the
client completes it and moves on to the next journal. Through the journaling, a special type of relationship and communication develops between youth and their counselors. Often young people will write down thoughts and feelings, and share experiences, they might be reluctant to disclose in face-to-face conversations.
There are nine journals in the program. Because of the sheer volume of material in
Challenge One, this challenge has been divided into two separate publications
Challenge One: Part One and Challenge One: Part Two. Because youth are asked to
make decisions about both lifestyle and drug issues in this program, Challenge Seven
is divided into two parts as well. Part One concerns follow up on lifestyle decisions.
Part Two concerns follow up on drug decisions.
COUNSELING / EDUCATIONAL SESSIONS
Young people with drug problems need to talk it out in counseling/educational sessions as they examine their lives and consider making changes. There is no pre-set
agenda for counseling/educational sessions in The Seven Challenges Program, nor are
there scripted sessions. Good drug counseling must be responsive to the interests and
needs of youth, and their current realities. Effectiveness is seriously compromised in
pre-scripted, one-size-fits-all programs. Therefore, counselors must plan sessions
according to the needs of individual clients at any given time. Although not prescripted, the content of each and every counseling session should be integrated in
such a way that young people can see how their efforts relate to helping them
through the decision making process using The Seven Challenges Process. (How to
skillfully do this will be discussed later in this manual, on pages 75-76.) It is also
important that counseling sessions are all working sessions not a time for game
playing and ceaseless argumentation (pages 127-135).
Counselors provide leadership at counseling sessions by pursuing discussions on
important issues relevant to youth or initiating activities that promote thinking about
relevant issues, or by teaching important life skills. This requires awareness of which
issues to focus on and when. It requires attentiveness to individual or group needs,
and responsiveness to youth concerns. Co-occurring problems need to be addressed in
counseling sessions. Some counselors with a background in drug counseling do not
feel prepared to help with mental health issues. The program materials help with this.
But these counselors may want to broaden their own training, or work on teams with
other counselors with a broader background in mental health. Also, they may find

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that they know more than they think about mental health issues as they work with
young, drug-abusing clients.
Life skills education may be incorporated in regular Seven Challenges group work, or
can be taught separately in life skills lessons or classes. Either way, connections are
made to The Seven Challenges Process so that young people understand our holistic
approaches and why they are being taught these various life skills.
Although planning and leading individual and group sessions require creative initiative, counselors do not have to keep re-inventing the wheel. A collection of activities
for use in The Seven Challenges Program has been compiled in the book The Seven
Challenges Activities and is provided to offer a menu of options. There are numerous
other books available in bookstores about life skills education or group activities that
can be integrated into work with The Seven Challenges.

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THE MAD RUSH

FOR
ABSTINENCE

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PRESSURE FOR IMMEDIATE ABSTINENCE

Aware of the harm and potential harm from drugs, most adults who work with drug
abusing and drug dependent teens would like to see these young people become
abstinent immediately. They want to protect them. Their well-meaning motives are
reinforced by enormous, external pressure for immediate abstinence: Parents, schools, the
courts and correctional settings want drug-free childrenand they want them now!
Individuals who work in the treatment field feel this pressure to deliver the desired
outcome: drug-free children quickly. The result of this pressure has been a mad rush for
abstinence in which drug treatment counselors try to convince young people to quit,
or cajole them, or even coerce them into quitting. In this context, counselors tend to
focus narrowly upon the harmfulness of drugs and pound away on this topic. They
cut off or dismiss discussion about drug benefits, and persist with pressure for immediate decisions to quit.
Mainstream approaches of this sort have not been proven to be effective.9 Drug
problems do not start overnight, nor can they be remedied overnight. Often drug
problems are the culmination of a lifetime of other problems. Furthermore, counselors
must consider readiness to change and the building blocks to success.
Counselors should not assume that youth, many of whom are dragged into treatment
by their collars, are ready to tell the truth and make instant changes in their lives.
They should not assume that underlying and co-occurring problems associated with
drug use are quickly and easily overcome.
They should not assume that youth in drug treatment possess all the life skills and
abilities that would enable them to successfully care for themselves or meet their
needs without drugs.
They should not assume that youth have enough self-confidence to believe that they
could succeed in quitting drugs, even if they wanted to quit.
No matter how much they may want quick fixes to the drug problem, counselors
have to be patient enough to find methods that are effective and start where young
people are at, not where they wish they might be.
The mad rush for abstinence that has typified drug treatment for adolescence has
generally elicited either of four negative response patterns, all described below,
all beginning with the letter F. Youth who follow these patterns can be categorized
as Fakers, Flee-ers, Fighters or Followers. These response patterns offer a likely
explanation for the poor outcomes and low retention rates that have historically
characterized drug counseling for adolescents.
FAKERS
Fakers tell adults what they want to hear. They readily say they will quit using drugs.
They will go through all the motions of pretending to learn how to be drug free. They
know that this is the quickest way to get out of drug treatment. In the mad rush for

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abstinence, adults teach these young people how to be drug free before they have
even decided they want to be drug free. The youth fake it. They say they will quit,
but clandestinely keep using. If they are in residential or correctional settings, they
say they will quit, accept counseling as if they were serious about it, but resume using
drugs quickly, as soon as an opportunity presents itself. Later they like to boast that
they told the adults what they wanted to hear. It is easy to get these young people
to say they intend to quit. The much bigger challenge is to get them to say what
they really think and feel, which usually is that they have no intention whatsoever
of really quitting.
FLEE-ERS (THOSE WHO FLEE)
No one wants to be controlled by others. This is especially true of adolescents who, as
part of a developmental process, are striving to form their own independent identities.
Healthy adolescents do not want to be told what to think or do. They are likely to
resist adults who they perceive as trying to dictate behavior and control them.
Many of those who flee treatment simply say, You cant make me and leave or try
to leave. These are the youth who dont return to outpatient settings or try to run
away from residential placements.
Others flee from the mad rush for abstinence because of fear. They hear that they
must give up drugs, but feel ill prepared to do so. They fear their life would be worse
without drugs (for example, they would be in a lot of emotional pain). Some fear that
they would fail if they really tried to quit, so they flee from drug counseling to avoid a
failure experience.
The large numbers of individuals who flee from counseling account for the low retention rate of adolescents in drug treatment. Even among those who do not drop out,
many others flee psychologically. They are physically present, but psychologically
absent.
FIGHTERS
The mad rush for abstinence tends to result in contentious and argumentative sessions. It generates resistance. Counselors talk about the dangers of drugs, and youth
resist either openly or passively. The tone is oppositional; the outcome of the counseling effort is predictable.
Fighters resist adults whom they see as trying to dictate or control their behavior.
Some fighters engage in open, straightforward resistance during individual or group
sessions. They say it is all stupid or a waste of time. Seeking attention and power,
many others waste countless hours of counseling time with oblique resistance as they
engage in the games of Try to convince me that drugs are dangerous (or that I have a
problem), or Try to make me quit. These are passive- aggressive games that frustrate
adults (pages 127-135).
In outpatient settings, fighters generally waste time through either passive-aggressive

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or open resistance, or are asked to leave. In residential settings, they usually fight
adult influence for a while with open or passive resistance, but eventually realize they
cannot beat the adults who run the system. At this point, most become fakers in order
to gain their release.
FOLLOWERS
Followers are the adolescents who respond positively to well meaning and caring
adults who are in a mad rush for abstinence. They are swayed to wanting to quit
drugs, and make a sincere commitment to change. Unfortunately, when adults are in
a mad rush, they pay insufficient attention to laying a solid groundwork for success
including the intensive focus needed to remediate underlying and co-occurring problems. Followers will try hard to quit, but generally fail because of insufficient preparation. For them, the outcome is another failure experience something many of them
have already experienced all too often.
It is not surprising that outcomes have been so disappointing in adolescent drug treatment, and the dropout rates have been so high. With the mad rush for abstinence,
young people either fake it (telling adults what they want to hear), fight (defy or
resist), or flee from adults. Or as followers, they fail because they have been inadequately prepared for success.

SLOWING DOWN THE CHANGE PROCESS:

THE LONG ROAD TO SUCCESS
The mad rush for abstinence runs counter to common sense and to so much of what
we know about human nature, adolescent development, the change process, and the
principles of good counseling. We should not attempt to teach people how to be drug
free before they have decided they want to be drug free. This is straightforward common sense: We dont put the carriage before the horse. People should make decisions
about their behavior after they have thought through the issues, not beforehand. The
common sense idea of slowing the rush for abstinence is also supported and amplified
by research findings about the stages of change in overcoming behavioral problems:
There are preparatory stages that precede willingness, capability, and commitment to
take successful action.
Furthermore, we know enough about human development to know that we should
not try to control the behavior of adolescent clients. No one wants to be controlled,
and this is especially true of adolescents who are forming their own independent
identities.
The Seven Challenges Program avoids the mad rush for abstinence. It takes corrective
action to ensure better outcomes in adolescent drug counseling. We initiate the
change process slowly: building a relationship, starting where youth are at, and
helping them think things through for themselves. We help them progress through

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the many stages of change. With our assistance, they identify their own problems for
themselves, determine it is in their own best interest to change, learn how to make
changes, and begin to believe that they can be successful in making changes. Then
they can make their own decisions, and we can support them as they successfully
implement the desired changes.
It should be noted that this is entirely consistent with the traditional role of the counselor, as well as with research findings about positive outcomes in counseling. The traditional counseling role is not to control behavior or tell people how to behave.
Doing so is condescending, takes away personal power, and is likely to increase resistance. Instead, drug counselors should perform the traditional role of the profession,
which is to help clients think things through for themselves, know their options,
expand their options, establish their own goals, and attain success in their own quest
for wellness.10
There is considerable evidence, as well, that effective counseling with positive outcomes depends to a large extent upon a positive client/counselor relationship, in
which the client feels that the counselor listens, understands, and empathizes with his
or her story.11 This cannot occur in the context of an argumentative, contentious relationship in which the counselor tries to control the behavior of the client. We need to
engage youth in the counseling process, not antagonize them and turn them off.

THE STAGES OF CHANGE

Common sense and what we know about adolescent development are two good reasons to stop the mad rush to get teens to commit to immediate abstinence. Another
strong argument against the mad rush can be found in a body of research, mentioned
earlier, about the way people change. Prochaska et al.12 studied the change process by
first looking at the way people overcome tobacco addiction. Later they studied how
people overcome the abuse of other drugs, as well as how they alter a variety of
health-compromising behaviors.
They found that people basically go through six stages of change: pre-contemplation,
contemplation, preparation, action, maintenance, and termination. They go through
these stages whether they change with the assistance of a self-help group, such as AA;
in treatment, with professionals; or on their own, without assistance.
It is important to look at these stages because the researchers also recognized that the
choice of intervention strategies should be keyed to the stage of change. As you will
see, treatment professionals working with adolescents have tended to gloss over the
early stages of change, and poorly matched the treatment methods to the stage of the
individuals.
In the pre-contemplation stage, an individual does not recognize the existence of a
problem, or is unwilling to honestly acknowledge it. In the contemplation stage, an
individual is beginning to think that maybe there is a problem. For example, an
adolescent with a drug problem may think: Well, my grades have fallen in school.

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Im getting in trouble. I said I would never smoke marijuana on school days, but now
I do. I said I would never use cocaine, and now Im using it. I better think about this.
Something does seem to be wrong. Also, a person in the contemplation stage may be
quite aware of the problem, but still contemplating trying to decide whether or
not to do something about it: I know I have a problem, but Im not sure I want to
change, or that I could change.
People in the preparation stage are getting ready and making plans for a substantial
change that they intend to make within a month. They acknowledge that they have a
problem, and may even take certain preliminary actions. For example, a person with a
drinking problem may experiment with short-term abstinence (sobriety sampling) to
see how it goes. In this stage of change, people are getting ready to take strong, decisive action.
Individuals enter the action stage when they take the type of significant behavioral
action that experts say needs to be taken in order to overcome the particular problem.
For example, this occurs when someone with a tobacco addiction actually quits smoking, or begins systematically reducing his or her use until becoming tobacco-free.
After six months of success in the action stage, individuals enter the maintenance
stage of change. This is when previous progress is consolidated and incorporated as
part of a changed lifestyle. During this stage, individuals must exercise caution to
avoid letting down their guard, which could result in relapse.
The final stage of change is termination when the problem has been completely overcome. People in this stage can be exposed to high-risk situations without reverting
to the problem behavior. With alcohol and other drug (AOD) problems, a person who
is abstaining would feel no temptation to drink or use drugs under any circumstance.
Some people with certain problems are always at risk. For example, there are people
who can never drink again and must always remain vigilant, or in recovery. In other
words, termination does not necessarily apply to all people with all problems.
Nonetheless, many people have had problems in their lives that they have totally
overcome.
It should be noted that people do not always move in one direction in the change
process. There may be advances and setbacks from one stage to another as people find
their way through the change process. For example, people may contemplate about
having a problem, decide they dont, and move back to pre-contemplation. People
may be in the action stage, try to make a change, suffer a setback, and move back to
earlier stages either preparation, contemplation or even pre-contemplation. Then
they can resume their efforts at changing, but from an earlier stage.
For optimal outcomes in treatment, clinical interventions should be matched to the
stage of change. Generally speaking, there is an especially important dividing line that
distinguishes between appropriate interventions for the action stage, and those that
follow, from appropriate interventions in the three earlier stages of change. In the
action stage and those that follow, individuals benefit most from behavioral interven-

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tions; that is, interventions that are designed to teach behavior. For example, people
who have decided to quit smoking tobacco would be taught how to quit and maintain abstinence. They would learn a variety of behaviors such as how to systematically
reduce their smoking until they quit or how to quit cold turkey. With this latter
approach, they would learn to establish a quit day, what to do on the day they quit,
and how to resist urges to smoke. With other drug problems, behavioral interventions
in the action stage would be designed either to help individuals maintain abstinence
and avoid relapse, or to moderate and control their use of substances. They would
develop a relapse prevention plan, learn how to initiate and maintain a healthy
lifestyle, and strive to overcome psychological and other problems that motivated
their drug use.
In the three stages that precede the action stage (pre-contemplation, contemplation,
and preparation), individuals have not yet committed to making changes. They are
either unaware of problems, thinking about problems, or perhaps in the process of
making decisions about future action. The type of interventions that are most appropriate with individuals in these stages could generally be classified as consciousnessraising. Such interventions help people gain awareness and insight, and ultimately
decide to change. Individuals may need help thinking through their situation, trying
to determine whether they have a problem. If they deem they do have one, then they
would consider what they might be able to do about it, whether for example, they feel
they are capable of making the changes, and whether the particular behavior changes
would make their life better and be worth the effort.
People are not ready for the action stage until they have decided a change is needed
and desirable, understood what is necessary to make the change, prepared themselves
to change, and committed themselves to making the change. Then, it is time to learn
the new behavior.
ABSTINENCE BASED? DISEASE MODEL? HARM REDUCTION?
There are numerous theoretical and political controversies that surround the field of
substance abuse treatment for adolescents. The Seven Challenges Program maintains
its clinical focus, without engaging in some of the hot political battles.
The Seven Challenges has been practiced successfully by people who think in terms
of the disease model, and those who do not. It has been used by people who call
themselves abstinence-based, by those who say they practice harm reduction, and
by others.
Whether counselors think in terms of disease or not, they still have to help young
people harness all of their power and abilities to make good decisions. Whether the
goal of those who run a program is stated as abstinence or harm reduction, young
people still need to learn to make wise decisions. This is universally agreed upon as
important. Thus, The Seven Challenges Program supports young people in making
good decisions, regardless of the political or theoretical position of practitioners.

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INSISTING UPON ABSTINENCE

We all wish that young people in treatment would immediately quit using drugs. A
small percentage of those who come to our attention really want to quit. Another
small percentage will quit on our insistence. Perhaps some can be swayed by a hard
line. The problem, however, is that most young people are far from ready to succeed
with abstinence. It is too simplistic to dismiss this un-readiness as mere rebellion or
defiance, although these can be factors. There are other psychologically significant
impediments to change that must be addressed when working with youth. Youth may
be in earlier stages of change because:
They may not recognize that they have a problem, perhaps because they live in
families or communities where drug use is almost universal, or because they do
not understand the nature of drug abuse, or because of psychological reasons,
unique to themselves.
They may see a problem, but not be aware of any way to resolve it.
They may see a problem and a way to resolve it, but feel overwhelmed by the
thought of what their lives would be like if they did not have drugs as a crutch.
(Here are a few examples: Young clients may be clinically depressed, perhaps even
suicidal, and have so much distress that they do not feel they could cope without
drugs; young clients may experience so much anxiety in their daily lives that they
do not feel they could make it through the day without drugs; young clients may
suffer such pain from abuse, or other trauma, that they do not feel they could cope
with these feelings without drugs.) They feel hopeless about their lives getting
better.
They may want to make changes, but feel immobilized by fear of failure. They
dont believe they could succeed with abstinence. Some of them have already had
numerous failure experiences and want to prevent another one. They are so afraid
of failing that they do not want to take the risk of trying.
Even if youth know they have a problem, know what can be done about it, want
to do something about it, and feel they would be successful in changing, they still
may lack the life skills or be plagued by psychological problems that would prevent them from succeeding.
So in working with youth with substance abuse problems, we have a lot of initial
groundwork to lay in order to get them to the point where they will be ready, willing,
and able to stop abusing drugs.

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