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Confronting the New Anxiety - Page 8


Advice isn't something to hide from your supervisor or peer supervision group; it's an absolutely essential aspect of treating 21st-century teens. There's nothing wrong with saying to young clients: "Read your e-mail to me and I'll tell you whether, in my opinion, it sounds okay to send. . . . When they get into your car, it's your responsibility what happens. . . . It'll be almost impossible to keep crashers from your party; it's a huge worry to deal with. . . . If you approach that kid in front of his group, he'll most likely turn down your offer. . . . Don't think that will be kept a secret; everybody will know by the end of the day." But certain guidelines are important. To give effective advice in treatment, a clinician needs to get the whole story, with as many nitty-gritty details as possible, while trying to suppress the almost hard-wired therapeutic urge to ask, "How does that make you feel?" It's also very important to let kids know that their situation deeply touches you; this isn't the time to retreat behind clinical neutrality. And, finally, it's essential you say that you won't be there to see whether your advice is taken.

For example, Jimmy, 16 years old, asked me if I thought he should drive a bunch of his friends to a party after the prom ended at 2 a.m. The prom would include tequila-braced punch, and the after-prom party was 100 miles away. Jimmy had a beat-up old car, a girlfriend to impress, and a couple of pals he'd already made promises to. Jimmy's parents weren't thrilled about this plan, but told me, "This is what kids do now. We basically trust him; he's a good driver, and he'll have a cell phone." Jimmy was ambivalent--he felt important, but was worried about the responsibility.

Me: How much will you have had to drink by the time you leave the prom?

Jimmy: Somewhere between six and eight drinks--but it's over a long night, and the drinks are pretty weak.

Me: And your friends?

J: Oh, they'll be wasted. I'm the designated driver. That's why I have to drink less that night.

Me: And you think six to eight drinks is taking it easy, right?

J: Yeah. I'm not going to be chugging. I'll be eating all night, and look, I weigh almost 175 pounds.

Me: I think you're absolutely out of your mind. I know I can't stop you, but I don't think you should do it. No way!

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