Dangerous Journeys A metaphor for passage through the teen years Marvin Krank

How can we help youth get through these perilous times

Project on Adolescent Trajectories and Health (PATH): social context, cognition, risk-taking behaviour, and health outcomes Three-year longitudinal study Three-year longitudinal study Funded by the SSHRC and CIHR Funded by the SSHRC and CIHR Partnership with SD#23 Partnership with SD#23

Grades 7-10 are a time of significant transitions in drug and alcohol use

Patterns in use of marijuana Source Krank and Johnson (1999a,b)

Why we should care

Adolescent risk is based on what they do Unsafe sex in youth leads to teen pregnancy, low birth weight babies, and STDs including HIV Unsafe sex in youth leads to teen pregnancy, low birth weight babies, and STDs including HIV Drug and alcohol use increase unintentional injuries, the leading cause of death in youth Drug and alcohol use increase unintentional injuries, the leading cause of death in youth

Early and heavy alcohol use is correlated with many negative outcomes Health Health –Aches and pains –Accidents –Hospitalization Violence Violence –Victim –Perpetrator –Various kinds Bullying Bullying Assault Assault Sex Sex –Early sex –Regretted sex –Sexual assault Problem behaviours Skipped school Stayed out all night without parent permission Damaged property Warned or detained by police School detention Stole something outside of home Stole at home Suspended out of school Suspended in school Ran away from home Carrying weapons

High risk behaviours tend to co-exist Drug and alcohol use, early and unsafe sexual activity, and violence tend to co- occur Drug and alcohol use, early and unsafe sexual activity, and violence tend to co- occur For example, heavier drug and alcohol use is linked to being both a victim and a perpetrator of sexual assault. For example, heavier drug and alcohol use is linked to being both a victim and a perpetrator of sexual assault. Used alcohol Percent used marijuana No2.8% Yes44.9%

Dating and sex 1/3 of grade eleven students have had sex 1/3 of grade eleven students have had sex 2/3 of females had sex under influence of alcohol 2/3 of females had sex under influence of alcohol 43% of the girls have given oral sex 43% of the girls have given oral sex ½ of the girls regretted having sex ½ of the girls regretted having sex 14% of grade 9-11 girls have been physically harmed by their dating partner 14% of grade 9-11 girls have been physically harmed by their dating partner 26% of drinkers and 28% of marijuana users have been physically harmed by their partner. 26% of drinkers and 28% of marijuana users have been physically harmed by their partner.

Just say no!

Mixed messages

The social and cultural roots of these cognitions Parents Parents Peers Peers Personality Personality Pop Culture Pop Culture

The effects of advertising –$1Billion/yr –70% on TV –22% magazines –50% on Saturday and Sunday –33% between pm

Tuborg

Crying

Thoughts precede actions Teens take risks for the same reasons adults do: they expect better things will happen to them. Fun, Sex, Relax, Socialize.

Modern Risk Prevention Programs Discuss social influences Discuss social influences Encourage alternative behaviours Encourage alternative behaviours Correct misperceptions about norms Correct misperceptions about norms Focus on changing false expectations Focus on changing false expectations

Contemporary Evidence-based Methods Less confrontational Less confrontational Motivate change Motivate change Meet individuals where they are Meet individuals where they are Brief interventions Brief interventions

Prevention in context: The Four Pillars ENFORCEMENTENFORCEMENT HARMREDUCTIONHARMREDUCTION PREVENTIONPREVENTION TREATMENTTREATMENT

Alternative Intervention for Marijuana Suspension (AIMS) A collaboration between School District #23, the RCMP, and the PATH Research Group.

The Objective Develop a proactive program to deal with students engaging in marijuana related behaviour on school property. Develop a proactive program to deal with students engaging in marijuana related behaviour on school property. Must operate under the limited resources of the school district. Must operate under the limited resources of the school district.

How AIMS Works Self-report questionnaire => Personalized feedback sheets will be created. Self-report questionnaire => Personalized feedback sheets will be created. Frequency of Marijuana in a Week

How AIMS Works The Counselling Session The single 60-minute counselling session must take place before students return to school. The single 60-minute counselling session must take place before students return to school. Utilize the four principles of MI Utilize the four principles of MI 1.Express empathy 2.Develop discrepancies 3.Roll with resistance 4.Support self-efficacy

The AIMS Program Goals Students’ use of marijuana will decrease. Students’ use of marijuana will decrease. Reduction in students’ recidivism. Reduction in students’ recidivism. Decreased police involvement in schools. Decreased police involvement in schools. Fewer number of marijuana related incidents on school grounds. Fewer number of marijuana related incidents on school grounds.

What can parents do? Goal is to change or prevent risky expectancies Goal is to change or prevent risky expectancies Parents can and do make a difference Parents can and do make a difference The problem is how do you do that?

Parent-Child Balance Independent Decision MakingParental Expectations

Positive Expectancy So what’s wrong with that?What else could you do? Have funArtificial high Replace safer and healthier choices for having fun Feel sexierNot how others see you Bad judgement – embarrassment Regret actions RelaxReplace more effective ways of relaxing Actually makes things worse Talk more easily Say stupid things that you will regret Fail to listen “More is less” is a general point What else could you do is an exercise for the youth, ask questions, but be ready to help answer with healthy alternatives that they would like. What should you say: What should you say: Cognitive Expectancy challenge

When to talk to them Quiet times when the opportunity arises Quiet times when the opportunity arises Away from friends and siblings Away from friends and siblings In the car In the car Watching TV – e.g. TV commercials Watching TV – e.g. TV commercials

Try to speak their language

How to talk to your kids Listening first Listening first Four principles Four principles –Be understanding and try to see things from their perspective “That must be difficult” –Present facts contrary to what their long term goals “Did you know that research shows that smoking marijuana interferes with learning and memory. I wonder how that might influence getting into university?” –Don’t confront or challenge work around the issue –Be supportive and positive about your child “You can do it” Be prepared and tell the truth – Be prepared and tell the truth –

Conclusion The real war on drugs is the battle for the hearts and minds of our youth The real war on drugs is the battle for the hearts and minds of our youth We don’t want to prevent them from taking the journey, but we do want them prepared for challenges along the way. We don’t want to prevent them from taking the journey, but we do want them prepared for challenges along the way.