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A Mindfulness-Based Approach to Working with High-Risk Adolescents
A Mindfulness-Based Approach to Working With High-Risk Adolescents is an accessible introduction to a new model of therapy that combines the Buddhist concept of mindfulness with modern trends in psychotherapy. Drawing on years of experience working with at-risk adolescents, the chapters explore ways to develop authentic connections with patients: building relationships, working with resistance, and ways to approach change using mindfulness-based techniques. Real-life interactions and illustrations are used to show how a mindfulness-oriented therapist can approach working with adolescents in individual and group settings, and the book also provides practical suggestions designed for immediate implementation. A Mindfulness-Based Approach to Working With High-Risk Adolescents is a must for any mental health professional interested in using mindfulness and other contemplative practices with at-risk youth.
eBook
Does Mindfulness Meditation Increase Effectiveness of Substance Abuse Treatment with Incarcerated Youth? A Pilot Randomized Controlled Trial
A growing body of evidence suggests that mindfulness meditation is associated with a number of physiological and psychological benefits in both adult and juvenile populations. Research on mindfulness-based interventions among at-risk and incarcerated youth populations has also shown feasibility as a means of enhancing self-regulation and well-being. This randomized controlled trial examined an 8- to 12-week program in which participants received individual and group psychotherapy. Participants in the experimental condition received formal mindfulness training alongside psychotherapy, while those in the control condition received psychotherapy without mindfulness training. All participants received the group intervention. Participants were recruited from a court-mandated substance abuse group treatment program at a juvenile detention camp in the San Francisco Bay Area. Participants were 35 incarcerated youth (100 % male; 70 % Hispanic; mean age = 16.45). Of these, 27 provided complete pre- and post-treatment assessment data. Measures of mindfulness, locus of control, decision-making, self-esteem, and attitude toward drugs were administered before and after the intervention. Detention camp staff provided behavioral rating points for each participant in the week prior to beginning the study treatment and in the week after completing the intervention. Significant increases in self-esteem (
p
< 0.05) and decision-making skills (
p
< 0.01) were observed among the entire study sample. Between-group analyses found significantly greater increases in self-esteem (
p
< 0.05) and staff ratings of good behavior (
p
< 0.05) in the mindfulness treatment group, consistent with prior research. These results suggest a potentially important role for mindfulness-based interventions in improving well-being and decreasing recidivism among this at-risk population.
Journal Article
A Mindfulness Model of Therapy
Research on the efficacy of mindfulness-based interventions has progressed over the last four decades, and, with the development of the \"evidence-based\" movement in psychology, many clinicians have sought training in mindfulness and incorporated it into their practice. There have been few books (Germer, Siegel, & Fulton, 2005; Hick & Bien, 2008; Shapiro & Carlson, 2009) that explicitly discuss different areas of application for which the practice of mindfulness can be applied in clinical interactions. Shapiro and Carlson (2009) and Germer et al. (2005) both suggest that mindfulness manifests in therapy as mindfulness-informed therapy, in which the philosophical principles of mindfulness can be applied to therapy; mindfulness-based therapy, in which therapists explicitly teach their clients formal and informal mindfulness techniques they can employ to cope with daily stressors; and therapist mindfulness, in which the therapist him or herself practices mindfulness in order to build therapeutic presence, develop self-awareness, and practice self-care. Of these three areas, mindfulness-based interventions have over whelmingly received the most attention (Baer, 2006) in the field, followed by an increased awareness of therapist mindfulness (Hick & Bien, 2008; Siegel, 2010). Because of our current paradigm's focus on proving interventions to be efficacious, one consequence has been a culture of using mindfulness in therapy simply as a \"technique\" (i.e., a solution to a problem) and rarely anything more. And although mindfulness as a technique is positive (e.g., this technique has proven helpful for many populations) and an integral part of the intersection between mindfulness and therapy, it is only one aspect of the mindfulness model of therapy that I present within these pages.
Book Chapter
Conclusion
In this book I have presented a mindfulness model of therapy as it relates to working with high-risk adolescents. I propose this model as one way, not the way, of incorporating mindfulness into working with this challenging but rewarding population. It is my hope that mental health professionals and authors continue to contribute to the literature on mindfulness-based approaches with high-risk adolescents, so that new and diverse approaches for incorporating mindfulness with this population may continue to develop.
Book Chapter
Group Facilitation
I have chosen to devote an entire chapter to group facilitation in this book because most mental health professionals who work with high-risk adolescents (especially in public agencies) facilitate groups in some form, be they skills groups, substance abuse groups, anger management, and so forth. Because the process and structure of group facilitation takes priority when working with this population, I will not cover specific curricula but rather review the conditions in which an optimal group experience can occur. Therefore, the focus of this chapter will be on the process of developing and maintaining a receptive learning environment in which successful treatment may occur. A \"successful group\" with high-risk adolescents will look substantially different from a group composed of adults seeking group therapy. Adolescents may be more reluctant to engage in self-disclosure, and it may take longer for the group to become cohesive. Because of this, the role of the facilitator is amplified. The facilitator has the potential to influence a receptive learning environment that can, in turn, contribute to a trusting atmosphere, authenticity, self-disclosure, and overall group cohesion (i.e., a \"successful group\"). Once this context is provided, any manual-based curriculum or process group will be more effective with high-risk adolescents. The way in which a facilitator can influence the receptivity of the group includes (1) his or her personal qualities as a facilitator, (2) skillful logistical decisions, and (3) skillful process decisions.
Book Chapter
Teaching Mindfulness to High-Risk Adolescents
In this final chapter, I present how to explicitly teach mindfulness to high-risk adolescents. I have deliberately positioned this chapter at the end of this book because of the misapplication within which many therapists teach mindfulness: as an isolated technique, while paying little to no attention to building an authentic relationship. The ability to engage high-risk adolescents in explicit mindfulness practice is strongly influenced by the conditions set forth in the therapeutic relationship. Thus, it was imperative for me to cover the building of an authentic relationship, the necessary facilitator qualities, working with resistance, and how to approach change and spiritual worldviews prior to presenting methods for teaching mindfulness explicitly. All too often, clinicians look for quick fixes and solution-focused techniques that can benefit their clients. While these clinicians' motivations may be pure, this limited use of the mindfulness practice does not do justice to the power that the therapeutic relationship and its potential for growth has when working from a continually mindful perspective.
Book Chapter
The Paradox of Change
One of the most critical aspects of working with high-risk adolescents is the clinician's personal and theoretical view on behavioral change, or the explicit intention to change behaviors and attitudes. The push for behavioral change is often a charged topic, because it creates a power struggle: most high-risk adolescents either do not see a problem with their behavior and/or do not desire to change it, and most authority figures push, force, and attempt to get them to change their behaviors. As I mentioned in Chapter 1, clinicians can harness certain qualities to become proficient in effectively engaging this population (e.g., authenticity, an intention to connect on a human-being level, and a relaxed stance on behavioral change). The role of behavioral change, how it happens, and our influence as clinicians are all critical elements in the development of a successful therapeutic relationship. Additionally, because most high-risk adolescents are mandated clients (e.g., from parents, caregivers, the court, etc.), clinicians should expect to encounter frequently the issue of behavioral change (e.g., the effect of parents pushing, or legal system forcing, change).
Book Chapter
Core Themes
Concurrent with the exploration of worldview is the presentation of a number of core themes. The philosophical underpinnings of a mindfulness model of therapy I presented in Chapter 1 included the givens of human life: suffering, choicefulness, change, and human connection. It is the mindfulness-oriented clinician that conceptualizes his or her clients in regard to these givens of life (or similar philosophical foundations) and develops a treatment path accordingly. It is no surprise, given that these philosophical underpinnings of life are universal, that the core themes that have arisen in my work with my clients have at their root a struggle with one or more of these givens. I do not suggest that every single high-risk adolescent client that walks into your office or place of business is going to discuss issues that can fit into one of these core themes, or even relate to, agree with, or conceptualize living among them. I am simply suggesting that, if you work with high-risk adolescents long enough, you will indubitably hear stories and experiences that can be conceptualized within such categories. Such stories are fruitful opportunities in which to conceptualize the primary issues occurring within your client and to develop a well thought-out, mindfulness-based treatment path.
Book Chapter