Tackle teens` resistance to group engagement

Teenagers are one of the toughest crowds in therapy. I have led adolescent therapy groups for years, and have grown accustomed to hearing phrases such as, “I don’t need to be here,” “This is stupid,” and “Let’s get this over with.”

Few teens attend therapy voluntarily, as most are required to attend by parents/guardians, school/juvenile officials, and state agencies. Some teens believe they are being forced to attend therapy. One of my teen clients, whom I will call “Cliff,” arrived to his first group with headphones in his ears and a smartphone glued to his hand. He said, “They can force me to come, but they can’t force me to participate.” He was right.

Most of your teenage clients do not wish to contribute. Yet clients who are engaged are more likely to benefit from group therapy. It is your challenge to establish and maintain engagement among your clients. You cannot force them to participate, but you can entice them. I promote engagement by utilizing creative interventions specifically designed to cater to the needs of teenagers.

Playing games

Boredom is the nemesis of teenagers. They are easily bored and have difficulty managing boredom. Therefore, you should avoid using interventions that breed boredom. Worksheets, workbooks, lengthy discussions and videos, when used alone, lead to napping and daydreaming. Teens want to have fun, and your groups can accommodate them.

I lead a weekly substance use educational group for teens. The purpose of this group is to educate teens about the negative impacts of substance use. My agency provided me with a stack of papers with all the information I needed. Some clinicians may have given the teens a few papers per group and led them in a discussion about the material. I would not have stayed awake long enough to lead this group. So I took the information and created quiz games.

The teens worked in groups to answer questions regarding the legal, health and psychological impacts of substance use. Each game covered one substance, such as marijuana or alcohol, and each group consisted of one game. I discovered that these teens loved the competition. They didn’t need prizes or rewards, as they simply wanted to win. Even Cliff, the teen who would not be forced to participate, began yelling out answers (“False, it’s gotta be false!”) Cliff was participating. I realized that not only were my clients having fun, but they were also absorbing the information.

Not all of the games need to be created by you. Some games can be bought and used to meet your needs. “I mix counseling strategies with everyday, familiar games,” says Grace Wilhelm, creator of Counselor Games. “For example, use pick-up sticks to teach relationships, and use Don't Break the Ice to teach stress management.” The teens in your groups who are having fun are more likely to be engaged. You may also find yourself becoming more engaged as you play these games.

Incorporating interests

Teens are likely to be interested in your group if you incorporate what already interests them. “I think about their interests and passions and try to incorporate that as much as possible,” says school counselor Leanne Hershkowitz, LPC. “For example, if a student really enjoys drawing, I will incorporate more art therapy activities. If a student is passionate about music, I will ask if they would play me a song that expresses how they feel. I often take time getting to know the teens in my group in order to discover what their passions are and then use interventions that include these passions that they have in common.”

After spending time with Cliff, I discovered that he was a devoted football player. He wore his school jersey to groups, and he could talk about his games for hours. Cliff had begun using marijuana and was attending my group as a requirement by his probation officer. I approached Cliff with the idea of presenting material to the group regarding famous football players who had experienced legal, relational or health difficulties as a result of substance use. He agreed and did a wonderful job with his presentation, which included pictures and a quiz that he created.

Get moving

You are attending a professional conference. At the end of an eight-hour day, which presenter would be the most successful at maintaining your attention: the presenter with a PowerPoint who provides a lecture on the success of physical interventions, or the presenter who requires you to stand and practice these same interventions? I would vote for the second presenter, and your teenage clients would agree.

Movement supports engagement. “I choose engaging activities that promote action in the group,” says teen specialist Kelly Peyton, LPC. “Sometimes I find games that require whole body movement, such as hitting balloons or changing seats in response to questions.”

Physical interventions do not need to focus on the entire body. One of my favorite interventions is to have teens complete puzzle blocks called Widgets. This requires only the movement of their arms and hands, but it is enough to keep them focused. Cliff needed to be in constant motion in order to focus. I encouraged him to have a stress ball in his hands during group, and this helped him to remain attentive and engaged at times when we weren’t discussing football.

Utilizing peers

Peer influence is strong among teens. According to Dr. Philip Ortiz, “A teenager will listen to almost any other teenager over a parent, teacher, counselor, or any other reasonable adult.”

You can use peer influence to promote engagement in your group. Teens who are already engaged can be your strongest assets, as they can model engagement for their peers. You can facilitate this process. “Anytime a teen asks a question in my groups, I don’t answer. I defer to the other positive teens in the group and solicit their info,” says Ortiz. Strategically deferring to positively engaged teens can elicit increased positive engagement from their peers. I often encourage engaged teens to participate first in order to provide opportunities for peer modeling.

Engaged teens also can act as peer leaders. Cliff became a positive influence on his peers, and he took on leadership roles. In addition to his football presentation, Cliff was willing to help me create an updated version of the marijuana quiz game. Cliff informed me that the questions I had created were, as he stated, “not what we really need to know.” He researched and came up with some questions that related better to his peers’ needs. A couple of his true/false questions were “Heavy marijuana use has no impact on a man's testosterone level” and “The marijuana drug industry is less violent than industries that sell other drugs such as meth and heroin” (“false” is the correct answer for both).

During the marijuana quiz group, Cliff was in charge of keeping score and providing encouragement to his peers. Instead of yelling out the answers, he was now yelling, “You guys were so close!” and “You got this one!” Teens can serve as leaders and can share ideas for interventions to increase their peers' engagement.

Avoiding lectures and advice

Lecturing hinders engagement and lacks success. Teens have received many lectures from parents, teachers, juvenile officers and counselors. If lectures produced results, these teens likely would not be attending your group. “Lecturing, in a relationship, is truly about the speaker’s needs and wanting to get their point across; that is simply not effective in the counseling relationship,” says Hershkowitz. “It tells the teen that I don't care about their thoughts or feelings, only my own thoughts.”

Giving advice is just as unsuccessful as lecturing. If teens took the advice they had received, they likely would not be attending your group. If they did take your advice, then they might continue to come to you to help them solve their problems. “If the student does not know a solution to their problem, it is most effective for me to guide them through finding their own solution so that they can problem-solve for themselves in the future,” says Hershkowitz. “I want to foster self-reliance, not codependence on professionals, as much as I can.” Lecturing and advice-giving are one-sided interventions. Teen engagement requires opportunities for reciprocity.

Identifing obstacles

It’s important that you identify any obstacles to promoting engagement in your group. I observed that Cliff’s engagement would significantly decrease whenever the group would be asked to write. Even short writing assignments would cause him to put his head down or take long restroom breaks. I spoke to Cliff, and he confided in me that he had dyslexia.

How many of the teens in my groups had learning disabilities? I had no idea. I had failed to identify a huge obstacle for Cliff and, perhaps, for other clients. I noticed that Cliff’s level of engagement returned when I stopped requiring writing and allowed the teens to choose if they wished to draw or write. The flexibility of your interventions can combat the obstacles.

Cliff became engaged as a result of interventions that catered to his needs. He successfully completed group and transitioned to aftercare services. On his last day he approached me and said, “The group wasn’t so bad.” It didn’t sound like much, but it was a great compliment coming from a teen who once had no intention to engage.

Amanda Gregory is a Licensed Professional Counselor and freelance writer based in Camdenton, Mo., specializing in the treatment of children/adolescents, attachment, trauma and anxiety. Her e-mail address is amandagregorylpc@gmail.com.