Empathy is about building a good rapport through an accepting non-judgmental approach. It involves trying to understand the young person's point of view while drawing out their reflections about their situation and what they would like to change. Without a respectful relationship, it will be difficult to help a young person move towards positive changes.

Discrepancy is the feeling that a behavior is out of line with a goal or value. Young people are more likely to be motivated to change a problematic behavior when they see a difference or discrepancy between the way their life is right now, e.g. their current use of alcohol or other drugs and any related problems, and the way they'd like their life to be. The aim is to amplify this difference and help the young person explore the present situation in relation to what is wanted and valued so they can identify their own reasons for change.

Rolling with resistant means avoiding arguments with a student who challenges their need to change. It means acknowledging that the youth is ultimately the one who will make the decisions about their health and well-being.

Showing respect for what the student thinks is more helpful than trying to force or convince them. Focus on showing interest in what they have to say and on being non-judgmental. Express the desire to understand and accept, but not necessarily agree with, reasons for their behavior and for their choices.

Self-efficacy means believing in yourself and your abilities. It's about knowing or trusting that you can succeed at setting and achieving a goal. Many people are more likely to follow through with a change in behavior if they believe they've freely chosen to make the change and that they can accomplish the change. It's important to help students build confidence by doing the following:

Open-ended questions require a student to explain something. They often start with one of the five W's:

Closed questions, on the other hand, start with the words such as ‘do’ and ‘don't’ and ask for a very specific yes-or-no answer.

Using open-ended questions can help a student think through their situation and weigh their desire to change. This is an effective way to pull out detailed information because it requires them to think more about what they're saying. They might also make statements that may serve as internal motivation to change.

Giving affirmations involves using statements of appreciation and understanding to express confidence in the student’s ability to continue positive behaviors or to make positive change.

These statements can help to create a supportive atmosphere and build rapport with the student. Recognizing a student's strengths and efforts to make change helps them build confidence and affirming self motivating statements encourages readiness to change.

Reflective listening involves listening to what the student says, and then restating it back to them to show that you have understood. It reinforces the students own positive statements about change and offers insight by highlighting the student’s own words.

For reflective listening to be effective, it is important to pay attention to those areas where the student expresses discrepancy between their desires and their current situation. Focus on the positive things the student said about changing, emphasizing the change talk. If only negatives about changing are mentioned, we can explore what it might take for the student to consider changing or why they think change is not an option.

Summarizing is a way of gathering what a student has said to prepare them to move on. Summaries serve to remind the student about major discussion points, their plan of action, and their reasons for taking action.

If the student slows or stops talking, summaries can help them continue. They may also help to remind the student of what they said or point out a connection between statements.

Keep the summary short and succinct. Summaries often include:

When we know someone who is struggling with substance use, we naturally have one of two reactions: anger or fear. Though each reaction looks different, both are coming from a place of concern and wanting the person to stop using in ways that are negatively impacting their life.

Reacting from a place of anger includes the following behaviour:

Reacting from a place of fear includes the following behaviour:

When we react from anger, we inadvertently send the message to the student, “you are bad,” “you are undeserving,” “you are unworthy.” When we act out of fear, we inadvertently send the message to the student, “you are not capable,” “you are not competent,” “you can't do anything without my help.”

It is easy to start from one emotional place and switch to the other when the person doesn't make the changes we feel they should. It is important to step outside these emotions of anger and fear, and start making decisions from a fact-based place.

It can be helpful to remember the three C's:

When we have a less emotional reaction, we can send a more motivating message to the student struggling: “I care about you and I know that you are capable of figuring this out. I am willing to listen to your problem without making it mine to solve.”

The following strategies can be helpful when supporting a student who is struggling: