First Contact: Activity Modality

Youth & Drugs and Mental Health: First Contact

Session 1: Decision to Change activity

Materials

• A bowl of small treats like popcorn, jelly beans or smarties
• Two paper plates or cups per person. One is labelled “good things,” the other, “not-so-good things”
• One copy per person of the Decision to Change exercise
• One copy of the list of prompts

Getting started

The group sits in a circle with the two plates in front of each person. The therapist has a Decision to Change exercise sheet for each person in the group and will record participants’ answers on their sheet.

Introduce the activity

We would like to talk about some issues you may be struggling with in deciding to change (reduce or stop) your drug use. What will you gain or lose by changing? What about not changing?

The activity

Pass the bowl around the circle. As each person receives the bowl, they talk about a good thing about their drug use, take a treat from the bowl and place it on the “good things” plate. The therapist records each person’s response on their exercise sheet. If clients have difficulty generating good things or not-so-good things, refer to the prompts list. Keep going around until everyone has talked about all the good things about their use that are important to them. Next, go around the group to have clients talk about the not-so-good things about use, and put a treat on their “not-so-good things” plate. Again, keep going around until everyone has had a chance to talk about as many not-so-good things about their drug use as they can think of.

Repeat the activity for the good things and not-so-good things about changing your drug use. In residential settings, with youth who are not using you may just want to do this part of the activity, although many of them may find it helpful to reflect on the pros and cons when they were using.

Discussion

• “When you compare the number of treats on each plate, how mixed are your feelings about making a change?”
• “Which costs (or benefits) are most important? Why are you concerned about those costs?”
• “What are some of the fears or hopes that you have right now?”

Session 4: Stages of Change activity

Getting started

Designate places in the room for each stage of the change process.

Introduce the activity

“This exercise is a way of figuring out where you are at. Change is like taking a journey. Some people aren’t interested; others are uncertain and are just thinking about it; and others are preparing themselves, and so on. Let’s look over the stages of change.” (Read out loud each of the stages.)

The activity

Go to the spot that reflects the stage you were in when you first came to the group. Now go to the spot that reflects the stage you are in now.

Discussion

• “What led to the change (if any)?”
• “What are the next steps (e.g., coping strategies, treatment referrals)?”

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