ABSTRACT
This chapter focuses on the implementation of Tier 3 counseling interventions, including how to establish a meeting schedule, address resistance to change, establish a structured format for each session, teach the cognitive model, assign homework, and document the intervention. When youth are seen for therapy in private practice or community mental health settings, they are typically seen outside of school hours. When therapy is provided at school, it can be difficult to establish a regular meeting schedule. The strategies for eliciting "change talk", meaning that we get students to talk about change with the goal of resolving ambivalence about change are asking evocative questions, elaboration, using extremes, looking ahead, and readiness rulers. In using elaboration, one attempts to get the student to talk more about particular reasons for change rather than moving on to another reason for change. Readiness rulers can be used to measure a student's readiness for change.
