Step 5: Negotiate An Action Plan

• Elicit a specific goal
• Collaborate on specific steps
• Explore the challenges of change

Ask Permission

PROVIDER: I'm hoping we could talk about some ways you think you might be able to cut back. What do you think about that?

JOSH: Okay

PROVIDER: It sounds like you have an idea when you've had too much to drink. How many is that?

JOSH: Well, I got really drunk tonight from a six-pack.

Elicit Goal

PROVIDER: What do you think would be a safe number of drinks for you?

JOSH: Maybe two or three.

PROVIDER: Okay, so what is a limit you'd be willing to set for yourself at this point?

JOSH: Um, well I guess I could stick to two drinks.
PROVIDER: Okay, two drinks. So that would be two 12-oz cans of beer, and you mentioned sometimes you do shots, so one 1-oz shot and one 12-oz can of beer might work for you.
JOSH: Yeah I could do that.

Elicit Steps

PROVIDER: What do you think you could do to stick to two drinks, and stop there?

JOSH: Well, I guess I could drink soda, so at least I have something in my hand.

PROVIDER: What would it be like for you to have two drinks at a party?

JOSH: Oh, uh well I could drink along with the guys, just stop sooner.

PROVIDER: And what could you say when someone asks if you want another drink, and you've already had two?

JOSH: Um I could just tell them, "Nah, I'm good for the night." Or ask for some soda..

COACH: If a teen can't think of ideas on his own, you can help him think through challenging situations, like peer pressure.

Explore Challenges

PROVIDER: How do you think your friends will react to you cutting back?

JOSH: (laughs) After tonight, they probably aren't gonna give me a hard time about it.

PROVIDER: Okay, so your friends might understand that you're drinking less so you don't get hurt again.

JOSH: (thinks about it) Yeah, I think so.

COACH: When creating an action plan, it's good to explore the logistics around implementing the plan, and peer pressure is an important consideration. Teens place a high value on what their friends think, so it's good to know how supportive their friends may be and how the teen might respond to peer pressure.

Affirm

PROVIDER: It sounds like your friends will be understanding that you're not drinking as much, so that's good to hear. And Josh, you have some good thoughts about how you can stick to two drinks at parties. I believe you can make those changes.

JOSH: Okay, cool. Thanks.

COACH: Providing genuine affirmation can increase an adolescent's self-confidence in his ability to change.

JOSH THOUGHT: Yeah, two beers. I can totally do that.

COACH: You negotiated an action plan and came up with some specific steps to help Josh stick with it. The more solid and specific the plan is, the more likely that Josh will be able to follow it in tough situations. Once you feel you've solidified the plan enough, your next goal is to summarize the conversation and thank Josh.