An Integrated Approach to Young Adult Mental Health Rehab

5 DBT Tools to Help Young Adults in Assessing Risk

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There are always risks in life. But during a pandemic, even everyday activities can feel risky. Young adults are struggling right now to balance concerns about keeping themselves and others safe with their natural developmental need to connect with others and explore their world.

Because the brain’s prefrontal cortex, which controls self-regulation, is not fully developed until our mid-20s, young adults tend to take more risks than their older counterparts. That’s part of the process of creating autonomy and establishing our own identity, says Newport Executive Director Leigh McInnis, LPC. Emerging adulthood is a stage of life that is typically about expansion and discovery, and that involves risk-taking.

Taking risks can help us overcome fear, achieve our goals, and make new connections with others and with our own strengths and passions. On the other hand, risky behaviors such as substance use, unsafe sexual activity, and, currently, activities that expose us or others to COVID infection can endanger both mental and physical health. Unfortunately, it’s not always easy for young adults to discriminate between levels of risk or to make choices that will ultimately serve their short- and long-term growth and development. Moreover, while some young people don’t spend enough time considering the consequences of their actions, others are paralyzed by fear and anxiety, which can be heightened by external stressors and pressures such as the current pandemic.

Know the Facts

Research shows that young adults and adolescents weigh the pros and cons of decisions differently from adults, overestimating the rewards of a decision while inaccurately assessing risk possibilities.

Dialectical Behavioral Therapy (DBT) offers approaches that support young adults in assessing risk, considering all sides of an issue, and learning from both failures and successes. “DBT interventions can help young adults make productive, informed choices that take into account the natural consequences of their actions,” Leigh says.

Here are five strategies drawn from DBT that can support young adults in assessing risk as part of their decision-making process.

1. Balance the benefits on both sides.

Research shows that young adults and adolescents weigh the pros and cons of decisions differently from adults, overestimating the rewards of a decision while inaccurately assessing risk possibilities. So the downside of a risky choice—for example, the health risks of smoking cigarettes—holds less sway over them than the perceived benefits, such as fitting in with peers or looking cool with a cigarette in hand.

“Young people’s brains tend to respond more to reward while older adults tend to weigh risk more heavily than reward,” Leigh explains. “As parents and treatment providers, we need to support young adults to identify the benefits of a behavior when they don’t see the immediate reward. What is the benefit to delaying gratification or to resolving this conflict?” In the example of smoking cigarettes, the immediate benefits of being able to breathe more easily and maintain fitness performance will have more impact on a young adult than the risk of future health issues.

“Young people’s brains tend to respond more to reward while older adults tend to weigh risk more heavily than reward. As parents and treatment providers, we need to support young adults to identify the benefits of a behavior when they don’t see the immediate reward.”

Therefore, weighing pros and cons is a primary DBT skill that gives young adults a more complete picture of the potential consequences of their behavior. One way to do this is to encourage them to create a visual representation of the risks vs. the rewards, using a pie chart or lists. Young adults might also rate how important each benefit of the behavior is to them on a scale of one to 10.

“This helps them to see, compare and ultimately highlight the likely outcomes,” Leigh said. “Moving information from the emotional mind to the rational mind enhances problem-solving skills and executive functioning.”

2. Look for insight in past experience.

Another supportive DBT skill involves looking back at how similar situations have unfolded in the past, as a way to assess your risk tolerance. “Ask yourself, what’s a time that I overcame something similar, used a similar skill, or challenged myself in a similar way, and what did I see come out of it,” Leigh suggests.

Bringing to mind the positive and negative aspects of the experience, as well as the way they reacted to it, helps young adults bring greater awareness to their decisions. Where were the pain points? How did they manage the anxiety associated with the risk? Were the results worth the anxiety and pain? Or did they end up ultimately creating problems or obstacles? Sometimes we try to put past experiences, especially difficult ones, out of our mind. But recalling them in detail can help in assessing risk to support wiser choices in the future.

3. Bring in additional perspectives.

No matter how strongly you feel about something, there’s always another point of view. Young adults can consider asking the opinion of a person or several people who will offer thoughtful counsel—family members, a significant other, close friends, or a trusted colleague or mentor. Do they see the situation the same way you do, or can they offer a new angle or illuminate something you’re not focusing on?

Moreover, young adults can bring in another perspective by stepping outside their own POV. This strengthens their ability to consider all sides of an issue, and to observe their own opinions more objectively.

“If you were going to give a friend advice, what would you say?” Leigh asks. “Before making an impulsive choice, try taking a point of view that’s not just your isolated perspective, driven by what you want in that moment.”

4. Consider the impact, for yourself and others.

When assessing risk, DBT suggests looking closely at the consequences. When considering how your action may impact others, ask yourself, Who will be impacted? Is the effect on that person your responsibility or concern? If yes, do you have power over how they will be impacted?

DBT recommends considering the following when evaluating whether to say yes or no, either to a risky choice or to a request from someone else:

  • Your capability
  • The priorities you hold
  • Possible effect of your actions on your self-respect
  • Whether you are well prepared to take the action
  • How your action will impact your long- and short-term goals.

Let’s say you’re deciding whether or not to go skydiving. You’ll want to consider emotional factors, like your level of anxiety, and practical factors, such as how much it will cost. You’ll want to look at longer-term impacts, such as how achieving this goal might support your self-esteem or life satisfaction. And you’ll want to look at your ability to cope physically, emotionally, and financially should things go awry—for example, if you break your leg upon landing. All of this information can influence your decision.

5. Reflect on the outcome.

After the choice is made, action is taken, and the consequences are clear, self-reflection can help young adults reap wisdom from both failures and successes. Reflecting on the motivation for the choice, the desired outcome, and the actual outcome supports better decision-making in future. In addition, the essential DBT skill of distress tolerance is enhanced when we consciously process our experiences. In recognizing and accepting the discomfort as well as the gifts along the way, we become stronger, wiser, and more resilient.

“When redwoods are damaged by forest fire or struck by lightning and a limb falls off, new growth emerges from that place,” Leigh says. “In the same way, when we experience trauma and suffering, it doesn’t have to destroy us. It can help us grow.”

Sources

Nat Commun. 2016 Dec; 7:13822.

Nat Rev Neurosci. 2015 May; 16(5): 278–289.

Photo by Michael Shannon on Unsplash

Photo by Artem Beliaikin from Pexels

Photo by Zac Wolff on Unsplash

Mental Health / September 3, 2020

Newport Institute

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