Motivational Interviewing for Teens Suffering From Addiction

Talking with teens can be tricky at best. If they perceive judgment, they’ll shut down faster than you can say “Snapchat.” Using an interview technique called motivational interviewing, professionals and family members can find ways to talk with teens, even about difficult subjects — including addiction — without triggering the shut-down response. Humanistic psychologists building upon Carl Rogers’ work developed the principles and techniques of motivational interviewing in the early 1990s. These techniques have been adapted for use with a wide variety of clients in many different setting, from pediatrics to probation.

The Starting Point

Motivational interviewing starts from a set of assumptions about the best ways to approach “interviewing” (or just talking with) a teen. These assumptions are

  • Collaboration. The “expert” (therapist, doctor, parent, etc.) seeks to collaborate with the teen, instead of teach, restrict or control. Think of the teen an expert in his or her own life and collaborate to assist the teen in achieving his or her own goals.
  • Evocation. The therapist tries to use a variety of techniques to help evoke the teen’s own motivation to change. Asking open-ended questions is one key evocation technique.
  • Autonomy. Respect for the teen’s autonomy and a clear understanding that the teen is in control of his or her own change is key to this approach.

The Five Principles of Motivational Interviewing

  • Empathy. Eliminate judgment as much as possible and empathize with the teen.
  • Discrepancy. Help the teen see the discrepancy between what he or she values and the behaviors that he or she is engaging in that run counter to those values.
  • Arguments/Confrontation. These strategies are to be eliminated or avoided. Teens tend to become increasingly defensive when confronted and that doesn’t foster the desired change.
  • Resistance. Work with the teen’s resistance, like a tai chi master. Resistance is part of the process and most teens will soften if you give them room to do so. Avoid confronting resistance or labeling it; these techniques are not considered helpful.
  • Optimism. Be positive. Focus on what can be changed. Appreciate the small steps.

Working with teens can be energizing, exciting and dynamic. Using the techniques and principles of motivational interviewing can help parents, caregivers and therapists reach teens and make progress even regarding the most challenging issues. Resources: https://pubs.niaaa.nih.gov/publications/Practitioner/YouthGuide/AAPAdolescentHealthUpdateBMI.pdf https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/communicating-with-families/pages/Motivational-Interviewing.aspx https://www.ncbi.nlm.nih.gov/books/NBK64964/

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