Risky Business: What Can We Do to Keep Teenagers Safe?

An interview with author and child psychiatrist Dr. Jess Shatkin, Part 2

Posted Dec 04, 2017

Used with permission
Leap of Faith Flip, Superhero Scramble, LLC (2012)
Source: Used with permission


 

This is Part 2 of an interview with Dr. Jess Shatkin about his new book, Born to Be Wild: Why Teens Take Risks and How We Can Help Keep Them Safe. Dr. Shatkin is the Vice Chair for Education at the Child Study Center at Hassenfeld Children's Hospital of New York at NYU Langone.

You can read Part 1 here.

JP: You talk about how adults have the benefit of experience and more efficient neural networks so that they act based on “gists” rather than by weighing pros and cons. But part of what I focus on in Psych Unseen is how adults often get into trouble when they make value-based decisions instead of objectively weighing pros and cons. Is there a lesson for parents there?

JS: The decisions that concern me are those that our adolescents make at times of risk or moments of so-called “hot” cognition – when they’re under-slept, over-caffeinated, feeling pressure from school and parents and coaches, and while peers are watching. At these moments, our teens all too often make some pretty bad decisions. Helping them to understand the “gist” of what they’re dealing with will assist them in making more automatic decisions that can be protective. I’m all for a discussion of pros and cons and utilizing what Daniel Kahneman and others call “system 2” thinking or conscious deliberation for all sorts of decisions, just not at a moment of immanent risk. In moments of cold cognition, or when adolescents (at least those who have reached about 16 years of age) are feeling calm and aren’t pressured by peers, experimental data shows that they make very good decisions and can weigh pros and cons as well as adults if they have the same information. But when they’re in moments of hot cognition, they often struggle with making safe decisions, and those decisions are often even worse when they deliberate pros and cons; at those moments, they too often justify a risky decision. 

The lesson for parents is to have the pro/con discussions at home and then to help their kids to come up with decision algorithms for the moments at which they will inevitably face risk (like when their friend has been drinking and now is about to drive everyone home from the party). Then parents can even role play with their kids how they would enforce this decision in real life. Parents can also use many of the other “gist”-based strategies discussed in the book, like identifying red alerts, employing analogies, and identifying specific emotional cues.

JP: You take schools to task for going about adolescent education in all the wrong ways and have many suggestions for reform. Aside from the use of performance metrics to determine funding that’s in vogue, why do schools insist on wrong-headed approaches? What can parents or mental health advocates do to lobby for change?

JS: I think that schools, just like all of us, get stuck in certain paradigms and ways of going about solving problems. I think that as adults we imagine that if something makes logical sense, we believe that people will behave accordingly. But we know that intentions only predict about 30% of our behavior and that we most often don’t act in accord with what we know and intend to do. You can’t find a single smoker or overweight individual, for example, who doesn’t know that smoking will eventually make them sick or even kill them and that being overweight puts them at risk for a host of health problems, but still they smoke or don’t lose weight. I think our schools are a larger version of the same struggle – knowing what’s good for us or what will be more effective in schools is part of the story, but now we have to actually do it and change things. I believe that we become very short-sighted often and focus on what’s directly in front of us, just getting through the day, akin to how our political system all too often operates. It’s hard for someone who is smoking to imagine what it will be like to be in the hospital with emphysema or cancer 20, 30 or more years from now. Likewise, it’s difficult for us to understand what the air quality of our world will be like and how that will affect us if we keep burning fossil fuels at the same rate as we’ve been doing for the next 20, 30 or more years. The same is true with our schools – our teachers and administrators are struggling to get through the day. To fix this we need to be looking a few moves ahead, like a good chess player. Some of the most immediate things we can do would be to lobby for later school start times for middle and high school students; a relatively straightforward fix that has been shown to result in many significant benefits for our kids. And change takes time. We’re only now learning some better approaches, and I think that in the years to come, we will start to see these changes take hold.

JP: In addition to schools, you finish the book by making the case that beyond schools, society at large takes a potentially harmful approach to adolescents in a lot of ways. This left me with a sense that even the best parents who follow the advice you lay out for raising teenagers have the cards stacked against them, but I suspect that hope lies in the fact that good parenting can trump the potentially harmful influences of school and society at large. Do you agree?

JS: Yes, I think that good parenting trumps all. However, so many kids are being raised in families that also have the cards stacked against them – whether it’s poverty, a lack of education, poor health, mental illness, violence or abuse in the home…we can go on. Because so many of our kids come from families with these struggles, we need to take a greater role as a society if we want to see these kids grow into productive and happy members of society, who don’t put themselves and others at risk. 

JP: You include many anecdotes in your book about particular patients.  In Chapter 5, the story of Gregory — a young man who threatens suicide when his parents suspend his phone privileges — was the most compelling to me as I pictured myself in the place of his helpless-feeling parents.  Can you tell us how his story ends and what interventions were helpful?

JS: Yes – Gregory is doing just fine. His story sounds dramatic, and his parents were shocked and actually embarrassed by how intense and urgent the emotions had become at home. But these moments are more common for our teens than most of us parents would like to admit. So, part of the solution is the psychiatrist’s stock and trade – good old fashioned psychoeducation and teaching parents about what’s typical, that teens’ emotions rise and fall pretty quickly sometimes, especially where peer relations are involved (for all of the reasons I talk about in the book).  The second part of the intervention is teaching parents about behavioral parent training, which I outline in Chapter 9. Parents do SO MUCH BETTER when they utilize positive reinforcement, effective commands, and selective ignoring, which allows them to parent authoritatively and leads to many good outcomes. We have both academic and community-centered programs that have successfully taught these skills to parents, but they do cost a bit of money. I am certain, however, that they will save money in the long run by keeping kids in school and out of juvenile detention.

References

Shatkin J (2017). Born To Be Wild.  New York: Penguin Random House LLC.