152: Treating At-Risk Teens with TEAM-CBT. Can you REALLY Make a Difference?

In today's podcast, Rhonda and I interview the incredibly brilliant, funny, and creative Amy Spector. Amy is a licensed marriage and family therapist and credentialed school counselor with over a decade of experience working with adolescents and their families. She is passionate about providing school-based mental health services and advocates for legislation to mandate universal mental health care for youth. Amy works with "at risk" teenagers at Vicente High School in Martinez, California. This is a continuation high school, as well as teens at Briones School, an independent study school. Her students are credit deficient and at risk of not graduating from high school. Nearly all have experienced significant trauma and most are severely depressed, anxious and angry when first referred to Amy, and some have suicidal thoughts or urges as well. Although you might think that this would be an exceptionally challenging, oppositional, and frustrating group to work with, Amy has had tremendous success treating these teenagers with TEAM-CBT. She measures symptom severity at the start and end of every session, just as we do with adults, and often reports a phenomenal reduction of 60% in depression and anxiety in a single, 30-minute therapy session. Although this may be hard, or even impossible, to believe, it is real, and you'll see why when you listen to this amazing interview. Amy's secret involves a combination of superb E = Empathy skills to form a meaningful relationship, along with A = Paradoxical Agenda Setting to reduce resistance, followed by truly creative applications of M = Methods. And, of course, she does T = Testing with every student at every session, and plots her effectiveness over time. Amy describes her work with a severely anxious young man with artistic skills, who drew an "Anxiety Hero" figure who saves the world by worrying constantly about every little thing, plus a "Chilled Out" figure who never worries and ends up getting hit by a bus. In other words, Amy skillfully emphasized the many BENEFITS of the young's man's constant anxiety, as well as the downside of getting cured. This paradoxically boosted his motivation, and he improved rapidly. This is prototypical TEAM, which is difficult for many therapists to learn, because therapists are so used to, and addicted to, "helping." Amy has developed expertise in aligning with the resistance of her students. paradoxically, she ends up on the same page, and this allows some awesome TEAMwork to emerge. Amy, Rhonda and David talk about the idea of teaching TEAM through creative innovations, with many examples of games Amy has created. For example, she created a game with another one of our fabulous TEAM-CBT therapists, Brandon Vance, MD, which can be played with teens and adults, called "Tune In / Tune Up." This game provides a really fun way to learn the 5-Secrets of Effective Communication. If you're interested, you can check it out at  www.gamefulmind.com. Amy and her students have also created a podcast that you might want check out. Although I (David) have been primarily an adult shrink, I have really enjoyed working with teenagers as well. A few years back, I tested hundreds of juveniles who had been arrested in California, many for violent crimes, including murder, at the request of the probation department, using my Brief Mood Survey to find out how depressed, anxious, suicidal, and angry the kids were. Toward the end of the podcast, I describe what happened when I was invited to visit two groups of incarcerated gang members at the Juvenile Hall in San Mateo, California to find out how they felt about the tests I administered, and to get their take on the causes of so much teen violence. I think you'll find this episode to be fun, funny, and inspiring! Amy is a strong advocate for including mental health training in high schools, and her experience illustrates the enormous potential for rapid and profound mental health growth and learning in teens. If you would like to contact Amy, she can be reached at [email protected].    

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