See also
Pros and Cons (Decisional Balance) exercise for video role play...
This is a technique (also known as "
decisional balance" but ultimately a version of a
"cognitive challenge") that is designed to elicit thinking (
Mentalizing) about a specific
behaviour (eg drug use), or a specific
cognition (eg a belief that the young person is perceived to be clinging to, which the therapist believes may be associated with other symptoms - such as the depressive cognition
"I am useless").
Materials/techniques:
- Paper, pens
- Use a diagram of a set of weighing scales (this is apposite for young people who may have seen dealers weighing out cannabis)
- one pan for PROS
- one for CONS
Start with the PROS first, not the CONS.
- Avoiding starting with the cons first is an Engagement technique from Motivational Work
- Invite the young person to reflect (Mentalizing) on why they like Cannabis/other drugs, or why they agree/support the cognition in question.
- Only prompt when they get stuck:
"I am thinking to myself, that there may well be more reasons than that - most people don't do something unless they are getting something back..."... in the case of drugs this might be:
- Pleasure (never deny the possibility of this)
- Socialising
- Joining techniques? A way to join a group in which the young person is less confident (Cue discussion of SocialEcology)
- "Psychonauts" - exploring the intriguing fact that "I have this thing called a mind!", creativity, etc (Consider the possibility that this is a form of Pseudomentalizing?)
- Self-medication (a "Smokescreen" to blank out trauma, depression, etc) - see Assessment for SUD-Rx.
- ...others
Move on to CONS
- If there are none, consider the Stages of Change and Adapt your Discourse accordingly.
- Be very careful to Roll with Resistance (a principle from Motivational Work)
- Use Normalising techniques to suggest possible cons that "other young people have told us about":
- Cost ("We can agree that it could be cheaper!")
- Criminal record
- Interference with academic work or employment
- Disruption of family/other relationships ("...So you don't have any particular problems with the weed, but when you smoke it your family go ballistic and THAT is a drag for you - have I got that right?")
- ...others