Module 9: working with young people on AOD issues: learner's workbook

5.4 Worst-case scenario/best-case scenario

Page last updated: 2004

It can be useful to ask young people to consider 'worst-case' and 'best-case' scenarios in response to change.

Some questions that you could use in this strategy are:

  • 'If you were to stop using heroin, what do you imagine would be the worst things that could possibly happen?'
  • 'If you were to keep using heroin, what do you imagine would be the best things that could possibly happen?'
These questions could be varied to include the 'worst-case' and 'best-case' imaginings around change and staying the same.

Task
Continuing a conversation about change using some motivational interviewing techniques
Summary
Distance learners

Task

Question - In terms of the Stages-of-Change model, in which stage/s do you think the best-case strategies might be appropriately used with a young person? Why?
Remember the goal is always to facilitate or lead movement to the next stage of change if the young person is ready.

Continuing a conversation about change using some motivational interviewing techniques

Role play

The following role-play activity will provide you with an opportunity to practise using the three motivational interviewing techniques (good/less good things, looking forward/future directions and worst-case/best-case scenario) for facilitating a conversation about the possibility of change. Remember, this is intended to be a constructive learning opportunity and its success will depend on the way you provide and take on feedback.

Working in groups of three, each participant takes a turn in the following roles:
  • the school counsellor
  • the young person
  • the observer
Read the following:
  • Role play scenario
  • Debriefing sheet
  • Observer worksheet
  • Reflection sheet
Allow approximately 15-20 minutes for each role play including the debriefing. Allow time for role changeover. The Observer will manage time and the debriefing process.

(A good point for student to contact faciltator.)

If you are undertaking this task via distance learning complete the role play with your co-workers. Complete the Debriefing Sheet and the Reflection Sheet and use the Observation Worksheet as a self-evaluation task if you are unable to find an Observer for the role play.Top of page

Role play scenario

Troy (the 14-year-old male from the previous scenario) has admitted that he has been drinking quite a lot, sometimes by himself, to 'get away from things'. However, he doesn't see that there is a problem with his drinking and believes that the teachers should mind their own business. He doesn't really see the point in school because he isn't doing well anyway although he did want to at least finish high school.

Troy says that he sometimes thinks about changing his drinking behaviour, but then things 'get on top' of him and he tends to have a strong urge to drink more often which he says makes him feel better. He also likes having a good time drinking with his mates. He rates himself as being somewhere between 3 and 4 on the scale and seems to be ambivalent about change at this time.

The school counsellor who has been speaking with Troy about his alcohol use and the other problems that have been arising at school.

The counsellor's aim is to:
  • determine what stage of change might be consistent with Troy's current state
  • respond to Troy's elected position on the scale appropriately
  • respond appropriately to ambivalence
  • roll with any resistance from Troy (e.g. using reflection)
  • use one or more of the techniques outlined to provide Troy with an opportunity to explore some of the pros and cons of changing.

Role play debriefing sheet

Those taking the observer role are responsible for facilitating the debriefing.
  1. Ask the person who played 'the worker' to state their response to the role play - what they think they did well and what could be done differently next time.

  2. Ask the 'young person' to give constructive feedback to the worker stating how they responded to their approach. (What was helpful, and not so helpful, including verbal and non-verbal aspects of worker's approach.)

  3. Give the worker an opportunity to comment or seek any further feedback (e.g. 'How was it for you when I ....... ?')

  4. Ask the young person and worker role players to stand physically move away from their seating position and shake off the role. State their real name and two qualities about them which are different from the role they played.

  5. Observers then give constructive feedback to the worker. Finish by restating what strengths the worker demonstrated.
All group members then identify the key learning points of the role play.

Role play feedback sheet

Starting a conversation about the possibility of change using the ten point change scale

Provide feedback on the school counsellor's response to the situation, by giving comments on the following:
  • Communicated in a non-threatening and non-judgemental manner
  • Dealt with any resistance from Troy by responding empathically and using reflection where necessary
  • Approached Troy's apparent ambivalence appropriately
  • Used one or more of the techniques described to continue the conversation about the possibility of change with Troy:
    • Good things/less good things
    • Looking forward/future directions
    • Worst-case scenario/best-case scenario
Top of page

Reflection sheet

Task

Reflect on what you have just learnt and write down your thoughts to the following questions:

Question - What went well in the role play and what didn't go so well?

Question - What would be some constraints that you may come across in this type of situation at work?

Question - What steps might you take in your workplace to apply what you have learnt in this topic?

Summary

Motivational interviewing:
  • is one way to work with some people, some of the time, in some situations
  • is an approach that aims to work with people at their own pace, and addresses the need for change
  • uses a quiet, eliciting style rather than directive approach
  • has application in both specialist AOD and other settings
  • is useful in brief interventions.
Some useful motivational interviewing techniques for working with young people include:
  • good/less good things
  • looking forward/future directions
  • worst-case/best-case scenarios.

Distance learners

(A good point for student to contact facilitator.)

Distance learners should take time now to reflect on their learning, check in with their facilitator and determine their progress.