Discussing parental support
Good options
Provider: Do your parents know how you feel about all of this?
Justin: Not really... They love it here, and, I don’t know, I don’t want to bring them down.
Provider: Have you tried to talk to them about it?
Justin: Maybe a little when we first moved. But they said this is such a great town, and the school has a really high rating and more classes and I’ll get used to it and blah blah blah. But they don’t know what it’s like to be there, you know.
- Advice: Motivational Interviewing encourages asking open-ended questions, but a closed-ended question delivered with sympathy and attention can still be consistent with the spirit of MI.
Provider: Your parents are really happy in this new town, and you’re worried that your feelings might ruin that.
Justin: I mean, we moved here so my mom could start her new job, and it’s, like, exactly what she wants to do. And my dad is happy meeting new people and, I don’t know, just seeing my mom so happy. It’s… this move seems like a great thing for them, and I don’t want to be the big problem.
- Advice: This reflection validated Justin’s feelings and encouraged him to open up.
Bad option
Provider: You really should tell your parents about this. They might be able to help you figure out what to do.
Justin: But I talked to them about the school and the move like months ago, and they didn’t really get it. They think this town is, like, the best place ever.
Provider: Well maybe you could try talking to them again. Being a teenager isn’t easy, and your parents understand more than you think.
Justin: Sure, whatever. I’ll talk to them.
Justin’s inner thought: Why can’t adults ever listen? I already said they didn’t get it, I’m not gonna talk to them again, it’s pointless.
- Advice: Dictating this idea to Justin isn’t productive. Not only can you not know what his parents will understand or not, it also makes you into the authority figure and doesn’t allow Justin to actively participate in the discussion.
Discussing Suicide
At this point, Justin says:
Justin: (distant) Sometimes I just want to give up on everything. I mean, I’ve got nothing to look forward to, so why even try?
It’s best to respond to suicidal statements like this by asking Justin directly about his ideation and intentions. Asking directly won’t put the idea in his head if it isn’t there already.
Good option
Provider: Are you thinking about killing yourself?
Justin: (momentarily speechless) Um… I guess… I would never actually do it, but sure, sometimes I wish I wasn’t… Yeah, I’ve thought about it. Sometimes I wish I just didn’t have to deal, you know?
Bad option
Provider: When you say you want to “give up on everything,” you’re not talking about suicide, are you?
Justin: Uh… no. No, I’m not crazy.
- Advice: Asking about suicide like this, by implying a correct answer, is never a good idea. It may discourage Justin from opening up to you, or anyone else who might be reaching out to him, for that matter.