Adolescence: Such a time of turbulence. For those of us charged with helping young people feel better, parent them or educate them, sometimes it can feel like we are on the losing team no matter which trick, technique or skill we try.
Luckily for both sides, we are not willing to give up so easily.
I have spent the better part of the past decade, trying, failing, and sometimes succeeding in helping young people make positive changes in their lives and accept help from others. The research is clear. We have developed amazing social and emotional techniques to help young people change their lives and feel happier and healthier.
Yet many adolescents don’t seem to benefit from our tried and true techniques, no matter which way we try to spin them. They build up the wall and refuse to budge.
So what is going on? How do we move from the losing team to the winning team? The key is accurately assessing motivation and choosing the right tool to address it, based on the young person’s position on the motivational spectrum.
I once worked with an adolescent male who was dealing with a recent HIV-positive diagnosis. Thankfully in this day and age, HIV care and medical advancements have moved HIV/AIDS from a terminal condition to a chronic condition that can be controlled by medication.
In the case of this young man, his medical doctors had prescribed him a cocktail of medications that would extend and potentially save his life.
“There is no reason to believe you won’t live to be an old man in his 80s,” his medical doctor joked with him one day as I looked on.
He wasn’t impressed. And, try as they might, his medical team could not get him to take his medication. They made sure he knew the risks, the sickness and the eventual death that would potentially come with his lack of adherence. But the message just did not get through.
How ready someone is to change or try something new can be described as a continuum ranging from “not ready at all” (precontemplation stage) to “very ready” (action stage). Knowing where a client is on this continuum is very important. Trying to give someone information, or ideas, that they just aren’t ready for isn’t going to work (especially with a teenager).
Assessing someone’s motivation isn’t as hard as you may think. My lab did a study in 2008: Asking young people how ready they are to change on a scale of 1 to 10 was as accurate as a full 15-question standardized measure (Harris, Leahy, & Walters, 2008).
In other words, assessing motivation can be as simple as asking someone how ready they are to make a change.
Telling that young man about all of the dangers of not taking medication was only making him dig his heels in, not helping him make changes. Instead, meeting him where he was at motivationally, helping him to feel comfortable, and persistently using motivational enhancement techniques led to acceptance of his medication and a healthy future.
Telling him the dangers of nonadherence did not work. Reflecting his feelings (anger, fear, withdrawal) and pointing out his underlying ambivalence led to increased motivation and eventual acceptance of the lifesaving drugs. His story was one I listened to over and over again.
It is possible to help adolescents in therapy in the same way. Jumping in with what we want the adolescent to do isn’t going to cut it very often. Seeing what they want, and helping them reach a point of acceptance of our proven techniques to assist them often will lead to success and brighter outcomes.
I can’t make you an expert in motivational enhancement in one article, no matter how motivated you are. But a few simple practices can get you started.
Ask your youngster, student or client where they are, how much they want to change a certain maladaptive behavior, and what they are willing to do. Listen. Accept. Reflect all of the anger, frustration, and pain. Search for nuggets of change talk and ambivalence with the status quo and work up from there.
Take time to understand where they are at from a motivational perspective and you will be on the right path to playing on the same team, as opposed to the one they want to obliterate.