Adolescents exhibiting at-risk behaviors (e.g., suicidal intent, physical aggression, extreme defiant behavior, and alcohol/drug abuse), present some of the most difficult challenges that a crisis/hotline worker can face. Typical characteristics of an out-of-control adolescent are highly impulsive and overtly provocative, sometimes violent, behaviors. These behaviors, along with a characteristically angry, blaming stance may lead a worker to assess that such a client greatly lacks insight about his/her current or past problems.
Such a profile, however, should not discourage a worker from supportively, but firmly, taking control of the situation. This can be done by calmly listening to, but not judging, the adolescent. Also, clearly define the parameters for respectful behavior during the interaction.
After the adolescent discusses his/her major problem(s) (suicide, family problems, etc.) try to connect these problems to issues of loss, low self esteem, depression and drug/alcohol abuse. It has been the presenter's experience that, for example, every adolescent at risk has unresolved conflicts with loss. Also delinquent behaviors and substance abuse may be masking other major issues/diagnoses (e.g., Attention Deficit Disorder, a mood disorder, or the adolescent's role in a highly dysfunctional family).
If these issues can at least be identified, an adolescent may even quickly de-escalate, revealing, at times, a remarkable capacity for insight and a willingness to accept responsibility for his/her behavior. They may also demonstrate a sincere desire to reconcile conflicts within their own family