Me, Me, “MI” – The Language of Teens

Test your Teen Speak skills.  Which of the following are true statements?

  1. Teens don’t like being told what to do.
  2. Teens don’t learn from our experiences.
  3. Sometimes teens resist our advice just to be resistant!
  4. All of the above.

Yes, it’s obviously “D”.  But why?

The answer is not because teens choose to be difficult.  (Although it can definitely feel that way.) Yet the answer does lie within their wonderful (and maddeningly) hard-heads…

Brain development during adolescence deeply affects what a teen can understand, how they hear and respond to information, and their decision-making about risky situations.   Resisting advice, not learning from our experiences and not responding positively to being “TOLD” what to do are all 100% normal for teens.  Unfortunately, risk taking and experimentation are also a normal part of adolescent development.  So, if our usual communication strategies are not working, how can we help teens avoid situations that may influence them to make risky decisions and instead engage in more positive risks that encourage personal growth and development?

Here’s one more quick quiz…

Data shows that the most effective strategy for helping teens reduce risk and change behavior is:

  1. Raising your voice until they hear you (or at least you feel heard)
  2. Locking them in their rooms until they turn 30
  3. Bribing them with clothes and/or screen time
  4. Using Adolescent-focused Motivational Interviewing (MI) techniques

We’re sticking with the obvious response of “D” (but couldn’t resist having a little fun with it along the way…) Adolescent-focused MI helps anyone (providers, professionals and parents) connect with and communicate more effectively with teens.  MI strategies create the opportunity for meaningful, two-way dialogue, increase engagement, and has been proven to increase the efficacy of behavior change and risk reduction efforts with teens.

So how does Adolescent-focused MI work?

The heart of an adolescent-focused MI approach is respect.   The success of this approach relies on enabling teens to drive the conversation.  With a mix of changes to your communication strategies (some big and some small) – Adolescent focused MI can successfully change the dynamic of your discussions with teens.  While some of these strategies can take years of practice – there are LOTS of simple changes that will immediately improve your “Teen Speak”.

To learn more about Adolescent-focused MI, it’s as easy as 1, 2, 3:

  1. Download this infographic for some straight-forward techniques you can start using today.
  2. Watch our webinar for a guided introduction to adolescent-focused MI, led by nationally-recognized expert and educator: Dr. Jennifer Salerno.
  3. And check out our suite of adolescent-focused MI trainings that can be tailored to the specific needs of your organization.

Creating a judgement free zone…

Most professionals who work with youth try to approach each interaction with an open mind.  Research shows this is an important step to making youth feel comfortable.  What else goes into creating a safe place for youth to share?  Some of the steps are obvious – but we think a few may surprise you!  Here are 5 critical steps to creating a truly judgement-free zone…

  1. Know the law! Confidentiality laws and minor consent vary from state to state.  The first step to ensuring a youth-friendly approach is understanding the confidentiality laws in your state.  Next is implementing a workflow that integrates and accommodates these laws (including processes for everything from notification of test results to insurance billing).  It is imperative that youth understand their rights, and what will or won’t be shared with their parents.  Explaining and sharing this information goes a long way towards building trust.
  2. Be non-verbal! Well – just for the assessment, anyway.  When a risk assessment is delivered verbally, it’s our nature to jump in and talk about each risk as soon as it is identified – making it hard to get to every question.  More importantly, it’s just not in a teen’s nature to be forthcoming about risk when asked questions face-to-face.  Research shows youth respond most honestly when screened with technology – but if that is not an option, then old-school pen and paper is the next best thing.
  3. Standardize your approach! There’s a reason why every leading youth health organization recommends a validated, standardized risk assessment. As humans we have subconscious biases and deeply held personal beliefs that can influence our approach to risk screening.  This can be especially prevalent with home-grown risk assessments that are cobbled together with “select” questions pulled from a number of different tools.   A validated, standardized screening tool eliminates individual (or even organizational) culture bias and ensures all youth are screened the same way, every time.
  4. No shoulder surfing! It catches many parents off guard when their “baby” is suddenly old enough to complete a risk assessment on their own.  You may find them peering “helpfully” over their tween or teen’s shoulder.  It’s important to provide youth with a private space to complete a risk assessment.  This is an essential step in increasing honesty in youth response.  Engaging and educating parents is also important. They need to be reassured of the importance of this step in their son or daughter’s development.
  5. Watch your body! It’s easy to get so focused on youth that we forget what’s happening with our own body language.  Young people are very sensitive to non-verbals – and they are looking for any signs that you might be judging them (however unintentional those signs may be on our part!)  So avoid little things like crossing your arms, narrowing your eyes, or raising an eyebrow.  (And the same rules apply to your tone and speech.)

For more information, the Society for Adolescent Health and Medicine has some helpful resources on confidentiality and this case study highlights effective adolescent workflows across three very different settings.

Click here to learn more about RAAPS – a standardized, validated, and technology-based risk screening system developed especially for youth (and the providers and professionals that work with them)

To D.I.Y. or not to D.I.Y….

We are long past the days when “Do It Yourself” or “DIY” described college students creating projects on a dime.  These days DIY is mainstream.  On a whole, the DIY philosophy is laudable.  It represents problem solving, independence, thrift, and creativity.   However, there are times when DIY should be “DDIY” (Don’t Do It Yourself!)

Adolescent risk assessment is just such a case – whether it’s developing a screening tool completely from scratch – or creating an assessment that has just the “right” risk questions from existing screeners.  There are actually a LOT of evidence-based, scientific reasons why adolescent risk screeners should not be a homegrown DIY.

Here are just 3 of the top reasons why Adolescent Risk Screening is a DIY Don’t:

  1. Risk assessment is about much more than just the questions. Many organizations who have created in-house screeners focus extensively on the questions to be included in the assessment. In youth risk reduction, questions are only the beginning. In fact – in the CDC framework for risk assessment development, only two of the ten recommendations (20%) focus on the questions themselves.
  2. Tailoring is critical. From an assessment that is tailored to literacy, culture and age – to the delivery of tailored, action-oriented, information – the CDC framework emphasizes the importance of tailoring in efficacy of risk identification and reduction.
  3. A risk screener must be evaluated for validity and reliability. In order for an assessment to be considered valid it must meet content, construct and criterion-related validity.  In addition – it should be reliable (give the same results, with the same types of people, consistently).

To learn more about the differences between DIY tools and a validated, standardized assessment (and why those differences really matter), please check out our newest resource:

The Science of Youth Risk Assessment


What can you do?

A rise in suicide rates among youth, widespread incidence of sexual abuse on college campuses, and an increase in risk-related driving fatalities…what do these have in common?  They all made recent headlines on the evening news in a single day!*

The relentless daily onslaught of risk related headlines can be overwhelming even paralyzing. It can feel impossible to affect change in the youth we work with on issues so important – as achievable as solving world hunger or peace.  How can we make a meaningful difference against the deluge of complex, inter-related issues – across an entire population of young people?It’s true, you alone can’t solve it all – but together if each of us takes a single step or action – we can make that meaningful, measurable, difference.

Here’s What You Can Do:

  1. BE A TRUSTED ADULT – Did you know that having a trusted adult is one of the biggest factors in reducing risk among youth and young adults? You don’t have to see them every day, you don’t have all the answers, you just need to be there in the moment and ask the important questions!
  2. LEARN THE LINGO – Teens can be intimidating. And let’s be honest, at times that extends from the earliest ages of adolescence (9-11 year olds) to college-age.  There are some time-tested, science-based tips and tricks you can learn to more effectively communicate with youth.  Check out this video on adolescent-specific motivational interviewing in action  And visit our new website to learn more Teen Speak.
  3. START THE CONVERSATION – 75% of deaths in youth are related to risky behaviors; yet only 21% of organizations use a standardized risk screening tool. Why the disparity?  Lots of possibilities – it’s an uncomfortable topic to broach, limitations on time and resources, or you just may not know how to respond when risks are identified. For insight on what you should look for in standardized, youth-specific assessment tool check out our assessment checklist.  And to learn more about the RAAPS risk identification and reduction system (which was created specifically to overcome all of these barriers and more) visit Possibilities for Change.


*It probably won’t surprise you to learn that each of the headline-grabbing risks making the news of late are issues screened for and identified by RAAPS – as RAAPS screens for each of the issues contributing most to preventable illness and death among youth and young adults.  What you might not know is that the providers and professionals using RAAPS are actually ahead of the curve – identifying AND REDUCING emerging risks among youth and young adults well ahead of available public health data and trends analysis.

Compare the key findings from the recently released 2017 “Youth Risk Behavior Surveillance System” report from the CDC to the RAAPS data released in February 2013 from Possibilities for Change:

“Sex and drug use are on the decline among US teens. Other health risks – including suicidal ideation and bullying – do not appear to be subsiding” 2017 YRBS Report from the CDC “Anger management, depression and bullying are more prevalent health risks for youth age 11-20 than drug use, alcohol consumption and unprotected sex.” 2013 RAAPS Data from Possibilities for Change

Key Takeaways?

  1. Just “being there” really does matter.
  2. Do some homework – ramp up your Teen Speak!
  3. Ask the questions. Teens and young adults need you to start the conversation.

You can make a difference, do one thing today and two tomorrow! Start local and together we’ll make a global impact.

The Top 5 Worst Reasons Why…

We help providers, professionals, and parents, identify and reduce risk behaviors among youth and young adults. So you might imagine that in our line of work that we’ve “heard it all.”

And yes, we’ve heard a lot, but it’s not the stories and information that young people share that shocks us. It’s what we hear from youth-centric organizations (provider groups, schools, health departments…) about why they don’t screen for risk behaviors that we find flat out scary.

Here are the top 5 worst reasons we’ve heard…so far.

1. If we know about a risk we’ll be responsible to take action. At it’s core, we believe that this reason isn’t just about liability – it’s about the fear of what happens if something goes wrong. Think past that initial reaction – and it becomes obvious that we’d all feel equally terrible (and potentially, even as liable) if something goes wrong (such as an overdose, a suicide attempt, unreported abuse or bullying…) and we didn’t know about it in advance. No one is expecting you to be the expert at every risk or situation. Identifying risks in advance allows youth to “get it off their chest” and you to provide resources and when necessary referrals to the right experts who can help to prevent bad things from getting worse – or maybe even from happening at all.

2. We don’t have the time. It’s true, you always need more time. Our company was founded by a clinician with years of experience in busy pediatric and adolescent practices. Finding practical solutions that minimize impact on time and workflow is at the heart of everything we do. Did you know that in less than 5 minutes RAAPS identifies the risks that contribute most to preventable illness and death in young people aged 9 to 24? Even in the tightest of workflows in organizations that run like clockwork you’ll find a 5-minute window of wait time for the patient – why not put that time to (really meaningful) use?

3. We don’t have the money. You’ve heard that expression: “If it’s important you’ll find a way. If it’s not you’ll find an excuse.” To be fair, we think this reason is more about priorities than excuses. There are so many competing priorities for organizations that serve youth it’s hard for anything new to find it’s way to the top of the list. Think about the things that do get prioritized: vaccines; assessments of height, weight and blood pressure; current medications and allergies… Why do these things sift to the top? They save lives. Now think about this CDC statistic: risk behaviors are responsible for 3 out of 4 (75%) of all preventable deaths and illness in youth. Risk screening saves lives. And the cost? One month of access to the RAAPS system costs the same as a single case of coffee pods or printing paper. Really, we think it’s all about the priorities.

4. We don’t want to upset parents. That’s cool. Honestly, neither do we, but realistically how upset do you think parents will be if there is an uptick in bullying, an increase in youth carrying weapons, or a widespread incidence of sexual abuse that could have been identified with standardized screening? As providers of risk identification and reduction tools we have time-tested, proven strategies and resources for helping parents understand risk screening – why it’s important and how it helps. And trust us, that’s an easier conversation to have proactively than reactively.

5. We don’t know what to say. There’s no doubt: conversations about risk are uncomfortable. But did you know that having a trusted adult to confide in is one of the single most important mitigating factors in reducing youth risk? Just by being present and starting the conversation you’ve helped. So take the next step. If you are uncomfortable with discussing certain topics – get help. Participate in a workshop on adolescent-focused motivational interviewing; choose a risk screening system that offers built in health education so all youth get the same information (every time); and make sure that system provides you with evidence-based messages and talking points to help get the conversation started. Because let’s be real – saving a life significantly outweighs one uncomfortable conversation.