Training and Advocacy for Youth Workers



LEARNING MODULE 7:AT-RISK BEHAVIORSHEIDI CHRISTENSEN, Diversion and Enrichment SpecialistView this video: Learning Module 7 from a youth worker’s perspective If you haven’t already clicked the video link on your YIC Syllabus page, please watch Heidi’s message now before you begin reading this learning module. Thank you.IntroductionHow will learning about At-risk Behaviors help me in my work? Risk-taking is a natural part of growing up and a necessary element of healthy youth development. Youth often have a difficult time thinking about the long-term consequences their current behavior may create. And the adolescent brain doesn’t yet have a strong ability to think twice before acting. Teenagers, in particular, often have a tendency to see themselves as invincible; they know some behaviors have high risk and potentially bad consequences but their perspective is “that won’t happen to me.” Learning to recognize the difference between normal, healthy risk-taking and potentially harmful, unhealthy risk-taking is a critical skill in your role as a youth worker. Perhaps even more important is developing the confidence to comfortably talk with youth about any unhealthy risk-taking you observe.It’s not an easy task. You may sometimes find yourself in a bit of a bind because you appreciate the need for youth to test their limits and most of your work is all about giving them the proper space and support to do that. There’s a trust that’s been built between you and the youth. You may feel reluctant to address unhealthy risk-taking for fear of breaking that bond.And because all of us have taken risks and survived, our own experience could cause us to have a perspective that “they’ll be fine” when we see youth taking some unhealthy risks.Yes, risk-taking is a normal part of a youth’s development. But clearly not all risk-taking is healthy. Research tells us that there are warning signs we can learn to recognize. And there are certain patterns of behavior that point to the possibility of a higher risk for negative consequences.Studies show that early intervention works in helping youth make more positive decisions and avoid unhealthy risk-taking. And that’s where you come in. So, this learning module is all about what risk-taking behaviors you need to be concerned about. You’ll also learn ways to effectively address those behaviors with youth.Remember that you are not solely responsible for preventing unhealthy behaviors or intervening once any troubling behaviors start. You are part of a team and you play an important role but you aren’t expected to do it on your own. Learning tip:Risk-taking behavior is a natural part of growing up. Because we all do it, it’s expected in a way. And that can actually complicate the decision you’ll need to make about whether or not to intervene in any given situation. There is an art to finding the right balance. The learning in this module is meant to help you develop that balance.Your ability to recognize healthy vs unhealthy risk-taking behaviors is critical to being able to give the right guidance to the youth you serve. You’ll be helping them achieve their developmental milestones in a positive way.As you’ll see from the learning objectives for this module, not only is it critical to know how to tell the difference between healthy and unhealthy risk, you also need to build up your ability to consult with others regarding how to address risk-taking behaviors. And you’ll need to hone your communication skills for talking with youth about unhealthy behaviors. This is an area where your commitment to continued learning will serve you well.Let these objectives guide your learning as you go through each section. And remember, the quiz at the end is based on these key insights.Learning ObjectivesUnderstand what drives risk-taking behaviorRecognize the warning signs of unhealthy risk-taking behaviorsLearn effective communication strategies for talking with youth about unhealthy risk-taking behaviorsKnow your role as a Youth Intervention worker and the importance of consulting with your supervisor01803401. Understanding Adolescent Risk-taking 1. Understanding Adolescent Risk-taking Let’s start with a high-level overview of adolescent risk-taking to understand what drives these behaviors.Risk-taking - no matter an individual’s age - is a natural and normal part of human development. It enables us to learn new skills and prepare for future challenges. For adolescents, risk-taking is a means to discover, test, and define oneself, as well as others and the larger world. Risk-taking is actually an essential part of adolescent development. Youth workers are likely to have concerns about risky behaviors in youth at any age but there is a greater cause for concern about patterns of risky behavior in adolescents. This is because adolescence is a time of both great potential and great vulnerability. The stakes are typically higher with risk behaviors during adolescence. Adolescents are at the peak of their physical strength, resilience, and immune function. However, mortality rates for 15 to 24-year olds are more than triple the mortality rates of grade school children. The CDC (Centers for Disease Control and Prevention) has identified three behaviors associated with the leading causes of death and illness in adolescents1: Injury and Violence: This is the leading cause of death for adolescents and young adults between 15 - 24 years of age. These deaths are most often a result of motor vehicle crashes (30%); followed by homicides (15%) and suicides (12%). Alcohol and Drug Use: These substances are a factor in approximately 41% of deaths related to motor vehicle crashes. More youth in the United States use alcohol than tobacco or other drugs. Risky Sexual Behaviors: These behaviors lead to increased morbidity and mortality. Almost half of the 19 million sexually transmitted infections diagnosed each year in the United States are in adolescents and young adults between 15 - 24 years old. Additionally, 39% of sexually active high school students report not using a condom during their last sexual intercourse. Brain Development & Adolescent Risk-takingTo help you better understand adolescent risk-taking, let’s take a look at the biological basis for risk-taking and why adolescents take risks even while knowing there are inherent dangers or consequences. Knowing the biological basis for behaviors will assist you in developing effective interventions.2We’re not going to go into a deep study of human brain development here but it is helpful to have at least a basic understanding. We have a short, 5-minute video by Dr. Ken Winters, Director of the Center for Adolescent Substance Abuse Research at the University of Minnesota. In the video, Dr. Winters lays out the fundamentals and introduces you to the appropriate terminology about brain development without being overly-academic about it. You’ll find it easy to understand and you’ll most likely be able to relate to the examples shown. Subsequent sections build upon information presented in the video so please take the time to watch the video now before moving on. Plus, it’s a nice break from reading! View this video: Teen Brain Development (run time 4:35 minutes) Welcome back! What was the best insight you got from watching the video? _________________________________________________________Advances in technology have provided us with a better understanding of brain maturation in adolescence. This includes how changes in the brain impact risk perception, sensation seeking, and self-regulation. Let’s explore each of those areas now.RISK PERCEPTIONDevelopmental psychologists have measured and documented a jump in cognitive capabilities in early adolescence.3 For example:Beginning around 12 years of age, adolescents decrease their reliance on concrete, here-and-now thinking and begin to show the capacity for abstract thinking, visualization of potential outcomes and a logistical understanding of cause and effect. Adolescents begin deciding whether a given situation is safe, risky, or dangerous. By 15 years of age, adolescents are capable of reasoning about the possible harm or benefits of different courses of action in hypothetical situations.These aspects of development correlate with the maturation of the frontal lobe, a shift from expanding neural connections to pruning of the connections and an increase in hormones released. All three drive an adolescent’s mood and impulsive behavior. Studies also show there is little difference in decision-making about hypothetical situations between adults and adolescents by 15 years of age.4 However, in the real world, adolescents still engage in dangerous behaviors despite understanding the risks involved. Why is this? To answer that question, the role of emotions and the connection between feelings and thinking need to be considered when trying to understand the way adolescents make decisions. Researchers have termed this type of thinking as “hot” cognition and “cold” cognition. “Hot” cognition: Thinking under conditions of high arousal and intense emotion. Under these conditions, teens tend to make poorer decisions. “Cold” cognition: Circumstances are less intense and teens can make better decisions. In addition to thinking, the teen is also having multiple complex feelings such as fear of rejection, wanting to look “cool,” the excitement of the risk, or the anxiety about being caught, it becomes even more difficult for them to think through potential outcomes, understand the consequences of their decisions, or even use common sense.5Research examining the amygdala portion of the brain and immature connections between the limbic system and the prefrontal cortex support this theory. As a Youth Intervention worker, you can be a mentor and role model to teens in your program by modeling how to control one’s emotions and make healthier decisions. You can also coach young people to develop these skills in their daily lives.SENSATION SEEKINGThe nucleus accumbens, located in the brain’s limbic system, is the area that processes information related to motivation and reward. Brain imaging studies conducted by the National Institute on Drug Abuse have shown that the nucleus accumbens is highly sensitized in adolescents and sends out strong impulses to act when faced with the opportunity to obtain something desirable.6 During puberty, increases in the hormones estrogen and testosterone bind receptors in the limbic system. This not only stimulates an adolescent’s sex drive, but also increases emotional volatility and impulsivity. Addiction researchers7 have also discovered that during puberty there are changes in the brain’s reward sensitivity. These changes are related to a decrease of dopamine, which is a neurotransmitter that has multiple functions including producing feelings of pleasure. Due to these various changes, adolescents may require higher levels of stimulation to achieve the same levels of pleasure/reward that they previously experienced. This may lead them to seek out new experiences and make riskier decisions. 3966210527621500According to the Center for Substance Abuse Prevention (CSAP), “Adolescents are more vulnerable than any other age group to developing nicotine, alcohol, and other drug additions because the regions of the brain that govern impulse and motivation are not yet fully formed.”8SELF-REGULATION Psychologists describe self-regulation as the management of emotions and motivation. It also involves directing and controlling behavior to meet the challenges of the environment and work toward a conscious purpose. Additionally, self-regulation encompasses “affect regulation” which relates to controlling the expression of intense emotions, impulse control and delaying gratification.9Self-regulation requires a higher level of cognitive and executive functions. These functions reside in the prefrontal cortex, which matures independently of puberty and is still developing well into an individual’s mid-twenties.As adolescents’ progress toward adulthood with bodies that are almost mature, the self-regulatory parts of their brains are still developing. An earlier onset of puberty increases the window of vulnerability: it makes them more susceptible to taking unhealthy risks over a longer period of time.10 During this period of development, adolescents should be allowed to make mistakes, learn from their experiences, and practice self-regulation. They should not be over-protected. Parents and Youth Intervention workers can help by listening, offering support and guidance.SOCIAL CONTEXT OF ADOLESCENT RISK-TAKINGWhen looking at adolescent social development, it’s important to consider environmental factors such as relationships with peers and other social influences. Peer InfluencesAn important part of adolescent development is peer influence. During adolescence, friendships develop that are more intimate and longer lasting than earlier friendships. At the same time, adolescents develop friendships with multiple groups similar in demographics or shared interests. These friendships allow adolescents to develop their identities and define themselves independently of their parents. These friendships also help adolescents feel accepted and provide an opportunity to practice social skills. Healthy friendships provide support and positive experiences as teens encounter challenges during these years of intense change. However, peer influence can also adversely influence unhealthy risk-taking. Psychologist Laurence Steinberg of Temple University has conducted significant research on peer influence and risk-taking in teens. In one study, using a driving simulation game, Steinberg found that when teens were playing alone they made safer decision (e.g. not running a yellow light), but made riskier decisions in the presence of friends.11Due to an immature prefrontal cortex, when teens find themselves in emotionally arousing situations, “hot” cognition comes into play. Adding in peer influence, adolescents are more likely to take reckless actions and make impulsive decisions in “hot” cognition.12 Societal InfluencesSocietal influences include mass media, community norms and role models. Each can influence risk-taking behaviors. Societal influences can make it difficult, even for adults, to resist some unhealthy behaviors. Think how much harder it must be for adolescents whose judgment and decision-making skills are still developing! Through mass media, adolescents are constantly bombarded with emotionally arousing and often dangerous messages (e.g. unprotected sex, substance abuse, alcohol use). Neighborhoods and communities also provide adolescents with opportunities to engage in risky behaviors. Legal ordinances that allow access and community norms that foster acceptability are two examples (e.g. the legal age to purchase cigarettes, drive a car, and have access to guns).13 The value of the trusting relationship that you have with youth through your role as a Youth Intervention worker is that you can be an especially important role model. The youth you work with have learned to trust you and they likely look up to you and know they can count on your good guidance. This makes you a reliable source of support to adolescents in particular. You’ll also be playing a role in making your community a safer, healthier, more teen-friendly environment. And your excellent role modeling of positive interaction with teens in the community could help other adults follow your lead.Adolescent brain development research should not leave you scratching your head thinking “So now what? How am I supposed to get through to an adolescent who is engaging in unhealthy behaviors if it is biologically determined?” Good question! The information on adolescent brain development research is intended to provide you with new perspective and insights. The material presented will help you better understand why traditional adult responses are not always effective in helping youth avoid high-risk behaviors.However, you must remember that while adolescent brain development research findings are important to know, those biological factors do not negate the importance of youth having support and guidance from caring adults.Your most important role will be in recognizing and addressing unhealthy and risky behavior patterns.02444752. Unhealthy and Risky Behavior Patterns2. Unhealthy and Risky Behavior PatternsTaking risks is a natural part of human development and essential to making the transition from adolescence to adulthood. To support that healthy development in a positive way with the young people you serve, you need to recognize when a youth may be engaging in behaviors that have gone beyond ‘normal’ and are potentially ‘unhealthy’ or ‘risky.’ This a big responsibility and the more you can learn about it, the better prepared you will be.Unhealthy risk-taking can take many forms. Such behaviors become even more troublesome when they occur on a regular basis. Here are some examples of unhealthy or risky behaviors in youth:Physical aggression, bullying and fightingA pattern of psychological, physical, or sexual abuse toward othersIntentional physical harm to selfCarrying a weaponBehaviors resulting in unintentional injuryBehaviors resulting in unintentional violenceHabitual criminal activityUse of alcohol and/or excessive drinkingUse of drugs or chemicals that were not prescribed by a health professionalAddiction to tobaccoExcessive use of electronic vapor products e.g. e-CigsDriving while intoxicated or impairedNot using condoms during sexSexual activity resulting in sexually transmitted infections and/or unintentional pregnancyRemaining in physical, psychological, or sexually abusive relationshipsUnhealthy eating patterns - excessive eating, binging, purging or excessive restrictionExtreme lack of exercisePoor diet leading to health problemsRegularly not wearing a seatbeltRegularly not wearing a motorcycle helmetRegularly engaging in reckless/dangerous drivingDistracted driving – using mobile devices while operating a vehicleThis list certainly does not cover all risky behaviors but it should get you thinking. What other behaviors have you observed in the youth you work with that you consider risky or unhealthy? ________________________________________________________________________________________________________________It’s a good practice to periodically consider this question. It will help you stay tuned in to the need remain alert and aware.HIGH-RISK BEHAVIORS AMONG YOUTH IN THE U.S.The youth that you directly work with in your program or who live in your community are only a small slice of the entire population of America’s youth. To get a broader picture, we can use data that the Centers for Disease Control and Prevention (CDC) collect by surveying youth across the country. These findings are published in the CDC’s Youth Risk Behavior Surveillance (YRBS) annual report. The YRBS monitors six types of health-risk behaviors that contribute to the leading causes of death, disability, and social problems among youth and young adults.To highlight just a few of the interesting findings from the 2015 YRBS for each of the six behavioral focus areas:Behaviors that contribute to unintentional injuries or violence: 41.5% of high school students had texted or e-mailed while driving during the 30 days before the surveyTobacco use:10.8% smoked cigarettes, 7.3% used smokeless tobacco during the 7 days before the surveyAlcohol or drug use:32.8% had consumed alcohol and 21.7% had used marijuanaSexual behaviors that contribute to unintended pregnancy, HIV, or other sexually transmitted diseases:41.2% had sexual intercourse, 56.9% had used a condom during their last sexual intercourseUnhealthy dietary behaviors:6.7% had not eaten vegetables, during the 7 days before the surveyInadequate physical activity:41.7% had played a video or computer game for 3 or more hours on an average school dayThe most recent YRBS findings may surprise you. For example, the CDC reports that since 1991 the prevalence of many priority health-risk behaviors among high school students nationwide has decreased. While that is good news, you should be aware of national studies that show today’s youth are engaging in risky behavior patterns at a younger age than in past years. Link to learn more: Youth Risk Behavior Surveillance dataWarning Signs of Unhealthy & Risky BehaviorsHave you ever been in a situation where you were not directly seeing someone engaging in a risky behavior, but you were noticing “warning signs”?Warning signs can be a precursor to a behavior becoming potentially dangerous. Being alert for warning signs will help you intervene earlier.While not an exhaustive list, these are common examples of potential warning signs that you should be aware of: Increasing mood changes (e.g. temper flare-ups, irritability, defensiveness)Sudden academic problems (e.g. poor attendance, low grades, disciplinary action)Changing friends and a reluctance to have parents/family get to know the new friendsPhysical or mental changes (e.g. memory lapses, poor concentration, lack of coordination, slurred speech, etc.)"Wannabe" or gang activityRunning away from homeSignificant isolation or withdrawalA "nothing matters" attitude (e.g. lack of involvement or loss of interest in former interests, general low energy)Self-abusive and/or destructive behaviorsFinding substances (e.g., drugs or alcohol) in youth’s room or personal effectsHarming animalsSuicidal threatsFire-settingFrequent lyingBullying behaviorNot all warning signs are going to result in harm but the fact that there is an increased risk of harm to a young person who is exhibiting warning signs is the reason you need to be alert and aware. Distinguishing between healthy and unhealthy behavior can be challenging. There is not always a bright line that distinguishes healthy behaviors from unhealthy or risky behaviors. But there are clues to be aware of: There are several concerning behaviors happening at the same timeThe concerning behaviors appear suddenlyThe behaviors are extremeThe behaviors persist for a significant amount of time and cause other problemsUse these clues to guide your decision-making when determining how you will respond to warning signs of unhealthy and risky behaviors in youth.Risk Factors & Protective FactorsIn the past two decades, there has been much research on risk and protective factors.14 The findings show that these factors and their influence can vary depending on the youth’s developmental stage.In short, risk factors increase a youth’s potential to engage in unhealthy behaviors while protective factors reduce the risk of unhealthy behaviors. Everything you do as a youth worker will likely involve strategies that aim to prevent problems associated with known risk factors while promoting and building on protective factors with the youth you serve.The Substance Abuse and Mental Health Services Administration (SAMHSA)15 offers these definitions of risk and protective factors:Risk factors?are characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes.Protective factors?are characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor’s impact. Protective factors may be seen as positive countering events.Risk factors tend to be positively correlated with one another and negatively correlated to protective factors. In other words, youth with some risk factors have a greater chance of experiencing even more risk factors, and they are less likely to have protective factors.Risk and protective factors also tend to have a cumulative effect on the development—or reduced development—of behavioral health issues. Young people with multiple risk factors have a greater likelihood of developing a condition that impacts their physical or mental health; young people with multiple protective factors are at a reduced risk.These correlations underscore the importance of early intervention and interventions that target multiple factors.Risk Factors:SourceRisk Factor ExamplesIndividual/InternalLow self-esteem; Youth with negative peer groups; Low school or educational engagement.FamilialPoor parent-child communication; Low parental monitoring; lack of family support; Parents engaging in risky behaviors.Extra-familialNegative school climate; Poor neighborhood quality and low socio-economic status; Poor or no relationships with non-parental adults.Protective Factors:SourceProtective Factor ExamplesIndividual/InternalMastery of academic skills; Good coping and problem-solving skills; Future orientation.FamilialConsistent discipline; Extended family support; Family provides structure, limits, and predictability.Extra-familialOpportunities for engagement in school and community; Neighborhood offers physical and psychological safety. Link to learn more: "Risk and Protective Factors for Mental, Emotional, and Behavioral Disorders Across the Life Cycle” from the US Department of Health and Human Services. Shout-out to self-care: PUMP UP YOUR PROTECTIVE FACTORSJust as it is important for you as a youth worker to work toward limiting risk factors and building up protective factors for the youth you serve, it is equally important to have your own self-care strategies around your own risk and protective factors.Your protective factors are the skills, strengths, resources, supports and coping strategies that help you deal more effectively with stress. There is no doubt that you experience stress as a youth worker. So, planning ahead for how you’ll deal with it is your best bet to avoid burnout.Take time right now to make a list of what you see as your own protective factors.Then consider how you can pump them up when you need them most. What would remind you to leverage one of the protective factors on your list? How does leaning into a particular protective factor help you? Really give it some thought.Did you feel like your list was a little light? Know that there are actions you can proactively take to create more protective factors for yourself. Some ideas:Get your own mentorDevelop some new skillsExplore some new interestsFind opportunities to engage within your communityFoster supportive relationships with your family membersDo things that stroke your self-esteemHaving pre-planned how you’ll draw on your protective factors, especially in times of stress or overwhelm, will help you have more positive outcomes in your work.-762003111503. Addressing Warning Signs: Talking With Youth3. Addressing Warning Signs: Talking With YouthYou are seeing warning signs of risky behaviors in a young person but you don’t have clear evidence. What should your next step be? The best step to take when you have a serious concern is to discuss it with your supervisor.He or she can recommend various actions to take. This may include asking you to talk directly with the youth. Your supervisor most likely can provide you with tips on how best to talk with the particular youth. What should you do if you find yourself in a situation when a young person says or does something on the spot that alerts you and you want to address it while it’s fresh, but your supervisor isn’t there for consultation? In this case, it might be best for you to talk directly to the youth without waiting to talk with your supervisor.In any situation where you believe a youth is in immediate danger (based on what you are observing or what they are telling you), it is best to find a way to keep the youth there while you somehow contact your supervisor. Before such a situation occurs, it would be helpful to discuss with your supervisor about having a general plan for addressing various types of high-risk situations. A policy and procedure may already be in place. If not, discuss with your supervisor about developing one.TALKING WITH YOUTH ABOUT THEIR BEHAVIORThere are various approaches you can use when talking with young people about their behaviors that are concerning to you. But remember, do not take it personally when the approach you choose is not working. Instead, try an alternate method for engaging the youth. Flexibility is the key here.Typically, one of the hardest parts of the conversation is starting it. Some simple ways to break the ice and open up the dialogue are to:Express genuine care and concernSimply state, “I’m a bit worried about you. You’re a good person AND…” and then name the concerns in observable behavioral terms when possible. An example would be: “Lately I’ve been noticing ___________________.” (e.g., noticing you have not been participating in activities much; you have shifted to a different group of peers, etc.). Ask gently about how they have been feeling Examples include: “How have you been feeling lately?” “I’m sorry if you’ve been hurting lately. What’s been going on with you?” Let them know they are not aloneShare with them. “Believe it or not, many young people go through things like this. They just don’t always advertise it.” Sometimes it can help to tell a generic story (without identifying information) about how other youth you have known who have gone through very similar things.An example: One of our staff members worked at a college counseling center and noticed a pattern where students in counseling sessions would say, “Everybody here drinks and I don’t. I feel so isolated.” Interestingly, the counselor actually heard this very same thing from quite a few students, so they really weren’t so alone! The counselor got in the habit of saying, “I certainly can’t give you names, but I can tell you I’ve heard that very same thing from many other students.” Be there for them and let them know they don’t have to go through it alone: Simply say, “Even though you might feel alone with it, you don’t have to be alone with it. I’m here for you.”If the young person seems to be clamming up, it may be best to back off for a while to give them some space. When backing off,Tell the youth that you or another adult are there to listen, to talk or to problem-solve with them and provide resources.It can help to say, “Can we check in again in X days?” STRATEGIES FOR DIFFICULT CONVERSATIONS WITH YOUTHTalking with youth about warning signs and disconcerting behaviors is difficult. But there are ways to make the conversation less difficult and more likely to have positive outcomes.For example, before starting the conversation, a good strategy is to think back to when you were younger. As a teen, you probably did not think much about the decisions you made, what you did, or even about the consequences of your actions.Right now, take a few minutes to reflect back on your own adolescence: What are some things you did then that you now recognize as being unhealthy or risky?________________________________________________________What are some choices you made then that would alarm you now if you saw a youth making the same choices? ________________________________________________________When you made those choices, were you trying to impress your friends or were you just trying to have new and exciting experiences?________________________________________________________Asking yourself these questions will help you be more empathic and patient in your difficult conversations with youth. Other ways to make a difficult conversation with youth less difficult and more likely to have positive outcomes include:16Promoting their self-esteem and self-respect. Youth with positive self-worth are less likely to be influenced by negative peer pressures. As a Youth Intervention worker, look for opportunities where you can support the youth. Try affirming and acknowledging good behavioral intentions. Also, help them begin problem-solving in areas where behavior is risky. Showing positivity and enthusiasm. Be positive and have an upbeat tone of voice during conversations. No one likes to listen to someone who is grumpy. Smile and show enthusiasm. Adding a touch of humor. Laughter IS good medicine for the body, mind, and soul. Keep things light to ease tension. Add humor to your conversations, as long as you're laughing together and not at each other's expense. Providing guidance and not criticism. Offer guidance that addresses the problem, behavior, or concern. Do not criticize wrong or bad behavior. Instead develop an action plan to help the youth change the behavior. Make sure to ask the youth for input in developing the action plan.Developing strategies with the youth. Talk with youth about strategies they can use in difficult situations. Helping them come up with a plan before they get into an unhealthy or risky situation will improve their chances for making better decisions and avoid getting into more dangerous situations. Here are two examples:Use hypothetical situations such as being offered drugs, alcohol, or cigarettes; being pressured to have sex; or being offered a ride by someone who has been drinking or using drugs. Teach youth to write a simple pros and cons list for difficult decisions. This may help them to be more thoughtful in their decision-making. It can also provide them with more time before acting on a choice. Another benefit is that the process can help create neural connections and experiences that will serve them well in making good decisions in the future.02025654. Reporting and Referring 4. Reporting and Referring When you have concerns or doubts about a youth’s well-being, talk to your supervisor. Seeking their advice and guidance will help you develop your skills faster and working together will relieve the stress of the situation.Asking for guidance from someone more experienced than yourself in a given situation is always a best practice strategy. It becomes all the more important if there is any potential for harm to a youth, or any legal requirements for proper protection.It is not an indication of weakness. It’s just not possible for you, as an individual youth worker, to know and do everything on your own. Asking for help, guidance, advice, input, and ideas is a sign of strength. It shows that you not only know your limits but that you respect those boundaries.Usually, problems will arise for you when you have not been clear and upfront with the youth you work with about their expectations of confidentiality. So, to avoid getting into a bind, let youth know that you will always strive to maintain confidentiality with what they entrust to you, but that there are certain situations where that is not possible. Be clear that you will let them know if the situation demands that you report or refer.In seeking counsel from your supervisor or another colleague, if you’re feeling a little uneasy about confidentiality, one way to start the conversation is by initially describing a “hypothetical” young person. This avoids naming names. You can start off by saying, “The other day I was concerned about a young person, so I talked with him about it. He said…….” Your supervisor can then decide whether he or she needs to know the name of the youth in order to know how to proceed. Your supervisor can be a good resource in planning how to address any potential situation of concern about risky youth behavior whether it is in general or for a specific youth.We talked earlier about confidentiality and mandatory reporting (if you want to refresh your memory, revisit Learning Module 4: Ethics). Keep these key points in mind:We strive to honor the confidentiality of what youth tell us, but sometimes the safety of the youth or others comes above confidentiality.Reporting requirements when someone is an imminent threat to themselves or others vary by state. You need to find out from your supervisor:whether you are a mandatory reporter in the state where you are practicing or employedyour program’s or agency’s policies and proceduresany state-specific requirementsIf you are a mandatory reporter, it is vital that you are clear with youth upfront the limits of confidentiality. Even if you are not a mandatory reporter, it is good professional practice to always let youth know your limits of confidentiality.Learning Module SummaryIn developing your knowledge, skills, and confidence around At-risk Behaviors, you have two big challenges; Learning to recognize the difference between normal, healthy risk-taking and potentially harmful, unhealthy risk-taking.Becoming comfortable talking with youth about any unhealthy risk-taking you observe.To be most effective in your role, it helps to remember how everything you learned in module 2 about Youth Development ties in with the learning presented in this module as it relates to adolescent brain development. Being able to distinguish healthy behavior from unhealthy behavior requires knowledge of both. Remembering the different developmental tasks associated with healthy risk-taking behavior at each age milestone will enable you to adjust your expectations to match where a youth is in the development process and any unique needs he or she may have. The information presented on adolescent brain development throughout this training is intended to give you new insights so you can better understand why youth do the things they do in the context of normal development. But there is an unintended consequence to watch out for… Don’t let your understanding about the brain development process excuse teens for making unhealthy decisions. You still have to know when and how to address unhealthy behaviors when you see them.The adolescent brain matures in part through encountering life lessons, rather than being sheltered or rescued from such lessons. You have to learn to tell the difference between healthy risk-taking and unhealthy risk-taking to ensure the youth you serve are able to thrive. It’s a fine balance that you’re learning to develop and an important responsibility. But it’s not on your shoulders alone. Helping youth avoid unhealthy behaviors takes a team effort – parents and extended family members, teachers, mental health and medical professionals, community members, your supervisors – are all part of the team. Developing your comfort level in collaborating with these various supports demonstrates your strength as a youth worker. The best ethical practice to use as a general rule is this:Whenever you are concerned about a youth’s behavior, seek guidance from your supervisor.Learning Objectives ReviewUnderstand what drives risk-taking behavior:It’s a natural part of human developmentIt’s how adolescents make the transition to adulthoodEnvironmental factors such as peers and societal factors play a roleThe prefrontal cortex of the adolescent brain, the area responsible for critical thinking, is not yet fully developedRecognize the warning signs of unhealthy risk-taking behaviors:Being alert for warning signs will help you intervene earlier Clues to be aware of: There are several concerning behaviors happening at the same timeThe concerning behaviors appear suddenlyThe behaviors are extremeThe behaviors persist for a significant amount of time and cause other problemsLearn effective communication strategies for talking with youth about unhealthy risk-taking behaviors:Express genuine care and concernLet them know they’re not alonePromote their self-esteem and self-respectShow positivity and enthusiasmProvide guidance, not criticismEngage them in developing strategies they can useKnow your role as a Youth Intervention worker and the importance of consulting with your supervisor:You’re a part of a team; draw on your supervisor’s expertise and experienceYou have mandated reporting requirements to keep in mindBe cautious about promising confidentiality before you understand the youth’s situation Learning Module QuizYour role in recognizing and addressing unhealthy risk-taking behavior in youth can make a positive difference in their development. Everything you’ve studied in this learning module has set you up for greater success in working with youth to avoid unhealthy behavior. Knowledge alone is not enough - put your learning into practice. Try at least one new technique in your very next program. Then try another the next day. Keep practicing. You’ll soon find this comes second nature to you.Now you will demonstrate your learning by passing an 8-question quiz. If you’ve paid attention to the videos and carefully studied the content of this workbook, you are well-prepared for the quiz. You need a score of at least 80%. Good luck!I’m ready to take the At-risk Behaviors quizReference Sources1 “Healthy Youth!” Health Topics. Steinberg L. Risk taking in adolescence: What changes and why? Ann NY Academy of Sciences 1021:51-58. 2004. 2 Steinberg L. Risk taking in adolescence: What changes and why? Ann NY Academy of Sciences 1021:51-58. 2004. 3 Steinberg L. Cognitive and affective development in adolescence. Trends in Cognitive Sciences 9 (2): 69 – 76. 2005. 4 Steinberg L. Cognitive and affective development in adolescence. Trends in Cognitive Sciences 9 (2): 69 – 76. 2005. 5 F. M. Benes, in C. A. Nelson and M. Luciana, eds., Handbook of Developmental Cognitive Neuroscience (Cambridge, MA: MIT Press, 2001), 79.6 Gardner M, Steinberg L. Peer Influence on risk taking, risk preference and risky decision-making in adolescence and adulthood. Dev Psych 41: 625-635. 2005. 7 Lopez, Schwartz SJ, Prado G et al. Adolescent Neurological Development and its Implications for Adolescent Substance Abuse Prevention. J Prim Prev 29 (1): 5-35. 2008.8 Carls, Jeanne. “New Research on Adolescent Brain Development.” Center for Substance Abuse Prevention. November 2004, Issue #1. 9 Casey BJ, Jones RM, Hare TA. The Adolescent Brain. Ann NY Acad Sci 1124: 111-126. 2008. 10 Steinberg L. Risk Taking in Adolescence: New Perspectives From Brain and Behavioral Science. Current Directions in Psychological Science 16 (2): 55 – 59. 2007. 11 Steinberg L. Risk Taking in Adolescence: New Perspectives From Brain and Behavioral Science. Current Directions in Psychological Science 16 (2): 55 – 59. 2007. 12 Steinberg L. Risk Taking in Adolescence: New Perspectives From Brain and Behavioral Science. Current Directions in Psychological Science 16 (2): 55 – 59. 2007. 13 Teens: A Synthesis of Research and a Foundation for Action. Center for Health Communication, Harvard School of Public Health. 2001. Available at: 14 Retrieved from Alaska’s Department of Health and Social Services; Table adapted from O’Connell, M. E., Boat, T., & Warner, K. E. (2009). 15 The Substance Abuse and Mental Health Services Administration (SAMHSA) Risk and Protective Factors16 Adapted from: Adolescent Family Life Self-Directed Modules Series, Office of Population Affairs, US Department of Health and Human Services. ................
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