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Motivating Teens to Make Healthy Choices

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IN DEVELOPING, IMPLEMENTING AND EVALUATING drug and alcohol prevention programs for adolescents, Dr. Elizabeth D’Amico, adjunct professor in the Fielding School’s Department of Community Health Sciences, is regularly reminded of the important role of mental health.

“There is a lot of evidence that youth who have anxiety or depressive symptoms may be more likely to use alcohol or drugs – and that youth who use alcohol and drugs also tend to show anxiety and depressive symptoms,” says D’Amico, a licensed clinical psychologist who, in addition to her Fielding School faculty position, is a senior behavioral scientist at RAND. “As a result, it’s important to provide opportunities for youth to discuss why they might want to use, and to help them understand that there are healthier ways to address these feelings.”

Through programming in a variety of settings, D’Amico is providing outlets for youth to discuss and better understand why some are drawn to using alcohol and drugs, dispelling myths about the prevalence of use among their peers, and empowering them to consider the healthier options available to them. Her programs employ an evidence-based approach called “motivational interviewing” that emphasizes respectful interactions, listening to the youth, and supporting them in meeting their goals. “We try to reach them in innovative ways, because we know that most teens aren’t going to access traditional services – whether it’s because they don’t see a need, are concerned about confidentiality, or don’t know how to find the necessary resources,” she explains.

CHOICE, a program D’Amico developed for middle school youth in Southern California, differs from typical school-based programs designed to prevent alcohol and drug use in that it is voluntary and held after school. Offered in five sessions during which youth can drop in at any time, the program provides snacks as well as answering questions – a setup designed to reduce barriers to attendance. D’Amico has found that youth who attend the program are less likely to initiate alcohol and drug use, and that schools offering CHOICE have overall lower initiation rates than schools that don’t have the program, even among youth who don’t choose to attend.

Among her other initiatives, D’Amico is teaming with Dr. Daniel Dickerson, an Alaska Native (Inupiaq) addiction psychiatrist at UCLA’s Integrated Substance Abuse Programs, to implement a program for urban Native American youth that integrates motivational interviewing and traditional practices. She also heads a major effort to learn about factors that predict initiation of alcohol and drug use. D’Amico’s study examines substance use patterns over eight years among a large and diverse sample of youth, beginning in middle school and high school and continuing through their late teens and early 20s. “We hope this will help us identify both successful prevention strategies and factors associated with lower likelihood of initiating alcohol and drug use, so that we can better tailor our approaches in developmentally appropriate ways,” D’Amico says. “Teens are often in vulnerable positions and have a lot of choices to make about risk behaviors. Providing them with evidence-based programming and information that can help them make the healthier choice is extremely important.”