I’m constantly at a loss for how to do effective CBT with the adolescents, since they don’t really want to take the initiative to consciously change their thought process, and it makes complete sense- what 16-year old ever thought, “let me analyze my negative outlook in this situation and see how I can make it more positive.”
Even though their main occupation isn’t play anymore, a lot of what we do with the adolescents is engage in therapeutic activities with them, so while playing they can verbalize the thought process we are trying to encourage, or we can sneak it in there with a closure or summary statement at the end of group when we are processing. I still feel like it goes in one ear and out the other.
I feel like it is sometimes difficult to use occupation-based treatment in a partial hospital setting because of all the restrictions involved, so I was trying to think of a therapeutic activity that would be purposeful like the games we play but something in which the kids would still be interested.
I’m a personal fan of Postsecret, and knowing how the site works conjunction with the Suicide Prevention Hotline, I thought it would be a perfect activity to do with my teenagers. I already had the idea in mind, but I read more about it on Karen’s blog and got more ideas from her post on how to introduce the activity so it has a therapeutic purpose to it, rather than just taking the risk of opening Pandora’s Box.
I basically said that when people are majorly depressed or stressed, we tend to forget that we have a wide variety of supports to choose from-whether they be peers in partial hospital, or community supports like from Postsecret. The good thing about Postsecret is that anyone can share anything, large or small, and anyone can join the community- by contributing or even just by viewing the site every Sunday.
A lot of the teenagers I work with say they have difficulty expressing themselves or feel like they can’t share what they’re going through, so I also said it was a creative way to get something off your chest that is difficult to say in words, or you can’t actually share with the person to whom you want to express yourself. Or, it could just be something you’ve discovered about yourself- whether it be a coping skill or a quality to trait- that you want to share with the world.
The kids loved it! It was so cool to see their awesome artwork, and receiving compliments on their creativity itself was a great way to meet self-esteem goals. When we processed at the end of the group, each kid had to share their craft, and express something about how their craft is related to coping- even if it was just stating that expressing themselves SOMEHOW to SOMEONE instead of stuffing felt better. In doing this activity, the kids were able to do something purposeful and verbalize a change in their thought process that could help them work on their coping skills.
PS- even though I earlier said that I didn’t want to open Pandora’s Box, I meant that I just wanted to make sure that I could tie the point of the activity to a therapeutic purpose. I still let the kids talk about negative “secrets” because I could control where that discussion went during group processing.