Understanding and Promoting Change

For young people facing issues with alcohol and other drugs, change is not something that can be achieved simply because they really hope to change. Change is what happens when a person is ready for action and they are in an environment that supports that action.

All change is motivated by:

• The desire to resolve or escape problems, or
• To achieve some benefit

The young person's social environment and relationships need to provide the resources and opportunities to make change possible...

Young people need to be able to understand the benefits of making changes and need to be hopeful that change is indeed possible. When a young person attempts to change their drug use but the social environment provides little positive reinforcement or reward of this, or if they are left with a range of unmet needs, the young person can lose hope or confidence. The young person’s social environment and relationships need to provide the resources and opportunities to make change possible and worthwhile.

Jodie is 16 years old and lives in foster care.

"She has been using cannabis and alcohol almost daily for about 2 years but recently showed interest in wanting to cease her use. Jodie was supported by her workers to spend one week at a residential detox to have a break from her use in a supportive environment. Jodie did really well at detox and despite feeling really focused when she went home, she struggled not to use."

...despite her motivation, Jodie struggled to maintain change...

"Whilst Jodie could recognise that she was at a different place than her friends who were all still drinking, she struggled to avoid them. She noticed that it was hard to find a connection with them that wasn’t about drinking alcohol or smoking cannabis and any effort to involve herself in new social groups was anxiety provoking and again triggered her to use. Whilst in foster care, Jodie still had contact with her family and rather than being proud of her efforts at detox, they remained sceptical about her ability to makes changes, telling her she couldn’t do it. Therefore despite her motivation, Jodie struggled to maintain any change to her substance use."

In this way it is useful to understand change as in part dependant on factors in a young person’s environment, not just as a result of will power or strength. 

Factors that support change:

• Supportive relationships
• Safe, stable environment
• Have meaningful education, employment or activity options
• Have experiences that enhance self-esteem and build a sense of worth
• Opportunities to develop skills, knowledge and self-belief

There are some other things to be aware of when supporting someone who is trying to change

They don’t always get it on the first go

There is often a risk that even long after a young person has reduced or ceased their drug or alcohol use that they will use again. Slipping up or returning to old patterns of use are quite normal in the process of making changes. These are actually really good opportunities to learn from. Be patient and understanding. If a young person struggles to stop using despite saying they want to stop or uses after a period of being abstinent, chances are they aren’t trying to upset anyone and they are probably disappointed themselves. Young people are often aware of what those close to them want and have a desire to please, yet may not quite have enough resources to maintain a change.

Motivation varies

A young person’s motivation and ability to plan ahead can be affected by their drug use or underlying issues. This means even when they seek professional help they might struggle to make every appointment. This doesn’t necessarily mean they aren’t interested in help.

The stages of change model offers a way to understand more about change and offers a platform to explore change with young people. However it is not a predictor of how young people will change their behaviours as often young people jump around the stages depending on external factors and motivation.

Building Protective Factors and Reducing Risk Factors

Supporting a young person isn’t just about reducing risk factors or fixing problems, it is also about building on their strengths and adding protective factors in a young person’s life. The more resources young people have to draw from to support their goals, the more success they will have. For instance, learning new strategies that help a young person manage their anxiety is just as important as taking action to cease their cannabis or alcohol use.

The more resources young people have to draw from to support their goals, the more success they will have

For young people living in out-of-home care, it is not unusual for them to feel quite isolated and disconnected and then find a sense of connectedness and identity with peers who have similar experiences, understand them and potentially have similar substance using patterns. A lot of the time, there will be encouragement for these young people to stop associating with their peers in order to support a reduction in their substance use. Unless this young person has established similar connection and belonging with others, they will be left with an unmet need and find it extremely difficult to maintain such change. As such it would be better to support young people to add non using friends or discover new friend groups rather than just “getting rid of” old ones.

It is always important to remember that drug or alcohol use problems don’t usually exist by themselves and instead have a complex interplay with other behaviours or co-occurring mental health issues. There is no simple answer.