First Contact: Giving Personalized Feedback at Assessment

Youth & Drugs and Mental Health: First Contact

Assessment not only functions as a means to determine a client’s appropriateness for First Contact, but also as an opportunity to engage the client in the therapy process. The First Contact materials for personalized feedback at assessment are intended to give the counsellor additional opportunities to engage and inform the client.

Providing personalized feedback on substance use and mental health to clients at assessment serves two distinct purposes. First, it incorporates information on substance use in the general population of youth and provides a normative standard for clients to compare their use. Normative information serves as a way of correcting client misconceptions such as “everyone uses.” This allows for the development of discrepancy, which is believed to increase motivation (Miller & Rollnick, 2002). Second, the information on the relationship between substance use and specific mental health indicators, such as depression, psychological distress and conduct problems, sets the stage for greater awareness of the interrelationship of drug use and mental health symptoms.

To aid in comparing clients’ use to normative data, the counsellor should collect information on the quantity and frequency of use for the types of drugs for which First Contact provides survey data, as well as screen for mental health problems.

Discussing the client’s drug use in comparison with survey data is the next step, thereby increasing the relevance of this feedback. The normative data used in First Contact are from the 2001 Ontario Students Drug Use Survey (Adlaf et al, 2002) of students in grades 7 to OAC. The graphs are specific to youth age 15 and younger or 16 and older. They show prevalence of alcohol and other drug use in the past year as well as the co-occurrence of substance use and mental health indicators such as psychological distress, depression and conduct problems. Generally, youth who use are more likely to experience these mental health indicators than youth who do not use drugs or alcohol. In most cases, the more a youth uses, the more likely that he or she will experience mental health symptoms.

Goals For Personalized Feedback At Assessment

1. Following completion of the assessment, increase client’s interest in participating in treatment by:
   • eliciting reasons for change from the client
   • presenting normative information on youth substance use and its relationship to mental health indicators
   • making drug education pamphlets available
   • clearly describing the purpose and format of the First Contact program.
2. Discuss and address barriers to attending the program.

Guidelines For The Counsellor

1. Give normative information and other summary information gathered at assessment. Review the graphs with the client that are relevant to the client’s age, drugs used and mental health indicators.
   “This graph shows you how many students age 15 and younger (or 16 and older) reported using (substance name; e.g., cannabis). This information came from a survey of students in grades 7 to 13 in Ontario done in 2001. The other graph is from the same survey and shows you what percentage of students who use (substance name) experience mental health concerns such as psychological distress, depression or behaviour problems compared to those who do not use (substance name). Generally, youth who use (substance name) are more likely to experience these mental health concerns.”
2. To personalize this information, ask:
   • “What do you think about this?”
   • “Does this make sense to you? If not, why not?”
   • “Does this information surprise you?”
3. Offer the drug education pamphlets.“Some people may want more information on the effects; for example, physical effects, of the drugs they use. If you are interested in taking any of these pamphlets to read more, please help yourself.”Youth may be uncomfortable taking the pamphlets in front of the counsellor. You may want to have the pamphlets available in a waiting area or outside the counsellor’s office. Do You Know… brochures can be ordered from CAMH by e-mail at marketing@CAMH.net, or by phone toll-free at 1 800 661-1111, or 416 595-6059 in Toronto
4. Introduce First Contact if appropriate.
5. Examine barriers to treatment.“What would stop you from coming to the group on May 15?”
6. Introduce individual counsellors or group facilitators (if not the same person as the assessor) and give their phone numbers and appointments.

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