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Subject Code:  P H   E   1  0  2  Study  
Period:

Subject Name:  Individual Determinants of Health

Name of Document:  Enquiry 2 Poster

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 Working with Adolescents
Enquiry 2 –Alcohol Consumption
Case scenario of Lauren

Lauren’s problematic behavior and alcohol consumption

Rob’s unhelpful actions/comments and modification
Lauren’s problematic behavior: Lauren’s resistance towards change and new experiences is a consistent problematic Action Example Explanation modification
behavior that seem to have a negative impact on her overall wellbeing.
The problematic behavior is evident in the case where Rob has constantly suggested her physical exercise, adherence to
Rob does not “(Interrupting) yes, but it was In both examples, Rob does not Taking evidence on the matter
her asthma medication, sports and other activities at her school and a wider social circle. Similarly, Laurel’s resistance to
validate Lauren’s only a low grade tear, wasn’t validate Lauren’s present under consideration, Rob may
read the pamphlet for her medications is also evident. feelings it? You should have been over emotions about her self-image. benefit by saying ‘I understand
Resistance to change and lack of openness towards new experiences is a common adolescent behavior (Caldwell & that by now…” For example, when she that it must be hard for you but
Darling, 1999). Research suggests that most adolescents have a negative attitude towards trying new activities to   discusses that her leg hurts, what seem to be triggering your
benefit their social and personal life because change is considered a challenge to form an independent identity in the “…not if you continue to drink Rob interrupts and confronts leg pain’.
society (Pfeifer et al., 2011). Lauren’s reluctance can be seen in the case; she may feel conscious about her weight to try like you do Lauren and her with a condescending Effective communication skills
physical activities at school, therefore, she may use her leg injury as an excuse. Similarly, she does not want to try continue not to do any sport or tone. Research suggests that infers that validating a teen’s
making new friends as she may feel out of place with them limiting her to hang out with a few friends in their exercise.” validating patient’s feelings feelings will open room to
basement.   build rapport as they view gather more data and motivate
Her resistance to change has a direct link with her alcohol consumption as she suggests that she drinks with her friends their practitioners them (Kim & White, 2018). Rob
only. Research suggest that often adolescents suffer with finding their place in social circles, prompting them to engage understanding their struggles can also encourage her about
(Kim & White, 2018). losing weight by saying ‘I have
in activities due to peer pressure of fitting in (May, 1993). It can be possible that Lauren also feels that she shares similar
no doubt that you can manage
interests with her group and therefore engages in similar activities without trying out any healthy outdoorsy things. your weight, however sports
Additionally, those individuals who usually are reluctant to try new experiences tend to find excuses to get out their and exercise will help speed it
comfort zone i.e. lack of exercise. up and make you healthy’.
Link between problematic behavior of Lauren and her adherence to asthma medication
Lauren’s resistance to change is a problematic behavior which overall impacts her health. However, as mentioned
above, her sedentary behavior is a result of her apprehensions about trying out new things. As she is not opening
herself to meet new people, try new activities, her judgment and executive functioning is poor and limited, which in Rob does not ”..Everything I say in here... I Confidentiality is a cornerstone A plethora of research suggests
return makes her believe that she does not need to change. She does not adhere to her asthma medication regime discuss consent and mean you’re not allowed to in maintaining an effective that practitioners should
because she does not try to read the pamphlet, moreover, she knows it is the first step towards changing her lifestyle. limits of tell my parents or anything?” patient doctor relationship. maintain adolescent’s sense of
Therefore, her own resistance does not allow her to stick to her asthma medication and feel healthy to try sports and confidentiality with   Legally it is documented that autonomy and explain those
tennis again (Pfeifer et al., 2011). Lauren Absolutely, things like this are information while treating the conditions when they will have
Rob’s helpful actions and comments just between you and me minor can be shared with to include their caregivers
Lauren. So how big is the cask? parents based on specific (Middleman, Olson, & Blake,
Action Example Explanation conditions such as self-harm 2017). . Rob could have
(Middleman, Olson, & Blake, benefited by saying “yes,
Rob is reassuring and “yes I can understand that you It appears throughout the conversation that Rob 2017). In the given examples, anything you share will be
determined must be feeling frustrated appears to be determined to find the reasons behind Lauren clearly asks rob that between us however, I will have
Lauren, I’m confident that we will laurel’s risky behavior and overall wellbeing. By everything she says will not to include your parents if you
be able to get to the bottom of emphasizing on administrating all the necessary tests reach her parents (such as engage in self-harming behavior
this” and reassuring her, rob is building rapport with her drinking), and Rob does not set etc.’
and encouraging her to believe in the assessment and the limits of confidential
results. Study suggest that adolescents prefer those information.
practitioners who are honest with them and reassure
them which consequently tackles building anxiety
and fears about their health (Wilkes & Anderson,
2000; Schmitt, 2009) Rob breaks Lauren’s I’d also like to address Lauren’s Rob caught Lauren off-guard in Rob could arrange an
trust drinking front of her family by bringing appointment with Lauren and
the subject of her drinking explore her apprehensions
Rob engages Lauren “What do you mean Lauren, Research claims that engaging a teenager or an without seeking her about including her family and
what’s a typical weekend for adolescent in a conversation regarding their permission first. He broke her sharing this piece of information
you?” maladaptive behavior can be tricky for the trust after saying that he will and encouraged her to seek
“What do you get up to on the practitioners due to a number of factors (Bennett et keep the information to their support instead of
weekends, do you play sport or al., 2017) (including age difference) however, there himself. Research suggest that breaking her trust and creating
anything?” are a few remarkable strategies that allow the GP to teenagers perceived sense of feeling of hostility in her. He can
  engage and pique the interest of their patients emotional safety and trust is say, ‘Lauren, how you think your
(Yonker et al., 2015) such as here, rob cleverly asks positively correlated with their mother will respond upon
questions about Lauren’s weekend to not only engage engagement and trust in the hearing about your alcohol
her in a conversation about her life but also to gather practitioner (Kim & White, consumption?’
data about her activities that may be precipitating her 2018)
lack of energy and mood swings.
Click to edit add your responses
Rob seemed to join ROB: is that true Julie, has Adolescents want health Research suggest that
Rob educates Lauren “A litre of wine plus other drinks In the examples given, it is apparent that Rob clearly forces with her Lauren’s health and school practitioners to be their adolescent are at an age where
about risky behavior in one go can have a dramatic educates Lauren about the effects of alcohol family against work deteriorated since she’s advocate whereas Rob seemed they trust others only when
effect on your health” consumption on her developing brain such as Lauren’s social circle met... I’m sorry, what were to team up with her family and they know that you are on their
“Did you know that as well as ‘dramatic effect on your health’. Additionally their names? talked about Lauren’s friend side and advocate for them in
increasing energy levels a bit of literature also suggest that adolescents sometimes   being a negative impact on her, front of others (Ginsburg, 2011).
exercise can do wonders for your lack factual knowledge and having a clear I don’t want to go into details which may create a feeling of Rob could have kept his advice
mood? It makes you feel less understanding of risky behaviors is positively but I think Lauren would be hostility between them and general and simply suggested
stressed, more energised, and associated with informed decisions they make. well served to make some make her feel that she cannot that ‘perhaps Lauren maybe you
can make you feel more Moreover, addressing any fables such as other friends, and avoid seeing trust him. would like to broaden your
clearheaded – easier to misconceptions about alcohol in young people e.g. those friends for a while. social circle and try new
concentrate. It would do Lauren suggesting that she doesn’t drink that much activities’.
wonders for your school work” which maybe affecting her health, is also necessary
and Rob not only addressed those but suggested the
positive changes Lauren can have in her life by
controlling her alcohol usage by saying ‘it would do
wonders for you schools work and your mood’. Theoretical models to motivate Lauren and assist in modifying her alcohol use
The two models which will allow Rob to motivate Lauren and modify her risky behavior of alcohol consumption are
motivational interviewing and the trans-theoretical model.
Rob incorporates family “all I would like to suggest is that Having a sense of belonging and support system for Motivational Interviewing has been used widely to modify an individual’s drinking behavior. It is defined as a patient-
to build support we should all work together to an adolescent during an illness is instrumental in centered and directive counseling style to modify behavior by helping the person explore and resolve their ambivalence
help Lauren take her medication, their recovery and treatment (Catalano et al., 1990). towards change (Hettema, Steele & Miller, 2005).
exercise more” In this example, it can be seen that rob addresses the Whereas, the trans-theoretical model, developed by Prochaska and DiClemente (1970s) is defined as an intentional change
immediate family of Lauren and encourages them to
model which focuses on individual’s decision making by facilitating the nonlinear stages of change. It operates on an
work together for her benefit. He explains that if
family members remind her of her asthma assumption that behaviors do not change decisively and quickly, rather it occur continuously with the help of cyclical
medication, help her exercise, it will do wonders for process (Marshall & Biddle, 2001).
her. Using both models to modify the behavior
In order to modify Lauren’s drinking problem while keeping her resistance to change, it is important to assess that current
stage of her behavior change on TTM. Based on the conversation between Rob and Lauren, it appears that Lauren is at the
contemplation stage of her of behavior change i.e. where she is aware of her problematic behavior and intends to modify it
References (Buultjens & Buultjens, (2017). She seemed to be in understanding that her lack of physical activity and alcohol
Bennett, E. D., Le, K., Lindahl, K., Wharton, S., & Mak, T. W. (2017). Five out of the box techniques for encouraging teenagers to engage in counseling. ACA consumption may have been affecting her decision making skills, her judgment and working memory (forgetfulness of
Knowledge Center.
Buultjens, M., & Buultjens, P. (Compilers). (2017). Individual determinants of health and human behaviour. Melbourne: Pearson Australia. asthma medication regime). At this stage, Rob can move Lauren to the other model by using a principle of MI which is
Caldwell, L. L., & Darling, N. (1999). Leisure context, parental control, and resistance to peer pressure as predictors of adolescent partying and substance developing a discrepancy. It will help her to become aware of her unhealthy behaviors at the moment and the goals that
use: An ecological perspective. Journal of leisure research, 31(1), 57-77. she wants to achieve, utilizing an important tool of MI i.e. goal setting (Marshall & Biddle, 2001). A mutual discussion will
Catalano, R. F., Hawkins, J. D., Wells, E. A., Miller, J., & Brewer, D. (1991). Evaluation of the effectiveness of adolescent drug abuse treatment, assessment allow Lauren and Rob to note down the short and long term goals in the next six months that Lauren will strive to achieve in
of risks for relapse, and promising approaches for relapse prevention. International Journal of the Addictions, 25(sup9), 1085-1140.
Ginsburg, K. R. (2001). Setting the Stage for Effective Communication with the Adolescent Patient. CommonHealth: The Journal of the American order to modify her alcohol consumption and her physical activities.
International Health Alliance, 9(1), 25-27. As Lauren will prepare for this change i.e. preparation stage of TTM, Rob will keep in mind the next principle of MI, i.e. roll
Hettema, J., Steele, J., & Miller, W. R. (2005). Motivational interviewing. Annu. Rev. Clin. Psychol., 1, 91-111. with resistance. It is already discussed that one of the problematic behaviors of hers is resistance to change, her
Hutchison, A. J., Breckon, J. D., & Johnston, L. H. (2009). Physical activity behavior change interventions based on the transtheoretical model: a systematic ambivalence can be managed by using another tool i.e. readiness ruler ranging from 0 to 10 with 10 being the highest. It
review. Health Education & Behavior, 36(5), 829-845.
Kim, B., & White, K. (2018). How can health professionals enhance interpersonal communication with adolescents and young adults to improve health
will help her keep a check on her motivation to change as well as motivate her to move further along the rule to achieve
care outcomes?: systematic literature review. International Journal of adolescence and Youth, 23(2), 198-218. next goal such as from limiting her alcohol consumption from one cask of wine to few ounces; additionally jogging/walking
Marshall, S. J., & Biddle, S. J. (2001). The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise. from 20 minutes daily to half an hour.
Annals of behavioral medicine, 23(4), 229-246. Similarly, it is important for Rob to communicate and work on Lauren’s self-efficacy which will help her overcome her
May, C. (1993). Resistance to peer group pressure: an inadequate basis for alcohol education. Health Education Research, 8(2), 159-165.
Middleman, A. B., Olson, K. A., & Blake, D. (2017). Confidentiality in adolescent health care. UpToDate. reluctance and change her lifestyle. Instead of coercing, Rob will mutually draw small social tasks or experiments to activate
Pfeifer, J. H., Masten, C. L., Moore III, W. E., Oswald, T. M., Mazziotta, J. C., Iacoboni, M., & Dapretto, M. (2011). Entering adolescence: resistance to peer new behavior such as say hello to a new class mate. Her success in these small tasks will reinforce her motivation to try and
influence, risky behavior, and neural changes in emotion reactivity. Neuron, 69(5), 1029-1036. change her behaviors, therefore, moving her along the next stage of action in TTM (Hutchison, Breckon & Johnston, 2009).
Schmitt, B. D. (2009). Pediatric counseling. In Developmental-Behavioral Pediatrics (pp. 847-855). WB Saunders.
Wilkes, M. S., & Anderson, M. (2000). Topics in review: a primary care approach to adolescent health care. Western Journal of Medicine, 172(3), 177.
Yonker, L. M., Zan, S., Scirica, C. V., Jethwani, K., & Kinane, T. B. (2015). “Friending” teens: systematic review of social media in adolescent and young adult
health care. Journal of medical Internet research, 17(1), e4.
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