The blog

The book What Works With Teens speaks to the importance of creating a strong bond with the young people we teach, treat, and coach. Research has shown that a strong relationship and good fit between teenagers and the adults who help them is critical for change to occur. Sometimes in fact, the fit itself may be the conduit to change. Teenagers report that having even one adult who believes in them is a powerful motivator. At other times, the fit is not quite enough. Let’s turn our attention now to the next step in the process, collaboratively establishing goals.

The medical research is replete with evidence that simply telling people what’s best for them is not adequate for change to occur. Doctors and therapists frequently talk with young people about the risks of vaping, alcohol and other substance use, unprotected sex, and other unsafe behaviors, to little avail. So what do we do?

Consider that most worrisome adolescent behaviors are actually attempts to meet a need. If somehow we were able to convince a young person to give up a risky or troubling behavior, but the underlying need is not addressed, they are likely to pick up another maladaptive behavior as a substitute. The need to belong, the need to be loved, and the need to feel safe are universal human strivings and explain most worrisome behaviors. Substance abuse? Fit in with friends, reduce anxiety. School avoidance? Increase sense of safety. Promiscuity? Feeling loved.

The path to change is to identify the underlying need, validate it, and then offer hope that the need may be met in more effective ways. I like to do this by asking teenagers what they will be doing differently when their problems are solved. They typically describe exactly what adults are asking for; effective mood management, age-appropriate social interaction, and good judgment. For example, an adolescent who is engaging in unsafe sex with multiple partners might respond by saying they will be in a long-term relationship. Or a teenager who is abusing substances might indicate that their anxiety will be under control, or they will feel confident with their friends. Techniques for eliciting these types of collaborative and reasonable goals for treatment are described more fully in our book.

Moving forward towards change without having shared goals is likely to frustrate the teenager and lead to burn out with the care provider. So take your time at this stage, explore what matters to the young person and flesh out goals that resonate for the teen and make sense to you so your outcomes improve. We’ll tackle tasks — the methods for achieving these goals — in a future post, stay tuned…

~Britt Rathbone