Substance use disorders (SUDs) among young people have been linked with a range of adverse health consequences that can be successfully mitigated with early SUD treatment. According to the Social Identity Theory of Cessation Maintenance (SITCM), psychosocial processes including self-perceptions and benefit finding evolve with treatment, influencing recovery-based identities that can facilitate treatment success. However, this process has only been documented with adults; thus, the current study seeks to characterize these psychosocial processes among young people in SUD treatment and their caregivers. Nineteen young people receiving SUD treatment and 15 caregivers were interviewed about treatment experiences including negative self-perceptions, positive self-perceptions, and benefit finding. Results support the SITCM: Adolescents described escaping negative self-perceptions associated with the “substance use self” identity and strengthening a new “recovery self” identity characterized by positive self-perceptions and benefit finding. Caregivers described how extrinsic sources of support can help mitigate negative self-perceptions.