Dangerous Journeys

1. Dangerous Journeys A metaphor for passage through the teen years Marvin Krank

2. How can we help youth get through these perilous times

3. Mixed messages

4. Justsay no!

5. Project on Adolescent Trajectories and Health (PATH): social context, cognition, risk-taking behaviour, and health outcomes • Three-year longitudinal study • Funded by the SSHRC and CIHR • Partnership with SD#23

6. Overview of theoretical approach Social Context Health Outcome Cognition Behavior • Social factors modify cognitions about risky behaviors • Cognitions affect transitions to risk-taking behavior • Risk-taking behaviors impact on health outcomes

7. Life style choices begin in adolescence Drug and alcohol use begin in the early teens Many smokers begin before age 14 Risky choices have long-term consequences for youth early pregnancy accidents unhealthy lifestyles lost opportunities

8. Grades 7-10 are a time of significant transitions in drug and alcohol use

9. Different patterns in use of marijuana Experimentation with marijuana occurs during the study period Regular use of marijuana also occurs during the study period Source Krank and Johnson (1999a,b)

10. A small, but significant percentage of these youth used drugs and alcohol in the past week

11. Why weshould care

12. Adolescent risk is based on what they do Unsafe sex in youth leads to teen pregnancy, low birth weight babies, and STDs including HIV Drug and alcohol use increase unintentional injuries, the leading cause of death in youth

13. Health Aches and pains Accidents Hospitalization Violence Victim Perpetrator Various kinds Bullying Assault Sex Early sex Regretted sex Sexual assault Problembehaviours Skipped school Stayed out all night without parent permission Damaged property Warned or detained by police School detention Stole something outside of home Stole at home Suspended out of school Suspended in school Ran away from home Carrying weapons Early and heavy alcohol use is correlated with many negative outcomes

14. High risk behaviours tend to co-exist Drug and alcohol use, early and unsafe sexual activity, and violence tend to co-occur For example, heavier drug and alcohol use is linked to being both a victim and a perpetrator of sexual assault.

15. Drug and alcohol use are highly correlated

16. General Bullying - Past Year Percent of Students Involved

17. Aggressor violence is related to alcohol use

18. Dating and sex • 1/3 of grade eleven students have had sex • 2/3 of females had sex under influence of alcohol • 43% of the girls have given oral sex • ½ of the girls regretted having sex • 14% of grade 9-11 girls have been physically harmed by their dating partner • 26% of drinkers and 28% of marijuana users have been physically harmed by their partner.

19. General problems and alcohol use

20. The social and cultural roots of these cognitions • Parents • Peers • Personality • Pop Culture

21. The effects of advertising • $1Billion/yr • 70% on TV • 22% magazines • 50% on Saturday and Sunday • 33% between 8-11 pm

22. Tuborg

23. Crying

24. Social Context Cognition Behavior Thoughts lead to actions • Social factors modify cognitions about risky behaviors • Cognitions affect transitions to risk-taking behavior

25. What do you expect to happen if you drank a moderate amount of alcohol Write down three or four things that would happen to you.

26. Thoughts precede actions Cognitive changes occur during these years. These changes predict who will take risks. Changes in expectancies occur before changes in behaviors

27. Modern Risk Prevention Programs • Discuss social influences • Offer skills training – alternative behaviours • Correct misperceptions about norms • Focus on changing false expectations

28. Contemporary Evidence-based Methods • Less confrontational – empathetic and roll with resistance • Motivate change – encourage discrepancies by realistic feedback • Meet individuals where they are – Age and Stage appropriate • Non-users • Experimenters • Users • Brief interventions

29. Cognitive Expectancy challenge “More is less” is a general point What else could you do is an exercise for the youth, ask questions, but be ready to help answer with healthy alternatives that they would like.

30. What can you do? • Goal is to change or prevent risky expectancies • Parents can and do make a difference The problem is how do you do that?

31. When to talk to them • Quiet times when the opportunity arises • Away from friends and siblings • In the car • Watching TV – e.g. TV commercials

32. Try to speak their language

33. How to talk to your kids • Listening first • Four principles • Be understanding and try to see things from their perspective “That must be difficult” • Present facts contrary to what their long term goals “Smoking marijuana interferes with learning and memory. I wonder how that might influence getting into university?” • Don’t confront or challenge work around the issue • Be supportive and positive about your child “You can do it” • Be prepared and tell the truth – www.ouc.bc.ca/path

34. Conclusion • The real war on drugs is the battle for the hearts and minds of our youth • We don’t want to prevent them from taking the journey, but we do want them prepared for challenges along the way.