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What are some hypothesized motivational issues for the population?
Hypothesized motivational principles that may apply to youth as
well as to adults: It's best if the youth argues for change and
elaborates about his/her ambivalence than if the therapist does this.
Important to monitor resistance and try to keep it low.
Hypothesized motivational principles that may differ for youth
vs. adults: Youth tend to rebel against prescriptive authorities
(parents teachers, etc.) who may foist misinformation on them in order
to change their behavior. So written feedback (e.g., norms for other
youth carrying weapons, binge drinking, driving while drinking, not
wearing seat belts or bike helmets) may have less impact on youth
than on adults (?)
How MI fits into range of typical treatments for youth and high-risk
behaviors?
Usual treatments seem to be providing information (education) and
skill-building. MI fits nicely here because it can prepare youth to
accept typical treatments or act as a stand-alone treatment for risky
behaviors.
How might one do MI or something consistent with MI with this population?
We are currently using MI in an ER setting, with youth presenting
for and currently being treated for injuries. We either intervene
with them right in the ER or, if hospitalized, we see them in their
hospital beds after they go through the ER. These brief interventions
last an average of 20 minutes, are performed face-to-face under only
semi-private conditions (e.g. behind drawn curtains in the ER), and
are loosely structured: Opening (rapport building, stage-setting),
open discussion about how youth view the behavior in question, informal
feedback using limited normataive information about other youth, a
brief negotiation of what the youth is ready/willing to do differently,
and a closing on good terms. This single contact is the extent of
the intervention, except for telephone calls to collect data on self-reported
behavior change at 3 and 6 months after the injury/intervention.
What are some references regarding research on MI with the population?
Colby, SM, Monti, PM, Barnett, NP et al. (1998). Brief motivational
interviewing in a hospital setting for adolescent smoking: A preliminary
study. Journal of Consulting and Clinical Psychology, 66(3): 574-578.
Monti, PM, Colby, SM et al. (1999). Brief intervention for harm
reduction with alcohol-positive older adolescents in a hospital emergency
department. Journal of Consulting and Clinical Psychology, 67(6):989-994.
Aubrey, LL (1998). Motivational interviewing with adolescents presenting
for outpatient substance abuse treatment. Doctoral Dissertation, University
of New Mexico. (DAI-B59/03, p. 1357, Sep 1998).
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