Barbara Bulkeley Family Therapist, Whirinaki CAMHS PhD candidate, Dept of Psychological Medicine Faculty of Medical and Health Sciences, University of Auckland Effective Ways of Working with Young People

What is important:  Your relationship with young person  Your knowledge about their difficulties & family circumstances  Your support for them & family  PLUS  Simple, evidence-based ways of working with young people who are stressed, depressed and anxious

Four effective ways to help adolescents cope 1.Activity scheduling 2.Goal-setting 3.Problem-solving 4.Relaxation

Activity Scheduling  Rationale:  Keeping busy & having enjoyable things to do improves mood and reduces anxiety  “When you are feeling miserable you have to do something that is fun”  Inter-relationship of thoughts, feelings and behaviours

How to do this:  Help young person make list of possible activities  Who can help them to have fun?  Include some form of exercise (multiple benefits) ‏

Goal-setting  Rationale:  When depressed or under stress, it is hard to think of goals or carry them out because of lack of motivation, energy or because goals may be too hard  Support young person to reach their SMART goals  S= specific  M=measurable  A= attainable  R=realistic  T=time-based

How to set goals  Help young person set goals that are important to them  Chose goals that they are likely to succeed with  Move on to new goals after initial success  Steps:  Young person and you chose goal  Young person carries out goal  Review goal next time you meet  Revise if needed or chose new goal

Problem-solving  Rationale:  Understanding that problems can lead to depression, stress & anxiety  When under pressure adolescents find it really hard to cope with problems of life  They can see problem as too big to deal with  They find it really hard to think of new ways to cope with problem  They find it hard to put plans into action

How to help with problem-solving  Help them to chose specific problem  Understand the problem, talk about it  Brainstorm possibilities to solve the problem  Don’t judge or rule any out  BUT do be aware of safety issues  Compare different solutions and evaluate each one  Be aware of good & bad points of each possibility  Help young person to see importance of evaluating solutions, and not just rushing ahead with the first one they thought of

What does young person do?  Picks best solution to try  Talks about what is needed to make plan work  Tries plan  Next meeting discusses outcome with you … did it work?  After some success, can try problem-solving on their own

Relaxation  This can be most effective of all techniques to help adolescents under stress (John Weisz, 2004) ‏  Costs little or nothing  Easy to learn  Portable  Adolescents like the sense of control that they regain  Can include:  Something as easy as deep breathing  Or can use visualisation, guided imagery, or muscle relaxation

Summary & contact details  These 4 techniques are simple & effective in giving you something to “do” with adolescents under stress  As well as active listening, ensuring safety & making decisions about whether to refer to CAMHS  You are able to help young person learn to regain some sense of agency over their life  Barbara Bulkeley 