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Perhaps you know someone who has dealt with a similar situation - how did they do it? If your problem is workrelated perhaps your organization offers a coaching scheme. If your problem is personal you may have a friend or family member who can help. Now that you have identified your options you need to consider the pros and cons attached to each one. As in the cost-benefits analysis earlier, it is best to write everything down. Brainstorming is a good tool for considering the consequences of a particular course of action. In an earlier chapter you were introduced to the power of imagery and using your imagination. You may wish to visualize your options and use your imagination to `see' what could happen. Youth are especially prone to using alcohol, drugs, and tobacco. Experimentation is normative, as is risk taking and the drive to defy authority as a path to independence. Moreover, the capacity of the brains of youth to control their impulses and behaviors is biologically limited because, as noted earlier, myelination is still under way. Finally, peer and media influences are everywhere, especially those pro-drug messages in music, TV, and movies. We can expect substance use and will likely continue to see it widely. Our collective work and responsibility is to limit its damages. Three levels of action, or intervention, have characterized scientific writings on prevention, including prevention of behavioral health conditions like addictions. This construction builds on public-health principles that consider a population--an aggregate group--of people, some at risk of a condition and some not. These definitions are described here more specifically for populations of youth. Universal programs aim to reach all youth, whether they are at known risk or not. These are also known as primary, universal prevention. Selective programs aim to reach youth exposed to known and high levels of risk for a condition, but who have not yet become symptomatic.

These are also known as primary prevention for at-risk groups. Indicated programs are those that aim to serve youth showing indicia of early behavioral health problems, and are sometimes called secondary prevention. As we dig more deeply, an understanding of prevention is nicely illuminated by a model that divides individuals according to their unique characteristics in two key ways: risk factors and protective factors. These are the yin and yang of prevention. Go to college and start your career with tons of debt. Memorizing, mostly useless, information in an overpriced institution instead of learning it free on the internet makes you better than others and is the real and only "education". Take out student loans, get a fancy-titled "degree" you can't afford and won't use, make a "name" for yourself and your family, and get a job living paycheck to paycheck so it'll take you 10 - 25 years to pay off your student debt. How much you have your act together depends on your daily habits and activities and the ones you focus on the most have the biggest impact on reaching goals and becoming better. Think about and write down everything you do from the time you wake up until you go to sleep. Next to each one, assign it a number of 1 through 10. 1 being the lowest payoff, negative, non-important, a waste of time, you don't learn, grow, or change and 10 being a wise investment of time, big payoff, highly impactful, important to reaching goals and getting your act together, and it makes you better. Example: Watching TV and playing video games =1. Getting enough sleep. = 9. Draw a triangle on a sheet of paper, divide it into 3 parts by drawing 2 horizontal lines through it, take the top 5 to 7 habits and activities you assigned the highest number to and put them in the very top. Then, take the next 5 to 7 habits and activities with the highest numbers and put them in the middle. Everything left goes at the bottom. The stuff in the bottom of the triangle is what 99% of us are focused on and why we don't have our act together. This stuff isn't important and wastes our time. The middle section contains secondary habits and activities.

These things are ok to do but need to be put on the back burner and done later. The very top of the triangle is where your attention needs to be. Focusing on these habits and activities more than anything else changes your life rapidly and helps you get your act together faster than you can imagine. This exercise helps you find what's truly important and helpful to you. It helps you become crystal clear, focused, efficient, and productive. Place your focus on everything in the top of the triangle and everything in the middle and very bottom will either disappear or take care of itself. It is impossible to solve the problem - maybe all that can be done is to manage the situation. You may need more information. You may be unclear about choosing between the various options available to you. If you believe the problem is impossible to solve try rewording it or breaking it down into smaller sections that are more easily resolved. If you require more information, you need to decide how to get this. When you are confused between two or more options you may find it useful to talk to a friend or colleague. Use the rating scale (0-10) you were introduced to earlier to see if any of the options has the edge over another. Think about each option and try to visualize how you imagine things would be if you took that course of action. Risk factors are those environmental, familial, or individual elements that carry greater risk for promoting a health problem, in this case a substance use disorder. Protective factors, similarly, exist outside and inside all of us and can reduce the potential for problem substance use and abuse. Risk and protective factors vary from one person to another and can change over a person's life. Adding to this perspective, which is useful in policy and program development, we can consider risk and protective factors by "domain"--namely, wherein the locus of the problem or intervention may principally be located. One way to understand risk and protective factors, essential in preventing drug abuse, is by the domain they affect. Let's go back to the life of Billie Holiday.

Is there a risk factor she did not have? Is there a blessed protective factor she enjoyed, in any or all of these domains? She didn't stand a chance: she was dead at forty-four, along the way having been a high "user" of health-care and correctional facilities, with their attendant costs. If you did throw up or pass out in front of other people, it might not be as scary as you imagined it would be. With a great many of the fears that people endure, it is often the case that anticipatory anxiety is far worse than the fear they experience at the moment (this is the "Samuel Butler principle" again). Many people who suffer from extreme fears of the possibility of vomiting often describe having almost no fear reaction at all on the rare occasions when they do actually throw up (because of course they don't - they are too busy throwing up!). So too, if people really faint or pass out, this will be a process beyond their control, and they will not be conscious of any discomfort or embarrassment while it is happening. Finally, most people in social situations don't actually respond in the ways we fear they will, even if we do have a bodily response we can't control. When someone throws up or passes out around us, most of us respond with sympathy, trying to help the person who is sick and contacting health professionals to make sure they get the help they need. We do not stand around passing judgment. Sometimes claustrophobia may be associated with a specific kind of enclosed space - such as an airplane, a subway car, or an elevator. In other instances, a person may be afraid of finding themselves in any of these places or other, similarly enclosed spaces. From the outside, such fears can often appear to people as "irrational." Those who do not experience anxiety disorders themselves will often try to "talk people out of it." They may remind the person with anxiety that flying is actually the safest way to travel; that the accident rate on elevators is extremely low and that modern elevators have fail-safe mechanisms build into them which would prevent the elevator car from ever falling or losing control for long distances. They may ask: when was the last time you ever heard of someone being hurt on the subway? They may remind people of all the millions of people who commute to work every single day and back on the subway and who are never harmed. How petty are your thoughts and emotions? Are they helping you or hurting you? Are they moving you closer to having your act together or farther away? Figure it out. Do the same exercise you did for your priorities and habits.

Draw a triangle and prioritize which thoughts and emotions are worth your time and helping you get closer to who you want to be. You'll be much happier and satisfied with your situation and life when you stop focusing on everyone around you and start focusing more on yourself. Pay attention to and focus on yourself - you need all the focus you can get. The better you get to know yourself, the clearer your road map to success and getting your act together is. Stop focusing on what others are/aren't doing. Stop focusing on how much others have their act together. Stop comparing yourself to others. Stop asking about others because you feel you're in competition with them. Stop looking for clues for how you should be walking, talking, dressing, thinking, feeling, and behaving. Stay off social media news feeds. They do a lot of psychological damage and give you a false impression of yourself and others. Stop comparing your life to those of your "friends" on social media. Stop thinking about how much fun they're having while you're not having any. Stop thinking about how many social media "friends" they have compared to you. Stop looking at their "likes" and reading the "comments" they post or get. Stop wondering how good/bad your life is compared to everyone else's. It's all a complete waste of time because what you're seeing on social media isn't real. It's not the truth. It's a manipulated representation of their activities, thoughts, emotions, behavior, habits, and life. Although you have considered the pros and cons of a variety of actions you may also find it useful to have a contingency plan worked out.