Monday, February 3, 2014

Encouraging Change with Adolescents

Motivational Interviewing (MI) is a powerful tool for clients struggling with change.  MI is most commonly used to treat issues around substance use.  I have found MI to be very effective with adolescents who are resistant to change of any kind.  Teenage-hood comes with an intense and appropriate desire for autonomy, which is necessary for this age group since they are forming their independent identities.  Therefore, using a technique that places emphasis on meeting the client where they are at, and focuses on asking questions as opposed to being directive, is effective.  As a therapist, consider a teenager struggling with completing their school work to the point of possibly not graduating.  They express that they don't see the purpose because they "won't make it to college anyway, so why not have fun while I'm still young?"  You begin to reflect back what you're hearing and ask general questions about their future desires.  Through these questions you can glean whether they do not see this as a problem (pre-contemplative stage), whether they see this as a problem but are not ready to change (contemplative stage), or whether they are ready to make a change (action stage).  The power of showing a teenager that you are hearing them and want to know what they think is not hard to recognize.  This significantly increases the chances that you will be able to facilitate a shift from their initial stage of change.  By using MI techniques, you are breaking the mold of their expectation of adults.  These techniques are not magic of course, and so the trust of your teenage client will still be difficult to earn.  However, seemingly before you know it, they may share things like their struggles around focusing in school and feeling ashamed in front of their well-educated family.  Instead of pulling out a white board and making a “life plan” with the adolescent, or pulling their parents into the session, you are using MI techniques to foster an adolescent's independence and autonomy.  Teenagers desperately want their independence, so why not help them develop that?  Using these techniques, will help your client to be more receptive and therefore change their behavior.  Certainly gauge where your client is at; younger adolescents tend to benefit from more direction.

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