{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Helping teenagers do more of what matters to them","description":"How does doing more of what matters help teenagers with low mood and depression? And what can we all learn from this, particularly at the moment? Prof Shirley Reynolds speaks to Dr Lucy Maddox. Show Notes and Transcript Podcast episode produced by Dr Lucy Maddox for BABCP If you want to know more the following resources might be helpful. Books Shirley has written two books about depression in teenagers, one for teens and one for parents: For parents: Teenage Depression:  CBT Guide for Parents https:\/\/www.amazon.co.uk\/Teenage-Depression-CBT-Guide-Parents\/dp\/147211454X For adolescents: Am I Depressed and What Can I Do About It? https:\/\/www.amazon.co.uk\/Am-Depressed-What-Can-About\/dp\/1472114531\/ref=pd_lpo_14_t_0\/260-4076808-4951665?_encoding=UTF8&pd_rd_i=1472114531&pd_rd_r=bd1ea151-b4d3-40bc-99bc-583aa3824613&pd_rd_w=xtKq9&pd_rd_wg=CFBxI&pf_rd_p=7b8e3b03-1439-4489-abd4-4a138cf4eca6&pf_rd_r=MFANFKSAD9RE92R6XS65&psc=1&refRID=MFANFKSAD9RE92R6XS65 Websites BABCP website www.babcp.com Register of BABCP accredited therapists https:\/\/www.cbtregisteruk.com\/ These resources about child and adolescent mental health might also be useful Young Minds https:\/\/youngminds.org.uk\/ MindEd https:\/\/www.minded.org.uk\/ Association for Child and Adolescent Mental Health https:\/\/www.acamh.org\/ Other resources Shirley is running a course with Future Learn from 1st week in June about adolescent depression \u2013 aimed to help parents and professionals understand and help young people who struggle with low mood: https:\/\/www.mooc-list.com\/course\/understanding-depression-and-low-mood-young-people-futurelearn Have you seen the BABCP animation about what CBT is? Only 1 minute long and available here: https:\/\/www.youtube.com\/watch?v=ZRijYOJp5e0 Photo by Daria Tumanova on Unsplash Podcast episode produced by Dr Lucy Maddox for BABCP Transcript  Lucy: Hi and welcome to Let\u2019s Talk About CBT with me, Dr Lucy Maddox. This podcast is all about CBT, what it is, what it\u2019s not and how it can be useful. Today I\u2019m speaking to Professor Shirley Reynolds from the University of Reading about how doing more of what matters can help teenagers boost their mood, and how this might be particularly helpful for all of us to remember at the current time.   Shirley: The thing I\u2019m really mostly interested in is understanding more about adolescent depression in order to help us really develop better treatments and better ways of preventing young people from developing depression. So that we can really try and divert them away from a path that can lead into a lifetime of problems with low mood.   Lucy: Fantastic. And at this time in particular when we\u2019re all shutting doors a bit because of the pandemic and teenagers are shutting doors as well, what can your research tell us that might be helpful at this time in particular do you think?  Shirley: I think there are some general points and some more specific points. I think the general point is that one of the things we know, not just from our own research but from many people\u2019s research is that when you\u2019re a teenager, most teenagers are going to be incredibly attached to and reliant on having relationships with their friends, their peers.   The family becomes a bit less important, it\u2019s not unimportant, but the importance of it becomes a little bit less and that\u2019s replaced by a really, really strong focus on needing to be part of a social group. Being accepted by other people, contributing to things with your friends, being part of something bigger than yourself.   And so what that tells us then is that a period like now when young people simply cannot have those relationships in the normal ways, that this is a potential point of really massive stress for them and distress for them. And we need to try and support them; to maintain any relationships they already have, in whatever way is possible.   And what most parents are currently struggling with, but I think getting a handle on, is that currently that is going to be on a computer.   It\u2019s not just young people, we all need these things. This is a lifelong thing for most people, but it\u2019s a particular importance at that critical development period when we\u2019re teenagers.   Lucy: So making sure that we\u2019re supporting the young people in our lives to maintain contact with their friends in whatever way is possible.   Shirley: In whatever way is possible, absolutely. And accepting and understanding that it\u2019s frustrating and difficult and anxiety provoking and that that\u2019s true for everybody, parents, children, and everybody else.   There\u2019s a degree to which we have to kind of let our normal expectations just be shifted around a bit and learn to live with that and be okay with that.   Lucy: Actually, just you talking about teenagers in particular made me think about that tension that can happen sometimes between teenagers really wanting to be independent and maybe family really wanting to comfort teenagers during this time. And sometimes that can be a really tricky balance to walk, can\u2019t it, if you\u2019re a parent who wants to offer comfort and your teenager is saying, \u201cNo, leave me alone.\u201d Is there anything, from your point of view, that you would say about that?   Shirley: I think that\u2019s absolutely right because the other task of being an adolescent or a teenager or growing up is to learn to be independent and to learn to do things on your own. And at the moment everybody is forced to spend 24\/7 with their families and that exploration and getting out there and taking a bit of a risk and learning about yourself in the world is something, it\u2019s very hard for teenagers to do at the moment. So they are going to need time to be separate and to be on their own.   And it is fine for them to tell you to back off and it\u2019s inevitable that people will feel a little bit pushed away and maybe left out or maybe tempers will be frayed and there\u2019ll be a bit more irritability. But again, I think that\u2019s one of those inevitable challenges that there\u2019s no right answer for this.   So I think that tension between needing support and also needing to be separate is really a massive struggle, especially for people who live in very small houses, don\u2019t have outside space. So sharing bedrooms. I think trying to find a space for young people to call their own, for at least some of the time is going to be really important, if that\u2019s at all possible.   Lucy: Yeah, really helpful. And helpful to remember that in the midst of trying to homeschool and all the rest of it as well actually, that to be somebody\u2019s teacher and mum and seeing them all the time is not possible.   And some of the research that you\u2019ve done that I found really interesting has been about valued actions. I wondered if you could say a little bit more about what valued actions are?  Shirley: Yeah, so this comes from the research we\u2019ve done with teenagers with depression and low mood. What we see when somebody has depression or beginning to become depressed is that as we feel a little bit worse, what we tend to do \u2013 this is in normal life \u2013 is to take ourselves out of our normal social activities. So young people who have got problems with depression very often, nearly always, spend more time on their own than they would have previously.   And as they do that, as they take themselves further out, they get less reward from life. So fewer of the things that would have just happened in their normal daily life, a smile from somebody or a shared joke or something that you notice outside of the house that just made you feel good about yourself, those things just are less available to you. They happen less because you take yourself out of what\u2019s happening in life.     As you withdraw what we see is you get less reward from life, or less of what we would call the \u2018feel good factor\u2019. And when you get less of the \u2018feel good factor\u2019, that makes you feel worse. And as you feel worse, you withdraw a little bit more and you get less reward and then you get less of the \u2018feel good factor\u2019.   So you find that young people with depression and adults with depression get themselves into this very hard to escape from cycle, this vicious cycle.   Lucy: Shirley\u2019s research looks at ways of trying to break the cycle of low mood and doing less.   Shirley: So, we want to break the cycle and the way we turn it around when we\u2019re working with young people is we help them to do more of what matters. More of what matters are things that are important to them and we help them decide what matters to them by talking to them about their values.   Lucy: Values are guiding principles in life, the things that show us the direction we want to go in. To work out what matters sometimes takes some real reflection on what it is that\u2019s important to us.   Shirley: Now, they\u2019re really big questions, why am I here? What am I doing? What is the point of it all? They\u2019re massive questions, but they\u2019re brilliant questions and lots of teenagers are sort of playing around with them anyway. So if we can tap into that need to work out why I\u2019m here and what I\u2019m doing and what my values are, it becomes a really exciting, interesting conversation.   Lucy: Shirley told me about three main areas that she tends to ask young people to think about. Values to do with themselves, like health or fun, values to do with things that matter, like education or politics and values to do with people that matter, like family and friends.   Shirley: And then the idea is that once we\u2019ve helped them think about what their values are, which we can do in a very structured way, we then help them to do a little bit more of what matters. These are the valued activities.   So tiny little, small, easy to do activities that help them get a little bit more of that \u2018feel good factor\u2019.   Lucy: By increasing time spent on things that matter, that vicious cycle Shirley talked about before can be reversed.  Shirley: And as that reward comes back, we start to reverse the cycle. They feel a little bit less bad, so they\u2019re able to do a little bit more and that makes them feel a little bit better. Then they can do a little bit more and so on.   So we\u2019re taking the cycle we had that was dragging them down and we\u2019re turning it into a cycle that can help them build their life back up again.   Lucy: Shirley encourages young people to think of a wide range of things that they can to help them move towards their values. Key is to make each step as easy as possible so young people feel a sense of achieving what they want, not failing. Also key is that the things really do matter to the young person.   Shirley: Most kids are doing a whole load of stuff that other people make them do. Their lives are much more circumscribed than adults\u2019 lives. They\u2019re told what to do by other people. There are hundreds of things they can\u2019t get out of. So you can be really busy doing loads of stuff, but if it doesn\u2019t really matter, you don\u2019t get that \u2018feel good factor\u2019.   We find even 11 year olds and 12 year olds can begin to tell you about things that really matter to them. And these don\u2019t have to be sophisticated or complicated or smart. The importance of the value is not in its cleverness, we just care that it kind of lights you up a bit.   Lucy: Because what matters to each young person is specific to them, how the treatment looks is very individualised.   Shirley: Everybody is following a similar recipe, but what they\u2019ll be doing and how they\u2019ll be doing it and how we\u2019ll help them to do it will be completely different for every young person. The way we get them into the this, we get them to keep diaries really. And that is to help us see, and for them to see what they\u2019re currently doing and what it usually shows us is that there\u2019s almost no reward in their daily life. And so it helps us also find times in their days and their weeks when we can pack a bit of reward in, or we can swap one activity to another.   So when we do it for ourselves and we write down our activities and then we write down our values, and we try and map across, we\u2019ll nearly all find a huge gap between what we value and how we\u2019re spending our time. We\u2019re just saying, \u201cWhere\u2019s the flex here in your life to put in more of what matters?\u201d   Lucy: Shirley\u2019s research has found that people are less likely to drop out of therapy when the treatment focuses on what matters to them in this way. It also helps young people move on from feeling stuck in the here and now.   Shirley: We don\u2019t talk about the future in an explicit way, but when you talk to a 15 year old about what their values are, they\u2019re nearly always going to connect with the future and where they want to go and what they see themselves as. And it allows them to kind of use a bit of, yeah, just a little bit of imagination about, \u201cOh, I don\u2019t know\u2026\u201d   And if they\u2019ve never thought about what they want or what their values are, they go, \u201cOh, I don\u2019t know.\u201d It\u2019s actually quite an interesting question, even if it\u2019s something you\u2019ve never thought about.   I mean the other part of what we do is we try and get other people in the young person\u2019s life to help them with those rewards because young people don\u2019t have as much autonomy or as much money. They don\u2019t have as many resources. They sometimes need practical help to get things done. Or they need encouragement, giving lifts or arranging things at home that are a little bit different to give a young person a bit more space.   Or thinking about rewards that might be shared, like deciding on somebody\u2019s favourite meal and then going out and doing the shopping together and then cooking together. That can be quite nice because it\u2019s a kind of value about wanting to get on with my family but it might also be learning a skill.   Lucy: I asked Shirley how we can use these same principles at the moment, even though young people, and adults too, are going to be unable to do all the things that they value at the moment.   Shirley: I don\u2019t think there are any fundamental differences. I just think we\u2019re looking at a different range and a different kind of repertoire that we can use.   Lucy: What Shirley said earlier about teenagers being so, so busy, but actually their time is all stuffed with things that other people want them to do made me wonder whether there\u2019s a slight perspective shift that\u2019s helpful for young people and for adults. From thinking about how much stuff we\u2019re all doing to really thinking about how much of that stuff matters to us.   Shirley: And I think if we thought more a little bit about well, what are the rewards I\u2019m going to get from this, what am I going to take away from this that\u2019s going to make me feel good, we might make different choices about how we\u2019re going to spend our time. For me it\u2019s all about the search for more positive experiences. It\u2019s not about getting rid of bad experiences because we\u2019re all going to have bad experiences, that\u2019s just part and parcel of life. But if we\u2019re filling a lot of our time with positive rewarding experiences, there is, by default, less of the time to have more negative experiences.   Lucy: There\u2019s maybe something here for all of us. At the moment when our usual schedules are for lots of us upside down, maybe it\u2019s a chance to pay attention in a different way, to helping young people in our lives to be doing stuff that matters to them. And also to be thinking about this for ourselves.   Shirley: Learning to savour things, paying attention to those positive things that sometimes we perhaps just let them go and they\u2019ve gone before we\u2019ve kind of properly enjoyed them. There\u2019s a sort of opportunity to just notice a little bit more deliberately some of the more positive aspects. And that could be something like our first cup of tea in the morning.  Lucy: Always the best one.  Shirley: Exactly! Or the cat purring on your lap or I don\u2019t know, silly things, tiny things and they\u2019re different, some of them are shared, but many of them are very personal. It doesn\u2019t matter what they are, it\u2019s just capturing them somehow.   I like my phone for that reason, I do a lot of photographs of things that make me feel good because then I kind of feel I\u2019m carrying them in my pocket. I think it\u2019s always about finding the thing that fits your preferences and your personal style. But I do think some sort of recording of what is happening in your life, especially when we\u2019re living through a weird time like this, is likely to be useful.   So that could be through writing. It could be through photos. It could be through just what you email your friends. But I think some way of kind of recording what you\u2019re doing, where you\u2019re at in your life and spending a bit of time just thinking about that becomes a very helpful habit to have. Because it can stop you falling down into those vicious cycles that when we don\u2019t notice we\u2019re falling into them, it can be much harder to climb back out later.   I would just say, I think everyone needs to give themselves a bit of a break, and their kids. And we just all need to just, what\u2019s that expression\u2026 Be kind.   Lucy: Wise words there I think, being kind to ourselves and each other goes a long way.   I hope you enjoyed that episode and can think about how both you and any young people in your lives can do more of what matters. It\u2019s challenging at this time but there are still lots of possibilities.   I\u2019ve put some resources that Shirley recommended in the show notes and if you want to hear more about values in particular, check out the episode on acceptance and commitment therapy. We speak about values in that as well.   That\u2019s all for now, take care.     END OF AUDIO      ","author_name":"Let's Talk About CBT","author_url":"http:\/\/letstalkaboutcbt.libsyn.com\/website","html":"