Michael J. Bradley, Ed.D.
PROFESSIONAL SERVICES SEMINAR
PARTICIPANT OUTLINE
TITLE: Working with the New Millennium Adolescent
DESCRIPTION: Over the past few decades, the work of adolescent intervention has evolved
into a highly specialized endeavor demanding skills, temperament, and training which are unlike
those required with younger and older populations. These changes have impacted heavily upon
all of those who work with kids to include therapists, psychologists, counselors, teachers, youth
ministers, probation officers, psychiatrists, social workers, nurses, physicians, and most of all,
parents. The cultural changes around teens have made adolescent work a higher-risk endeavor,
involving dangerous behaviors to include drug use and sexual activity, along with a three-fold
increase in the rate of teen suicide, factors which underscore the intervener’s need to quickly
establish a working relationship. This program will survey these issues and suggest a researchsupported, respect-based intervention approach which fosters an accelerated connection based
upon the neurological, cultural, and developmental factors of adolescence. The strategies
suggested here represent one generic style through which all of the specific specialty skill areas
listed previously may be more effectively expressed to teenagers.
PROGRAM OBJECTIVES/SYLLABUS:
Session I
1. Review of recent neurological research that redefines the picture of how the
adolescent brain functions and interacts.
2. Recent trends in American teen culture: implications for interveners.
Break
Session II
3. Intervention styles/models and their impact on outcome.
4. Respect-based techniques for adolescent intervention which address their
developmental, neurological, and cultural concerns.
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Contact: Sandy McWilliams
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www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
SESSION I
GOAL 1: REVIEW OF RECENT NEUROLOGICAL RESEARCH THAT REDEFINES
THE PICTURE OF HOW THE ADOLESCENT BRAIN FUNCTIONS
Neurological research has overwhelmingly supported most adolescent theorists’ views about
how best to intervene with teenagers utilizing non-fear-based techniques. Yet the majority of
Americans believe that fear-based options are best, and that respect-based interventions are weak
and ineffective. Interveners should be acquainted with intervention science to affirm their own
beliefs, as well as to better convince other interveners (i.e., parents) of the relative effectiveness
of fear-based versus non-fear-based techniques.
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“All-by-five” fallacy history:
o Based upon brain volume studies.
o Implications:
 assumed psychological definition by age 5.
 teen years viewed as a neurological postscript.
“All-by-five” mythology aligns with parents’ personal experience:
o Teens push for separation from parents.
o Teens seen as critical, oppositional, values rejecting/testing.
o Unacknowledged parental grief (from the “loss” of their small child) often leads
to emotional disconnect.
Thus a cultural view evolved seeing teens as small adults which has tremendous and damaging
implications where:
 Risk behaviors of sex, drugs and “rock ‘n roll” (violence) are perceived as
normal and unavoidable (Headden, 2005).
 Parents have 60% less contact time with their teenagers than 40 years ago:
mothers have less than 30 minutes/day; fathers have 8 minutes/day (Headden,
2005).
YET
Neurological research proves that teens are not small adults, they are large children (Strauch,
2003) requiring skilled parenting.
Page 2 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
THE NEUROLOGICAL “REVOLUTION”
MRI’s (brain imagings) of adolescents (see Giedd, 1997) discovered “2-year-old’s
exuberance” w/ subsequent pruning to increase efficiency: The most sophisticated brain
structures achieve most of their growth in adolescence. Structures such as:
o Prefrontal cortex- controls executive functioning (planning, organization, impulse
control, consequence/outcome prediction, emotional mediator for limbic system).
Our dreams and aspirations live here.
o Cerebellum- movement and coordination, and brain “co-processor” for cognition
and emotion, and perhaps much more.
o Corpus callosum – brain wiring.
o Hippocampus- memory functions.
GOOD & BAD NEWS
THE BAD NEWS ABOUT TEEN BRAINS
In brain development, exuberance=disorganization; in some cases, decrements in skills and
processes from pre-teen years
 Speed of identifying emotion drops 20% at age 12, then normalizes at age18 (McGivern,
2002).
 In responding to strong emotions, teens use amygdala (fight or flight) vs. pre-frontal
(sorting, reasoning, judging); (Yurgelun-Todd, 1999).
o Impulsive behavior- poor judgment/outcome predictive abilities
o Emotional misreads, i.e., see fear & concern as anger
 Dopamine levels drop and surge from pre-teen to teen years, and reward circuits shift to
pre-frontal (Spear, 2000).
o Dopamine-pleasure (and movement) circuits: “I’m soooo bored that I’m crashing
into door jambs.”
o Risk taking implications
 getting dopamine surges through “planning” novel/risk activities
 dopamine surges linked to risk behaviors as well
 Teen brains have underdeveloped EMPATHY and GUILT functions, i.e., when given
action/choice scenarios, adults thought “How would my actions affect me and others”
(pre-frontal-activity). Teens thought, “What happened to me prior?” (mid-brain);
(Blakemore, 2005).
 Adolescent “sleep clock” (melatonin production) advances with early-rise demands
(Carskadon, 1998).
Page 3 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
In summary, teen brains are sleep-deprived. impulsive, risk/novelty-seeking, have poor
judgment, exhibit poor organization, and suffer with poor motivational and emotion
recognition/processing skills.
THE GOOD NEWS ABOUT TEEN BRAINS
That same brain: miraculous
Incredible learning potentials & capabilities: insight, athletics, morality, music, and philosophy.
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Shaping the future adult here, a future parent of a child.
Enormous impact of environment on “plastic” brain- can undo years of neglect and
abuse; suffering a terrible “first five” years of life is NOT a terminal diagnosis.
GOAL 2: REVIEW OF RECENT TRENDS IN AMERICAN TEEN CULTURE AND
IMPLICATIONS FOR INTERVENERS.
GOOD AND BAD NEWS
THE BAD NEWS ABOUT THE WORLD OF TEENAGERS
I. The world around kids is crazy, per risk indices of drugs, sex, and violence.
o Record levels of risk prompts in media and culture (Schulenberg, 2007).
o Impact of prompts on kids- prompts work:
 Teens who see more on-screen smoking have 3x the rate of smoking
initiation than kids who see less even when controlled for all other factors
(parents & peers smoking, anxiety, depression). (Sargent, J.D. et al.,
2005).
 Girls who listen to degrading sexual lyrics have early and high-risk sexual
activity (Martino, S.C. et al., 2006).
o Current Teen Risk Behaviors:
[Risk data per NIH Youth Risk Behavior Surveillance Summaries (YRBSS)
(2007) unless otherwise noted. NOTE: As self-report tools, the YRBSS numbers
may now provide underestimates of risk behaviors, i.e., as YRBSS suggests
overall drug use has declined in the past decade, drug fatalities among teens have
increased by 300% during that same period (National Center for Health Statistics,
2007). Further, while self reports of suicidal ideation have decreased substantially
(per YRBSS ’97-’07), rates of attempts and completions have not decreased
accordingly]
Drugs:
 ALCOHOL
 10% qualify as alcohol dependent per DSM-V
Page 4 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
 30% binge drank past 30 days
 Alcohol kills 400% more teens than all other drugs combined.
 39% were given alcohol by their parents (American Medical
Association, 2005).
 24% drank with their parents (American Medical Association,
2005).
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Sex:
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“Pharming” (illicit use of pills): 19% tried pain pills in ’05
(Partnership for a Drug Free America [PfaDRA], 2006).
The “Choking Game”: A recent, Internet-inspired, non-drug activity to
produce a “high” by non-lethal asphyxiation, with or without sexual
stimulation (autoerotic asphyxiation). Estimates of lethality vary
widely, but run from perhaps 200 to 400 teens annually, with some as
young as 11 years of age.
DRUG PERCEPTION ISSUES: (PfaDRA, 2006).
o 40% of teens: “pills are much safer drugs”
o 29%: “not addictive”
o 31%: “nothing wrong with use”
DRUG ACCESS ISSUES: (PfaDRA, 2006).
o 62% can get pills at home
o 52% can get pills at school or on street
35% of 9th graders active; 24% w/4 or more partners.
At least 25% of female adolescents have active STDs (Fornan, 2008)
(this study tested only for four infections: human papillomavirus, or HPV,
chlamydia, trichomoniasis, and herpes simplex virus)
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1/3 of females become accidentally pregnant by 19.
Girls becoming the sexual predators in middle school, with long-term
emotional consequences.
10% more females than males are sexually active by 12th grade.
Average age of first exposure to pornography: 10 years
60% of 9th grade males watch pornography while doing homework.
Violence-Less and more:
 Less: murder/assault and school violence.
 Today’s adolescents are half as murderous as their parents were as
teens.
 School violence rates are down 25% to 40% over past decade.
Page 5 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.

More:
 Sexual assault:
 20% of 9th-12th grade girls (ages 14 to 18) reported that
they had been hit, slapped, shoved or forced into sexual
activity by a dating partner
 That number increases to 33% for sexually active girls
(Decker, 2005).
 1 of 3 girls in controlling or abusive relationship by age 18
 “Permissible hitting”: 33% of 9th grade girls say it’s “OK” for their
boyfriends to hit them for publicly disrespecting their boyfriend
(Safe at Home Project, 2003).
 Suicide:
 1 of 6 teens either attempts or plans their suicide (Headden,
2005).
 Today’s teens complete suicides at 2-to-3 times the rate of
their parent’s generation
 Teen suicide rates have decreased since 2005 (from 1 in 5);
however, that decrease is most likely a function of
increases in use of anti-depressants among teens (Gould,
2003).
 Most (54%) teen suicides are 50-minute processes with no
apparent warning signs. Less than half of adolescent
suicides occur in conjunction with clinical depression
(Headden, 2005).
Adolescent brain plasticity and growth exacerbates impact of risk behaviors not seen in
adult brains. For example:
 Alcohol
-specific, exclusive and immediate neuro-toxic effects on adolescent
prefrontal lobes (executive function), cerebellum (coordination, cognition,
emotion) and hippocampi (memory function); (Dahl, 2004).
-odds of alcohol addiction with first use at age 14 are 5X odds at age 21
(Center for Substance Abuse Research, 2006).
-47% of teens who drink before age 21 become alcohol dependent; 9% of
adults who drink after age 20 become alcohol dependent (Hingson, 2006).
 Nicotine – specific and immediate neuro-toxic effects on adolescent verbal
working memory critical to academic functions; (Jacobsen, 2005).
 Modeling – impact of perceived negative behaviors on pre-frontal lobes, i.e.,
predictors of drug (including alcohol) use:
Page 6 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
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parents and older siblings who use, and, most powerfully,
exposure to screen prompts (Sargent, J.D. et al., 2005).
II. Adolescent interventions by adults are often counterproductive, given the new
challenges.
o Intervention Model Paradigm: Fear-based (punishment) vs. Respect-based
(reward/consequence) models:
 Fear-based models don’t work.
 Fear only controls; it does not teach (Yurgelun-Todd, 1999). This
contradicts our “Prime Directive” in intervening with adolescents:
Our job is not to control kids, but to teach kids to control
themselves.
 “Get-tough programs don’t work.” (National Institutes of Health,
2004). ALL fear-based programs (boot camps, prison tours, and so
on) had no positive outcomes; many had negative outcomes
 Respect-based models work.
 Programs that had positive outcomes were respect-based
counseling, therapy, and educational approaches (National
Institutes of Health, 2004).
 Respect-based approaches have two very difficult requirements
 An upward looking admiration: Interveners must be seen
by kids as better people than kids.
o What teens don’t respect: loss of emotional control
(yelling, threats, begging, inconsistency), corporal
punishment, hypocrisy, self-centeredness, sarcasm,
and lack of empathy; teens also do not respect
“cool” (permissive or laissez-faire) parents
o What kids do respect: emotional control (especially
in the face of teen provocation), restraint, humility,
consistency, patience, compassion, selflessness, and
empathy (real listening).
 A relationship, yet – parents today are 40% less involved
with teens than 30 years ago (Headden, 2005). Factors
include:
o Rise in single parent households
o Rise in two-income families
o Rise in individual parents with two jobs
o Increased job time demands
o Cultural view of teens as small adults
Page 7 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
 RESPECT BASED INTERVENTIONS ARE NOT WEAK
INTERVENTIONS. FEAR-BASED INTERVENTIONS ARE
NOT STRONG ONES.
o The end point of a respect-based intervention can be to
remove an adolescent from his family, as in: “Son, we
agreed that if you put your hands on your mother once
more, that would be a sign that you are not in control of
your rage enough for you to live here for now.”
THE GOOD NEWS ABOUT THE WORLD AROUND TEENAGERS
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That plastic adolescent brain (truly critical years are 13 to 18) offers tremendous
possibilities for positive shaping if kids are connected in respect-based relationships with
adults.
The most powerful influence on teenagers: of culture (media, music), peers, genetic
predisposition, or parents, parents have the most impact.
o 90% of 9th graders report having excellent (53%) or good (37%) relationships
with their parents (Time Magazine/Harris poll, 8/8/05).
o Approximately 45% of parents believe that their own kids would rate their
parental relationship as excellent or good (Time Magazine/Harris poll, 8/8/05).
o Teens who have their significant life events (school graduations, achievements,
jobs, driving) celebrated by parents have half the rates of risk behaviors and
mental disorders as do uncelebrated teens (6th Annual Teens Today Report;
December, 2005; www.sadd.org).
o In absence of parents, alternative models can have great impact (teachers,
coaches, counselors) even in very small exposures.
Negative aspects of teen behavior are usually temporary and are usually actions not truly
intended to hurt others (“Mom, how does it hurt you if I get drunk?”) Therefore,
interveners should depersonalize frustrating adolescent behaviors with metaphor:
o “Toilet training”- adolescence is where kids are learning to control their
emotional (vs. bowel) function; a very frustrating but limited time. This is not a
predictor of how the future adult will behave.
o “Short time”- this is military slang for being close to the end of a tour of duty,
which is the phase in which to work even harder at staying alive. Adolescent
years are the ones where interveners should do their hardest and most skilled
work.
o “Temporary seizure disorder”- if a teen had an epileptic episode, interveners
would not take that behavior personally. They would allow the teen a safe space
to ride out the “seizure”, and then, after recovery, work with the kid to reduce the
Page 8 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
intensity and frequency of future problems. The same response should occur with
adolescent acting out.
A suggested platform to easily convey the principles of respect-based intervention: THE TEN
COMMANDMENTS OF PARENTING (OR INTERVENING WITH) ADOLESCENTS
(See separate handout. This may be copied for distribution to others as desired.)
[Break]
SESSION II
GOAL 3: INTERVENTION STYLES/MODELS AND THEIR IMPACT ON OUTCOME
Most adolescents are reluctant participants in interventions, even in ones they elect. They
have high (and desirable) needs for autonomy and independence from adults, low levels of
capability or willingness to self-disclose, and an ironic, powerful resistance to change.
Therefore most teen interventions are handicapped from the onset, and must be handled with
a set of engagement skills that are unique to adolescents, must precede the actual
intervention, and which are typically not taught or practiced in intervention training
programs.
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Less effective adolescent intervention models, still widely used today:
o Directive: guidance (advice giving), threatening, lecturing, challenging.
o Interpretive: analysis, insight provision.
o Disclosing: “war” stories, self-disclosure by intervener.
Most effective intervention model: questions posed within the structure of a
relationship (Schechtman, 2004).
Cognitive-behavioral approaches require examination of belief systems which dictate
behavior. Questions are the key tool to access beliefs. But adolescents in particular need
to establish a therapeutic relationship with any interveners prior to exposing their true
belief systems.
The most critical element of intervention is a RELATIONSHIP (Edgette, 2002) and
(Hanna, 2003)
A relationship is based on empathy, which is not seeing if a kid’s view makes sense, but
seeing how it does—particularly if that view is immoral, dysfunctional, or irrational.
Remembering our own crazy adolescent years helps us to better “feel” theirs. EMPATHY
MUST BE EXPLICITLY EXPRESSED BY THE INTERVENER AND FELT BY
THE CLIENT.
“Client-centered” approach is essential. Intervener’s ego must be left outside of the room.
Get help if your own buttons are easily pushed with lying, cursing, or disrespect. Many
kids use these diversion techniques to avoid having to look at themselves.
Page 9 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.

Intervention effectiveness has essentially no correlation with level of training or with
years of experience (some research suggests a negative correlation) (Hanna, 2003).
Therefore, the master’s level intern can be as effective as the 30-year-Ph.D.; 30 year
“professional automaticity” can destroy empathy and connection. All interveners should
strive to be as open, alert, and humble as the intern. Every client should be our “first”
client.
GOAL 4: RESPECT-BASED TECHNIQUES FOR TEEN INTERVENTION WHICH
ADDRESS DEVELOPMENTAL, NEUROLOGICAL, AND CULTURAL ISSUES OF
ADOLESCENCE.
1. ENGAGEMENT TECHNIQUES FOR INTERVENERS FACING RESISTANT TEENS
 Engage on new turf.
o Whenever possible, get out of the office, classroom, or family room to a new
environment. Even a new posture in an old setting works better. Walks or
chats at the coffee shop can lead to new thoughts and ways of talking that
might not happen in familiar places.
o DO feed the animals. Teens are almost always hungry. Sharing a snack
especially with a kid who has been frustrating can melt away barriers of
resistance, and promote equality with snacking seen as a shared experience.
o Provide hand toys. Adult conversations are tough for teens. They often talk
more easily when playing with objects or drawing or working in sand or clay.

Embrace their resistance. The fact that an intervention is required usually means that
the kid automatically hates the idea—because he should. Few people enjoy having
experts or authority figures forcing themselves into our private lives and telling us
what to do. And just like adults, kids enjoy intervention the least when they are
screwing up or having personal crises.
o Admire their expertise at making you or others crazy (see Fred Hanna’s
Therapy with Difficult Clients, referenced prior): “Cheryl, wow! You’re really
good at disrupting this group. No—I really mean that. You are able take over
this group and lead it where you want. That’s a valuable skill among people
who are leaders.”
o Affirm their emotions, don’t attempt to stop them. “Tony, I can hear that
you’re really pissed off. Man, you can really yell! What’s going on?”
o Ask if someone else needs to be involved in the intervention. “Susan, the fact
that you’re not talking makes me wonder if maybe somebody else should be
here talking with us about why you’re so angry?” The real problem might not
be in the room with you.
o Acknowledge their refusal to talk as their right and choice (“What’s it like to
be forced to come here to see me when this wasn’t even your idea?”)
Page 10 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.

Affirm human/social equality. Define differences as job function and life situation.
o “Partners in Problem” technique: “Look, John, we’ve got a big problem here.
I’ve got to teach biology and you seem to need to disrupt the class. How are
we going to get around this?”
o “Dispassionate Cop” posture: Link first, then intervene- “Sorry about the
ticket—just doing my job. By the way, cool car! Looks way too nice to risk
smashing up by blowing through stop signs.”
o Engage on equal footing on all levels. Avoid barriers which imply expert
status or rank superiority such as desks, titles, grossly unequal eye height, or
loudness of voice. Displays of power and control are easily blown off by
adolescents. Interveners are most powerful when they lay down their shields
of authority and directly engage kids as one human to another, with both
simply trying to get through another day of doing their jobs, whether that job
be counseling or creating chaos.
o Laugh at every opportunity, especially to poke fun at yourself, but never
towards a client. Being deadly serious only builds talk-ending tension.
o Tell clients what you learned from them, perhaps about your own crazy teen
years and thank them. Like adults, kids feel closer to people when the
relationship is one of “give-and-take.”
o Beware the two-edged sword of disclosure. If requested by the client, some
disclosure can be helpful. Overdone, it looks self-centered to the client. Say
nothing that you don’t want to read in tomorrow’s newspaper, and never
disclose unresolved issues (countertransference risks).
2. CHANGE TECHNIQUES FOR INTERVENERS WITH RESISTANT TEENS
 Affirm the client’s power.
○ Let them know that they are most in charge of the outcome: “James, only you
can decide whether to follow the rule or not. That’s up to you. So it’s also
your choice to see if we can make things better for you here at school.”
○ Always get their permission to mess with their lives before asking questions:
“Bobbie, is it OK if I ask you a question?” This defines the client’s power and
more commits her to answering.
○ AT ALL COST avoid power struggles. If an intervener feels personal anger
overtaking his clinical detachment, he should find an excuse to end the
interaction. The productive part is already over, crushed by the irony of a
professional telling a teen to control her emotions when he’s unable to control
his own.
Page 11 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
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Find a sub-personality inside the client.
○ This moves the conversation from “intervener versus client” to “client versus
client”:
“Mike, I hear you when you said that you don’t give a crap about going to
school. Now, is there any part of you, maybe 5%, that thinks you
should go to school? Yes? OK. Can I talk with that 5% part of you for
a minute?”
“Rhonda, I can see that you’re really angry a lot. Is there any part of you
that doesn’t like being so mad all the time?”
Become very stupid about adolescence but very interested in learning about it.
○ Avoid being the “expert” on teenagers. If we assume that we know a kid’s
experience, then we automatically don’t, and our arrogance can kill our
connection with them. Instead, ask them about themselves: “Tell me about
your world. What’s it like being 14 these days?”
○ NEVER TRY TO BE “COOL” or “HIP.” Kids see that as arrogance.
Conversely, they respect adults who say things like, “I have no idea what
being a teen these days is like. Can you tell me how it is for you?”
Beware of the insight game. Insight is not required to change behavior, particularly in
adolescence where cognitive abilities often preclude insight. Plus, kids can feel stupid
when they continue to do bad things even after achieving an insight that was
supposed to “cure” them.
Tell stories of kids similar to the client. Kids love tales about other kids, and can use
those as hopeful metaphor, particularly when they are in crisis and can’t see their way
out.
Don’t fear confrontation. Once you’re connected, don’t shy away from directly
asking “what’s up” with their behavior. If they feel the empathy and caring, they’ll
respect and allow your directness; but don’t push until you feel that connection.
Apologize at every opportunity. Adults are never larger in the eyes of teenagers than
when we readily admit to screwing up. They relate readily to imperfection, and see
imperfect adults as much more credible.
3. TROUBLE-SHOOTING TECHNIQUES: WHAT TO DO WHEN…
 She won’t talk
o Don’t:
- Get caught up in a power struggle to make someone talk.
- Take their behavior personally. Their silence is a measure of their pain.
o Do:
- Start the discussion, if possible, with family or teachers or relevant others with
her sitting there. Let her see that her silence cannot control the process, and
that she loses power by shutting up.
Page 12 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
- Dispassionately acknowledge their power, if in an individual setting: “What
happens here is up to you”; “Where do we go from here?” “Is there someone
missing who should be here with us?”
 He denies peeing in Dad’s truck (lies)
o Don’t:
- Judge their behavior: “Why are you lying?”
- Take their behavior personally. Lying to adults can make a lot of sense in a kid’s
world.
o Do:
- Review confidentiality rules and your own dispassionate role: “Look, I’m not a
cop or priest or your parents…”
- See their lying as serving some purpose, and see if you can isolate that. Perhaps
they were once betrayed to the police: “Can I ask you a question? Ok. Is there
some reason that maybe you can’t tell me what really happened? You don’t
have to tell me the reason, just if there is one.” The fact that he lied once
doesn’t mean the rest of what he says is untrue.
- Acknowledge their power and control of outcome: “If you feel like you can’t be
direct with me, this isn’t going to help you get whatever it is that you want.”
- Sow seeds for your successor: “I’m sorry that I wasn’t able to help you here.
Maybe down the road somewhere if you think you’re ready to talk with
someone, give us a call.”
 She says that she can’t discipline herself do her homework, chores, and so on
o Don’t:
-Challenge her belief directly (“Of course you can!”)
o Do:
-Highlight her convictions of helplessness within her own belief system: Ask if
she could do her homework or chores tonight if someone put a gun to her head, if
her life depended upon it. Next, illustrate her belief-driven choices: Ask why she
could suddenly do those “impossible” things under those life-threatening
conditions. Then ask if “having a life” depends upon doing things like homework.
 He won’t take his psychotropic medication
o Don’t:
-Argue that he must take the med.
-Minimize or discount his concerns.
o Do:
-Acknowledge that it is really up to him to accept medicine or not.
Page 13 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
-Acknowledge that taking medicine is a very serious decision with pros and cons.
-Ask about his fears. Most kids see taking meds as loss of autonomy and
control, and fear losing their identities, i.e., “This will change who I am.”
-Define meds as promoting autonomy, control, and identity, i.e., “There is no med
that can make you stay calm. Meds will only give you more choices of how
to be. It’s up to you to decide if staying calm is what you want to do.”
 She screams profanities
o Don’t:
- Allow her behavior to control your own by getting angry.
- Attempt to control her by ordering her to stop.
o Do:
- Stay calm but real, acknowledging the scene when she pauses: “Wow! That was
scary! What’s going on?”
- If she persists: “Ok! I hear you! Can I ask you a question? How does that rage
stuff change things for the better for you?”
- Remember teen neurology—they often can’t mediate their emotions very well,
particularly when they’re in pain.
 He picks fights with you
o Don’t:
-Get pulled into a power struggle. This is NOT about you, but about his need to
divert and avoid.
o Do:
-Predict the future—reveal his sabotage skills: “Ronald, here’s what I think is
about to happen. I think that when I ask about your arrest, that you’ll find
something to divert us from the topic…”
-Ask how that strategy helps him.
 She bolts out of the door leaving the group behind because someone made her mad
o Don’t:
- Run after her (assuming she’s safe) or get manipulated into doing “drive-in”
therapy in the parking lot.
o Do:
- Continue the session without her (assuming she’s safe).
- Review what happened when she returns: “What are our options? Should we not
say the truth so you’ll stay here or should we be straight-up and risk you
running out?”
Page 14 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
- Use the “Freedom Challenge” (Hanna, 2003): “Maria, it must be tough for you
to have other people control your behavior like that, to be able to make you run
away.”
 He talks nonstop with stories about his friends
o Don’t:
- Immediately confront him. This could be his shield that he needs for awhile as
he builds a relationship with you.
o Do:
- Tolerate this for awhile. If he invites your opinions, he might be testing and
learning about you.
- Eventually ask, “And what’s going on in your own life that perhaps I can help
with?”
 She blames others for making her snap out
o Don’t:
- Accuse her of ducking responsibility for herself or acting like a child.
o Do:
- Issue the Freedom Challenge (Hanna, 2003): by saying, “That must be tough,
not being free.” When asked to explain, point out that she can be controlled by
any jerk who feels like getting her in trouble. Acknowledge that she’s
certainly tough, but ask if she’s tough enough to take back her freedom from
the jerks.
 He will only talk about hurting others
o Don’t:
- Appeal directly to his empathy for his victims. He may not be able to go there.
o Do:
- Ask what the payoff is. When he says “to make them hurt” ask if he knows what
real bad hurt feels like. Then ask if he would be angry if he had not ever felt
that real bad hurt. Then point out, “Wow! All that trouble you get into because
some jerk hurt you so bad. It’s like that jerk gets to keep hurting you, you
know?”
- If they deny feeling hurt, ask if they ever felt hurt when they were little kids
(this is “another person” through whom they might be able to “remember”
safely feeling pain without becoming vulnerable).
Page 15 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
 She continues to use drugs (non-life-threatening)
o Don’t:
-Lecture. She’s likely heard it all before.
-Let her feel that you see drug use as a character flaw or
weakness via verbal or non-verbal cues.
o Do:
- First isolate her hurt, and ask what the drugs do with that pain. Then ask how
that pain is when the drug wears off. Suggest that therapy can make the pain
go away without any side effects or hangovers. And, over time, it’s a lot
cheaper.
- If no hurt is apparent, ask about emptiness. As with hurt, explain that emptiness
can be helped with therapy.
- Make her need for autonomy fight her need for drugs. Paint the drugs as
controlling her behavior and bending her will.
- Use the sub-personality technique to talk about the “user” and the “nonuser”
within her.
PARTICIPANT PROBLEM SOLVING SESSION
Page 16 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
BIBLIOGRAPHY/REFERENCES
American Medical Association, (2005). Adults most common source of alcohol for teens. April,
2005. www.ama-assn.org/ama/pub.
Blakemore, S.J., Frith, U. (2005). The Learning Brain. Malden: Blackwell Publishing
Professional.
Carskadon, M. et al. (1998). Sleep schedules and daytime functioning in adolescents.
Child Development, 69 (4) (August, 1998), 875-87.
Center for Substance Abuse Research; 7/31/06, Vol. 15, Issue 30.
Dahl, Ronald E.& Spear, Linda Patia, Editors. (2004). Adolescent Brain Development:
Vulnerabilities and Opportunities. Annals of the New York Academy of Sciences, Volume 1021,
June 2004.
Decker, M.R., Silverman JG, Raj A. Dating Violence and Prevalence of Sexual Activity.
Pediatrics. Aug 2005 (Vol. 116, Issue 2, Pages e272-6)
Edgette, Janet Sasson. (2002) Candor, Connection, and Enterprise in Adolescent Therapy. New
York: W.W. Norton & Company
Fornan, S. (2008) 2003-2004 National Health and Nutrition Examination Survey; Centers for
Disease Control: www.cdc.gov
Giedd, J.N., Blumenthal, J., Jeffries, N.O., et al. (1999). Brain development during childhood
and adolescence: A longitudinal MRI study. Nature Neuroscience, 2, no.10 861-3.
Gould, Madelyn S. et al. (2003). Youth Suicide Risk and Preventive Interventions: A Review of
the Past 10 Years. Journal of the American Academy of Child & Adolescent Psychiatry.
42(4):386-405.
Hanna, Fred, J. (2003) Therapy with Difficult Clients: Using the Precursors Model to Awaken
Change. Washington D.C.: APA Press.
Headden, Susan (Editor) et al (2005). Mysteries of the Teen Years. U.S. News & World Report,
Special Edition. New York.
Hingson, Ralph W.; Heeren, Timothy; Winter, Michael R.
Age at Drinking Onset and Alcohol Dependence: Age at Onset, Duration, and Severity.
Archives of Pediatric Adolescent Medicine, Jul 2006; 160: 739 - 746.
Page 17 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com
Michael J. Bradley, Ed.D.
Jacobsen, L. et al. Effects of smoking and smoking abstinence on cognition in adolescent
tobacco smokers. Biological Psychiatry, Volume 57, Issue 1, Pages 56-66
Martino, S.C. et al. (2006) Exposure to Degrading Versus Nondegrading Music Lyrics and
Sexual Behavior Among Youth. Pediatrics, Aug 2006; 118: e430 - e441.
McGivern, R. F., et al. (2002). Cognitive efficiency on a match to sample task decreases at the
onset of puberty in children. Brain and Cognition, 50, 73-89.
National Center for Health Statistics (2007). www.cdc.gov.nchs.
National Institutes of Health (2004). Get Tough Programs Don’t Work.
http://www.ahrq.gov/clinic/epcsums/adolvisum.htm.
Partnership for a Drug Free America (2006). 2005 Annual Report. www.drugfree.org
Safe at Home Project (2003) (awaiting publication). University of Wisconsin/Milwaukee
Women’s Center 414 229 5008.
Sargent, J.D. et al. (2005). Exposure to Movie Smoking: Its Relation to Smoking Initiation
Among US Adolescents. Pediatrics, Nov 2005; 116: 1183 - 1191.
Shechtman, Zipora. Client Behavior and Therapist Helping Skills in Individual and Group
Treatment of Aggressive Boys. Journal of Counseling Psychology. 51(4), Oct 2004, 463-472.
Schulenberg, C. (2007). Dying to Entertain. Parents Television Council Special Report,
www.parentstv.org/publications/reports.
Spear, L.P. (2000). Neurobehavioral changes in adolescence. Current Directions in
Psychological Science, 9 (4) (August 2000).
Strauch, Barbara (2003). The Primal Teen. New York: Doubleday.
Youth Risk Behavior Surveillance Summaries (2005).
www.cdc.gov/HealthyYouth/yrbs/index.htm
Yurgelun-Todd, Deborah H. (1999). Functional magnetic resonance imaging of facial affect
recognition in children and adolescents. Journal of American Academy of Child and Adolescent
Psychiatry, 38 (2), 3195-99.
Page 18 of 18
Contact: Sandy McWilliams
HARBOR SPEAKERS BUREAU
5407 35TH AVE NW G104
GIG HARBOR, WA 98335
Rev. 03/23/09
www.docmikebradley.com
Phone: 253-509-0110; Cell: 253-468-3010
E-mail: sandyhsb@gmail.com