《10到25岁》第一章(8)：贝尔奎斯特的倡议，尊重年轻人，赋予他们社会地位，与他们一起协作排难

说明：我正在连载《10到25岁》这本书的原文和翻译。本文是第一章的第8篇，也是第一章的结束。到目前为止，原文的结构

• 介绍
  • 介绍(1)：导师的困境
  • 介绍(2)：智慧反馈
  • 介绍(3)：10到25岁的大脑
  • 介绍(4)：传奇篮球教练奇普·恩格兰的故事
  • 介绍(5)：家族文化传承之皮特和蕾奥娜的故事
• 第一部分：理解10到25岁的年轻人
• 第一章：我们为啥错了
  • 第一章(1)：花费巨大但效果堪忧甚至反转的干预年轻人的两个项目
  • 第一章(2)：对神经生物学无能模型的质疑和真相运动
  • 第一章(3)：一场科学革命和父母唠叨研究
  • 第一章(4)：颠覆无能模型
  • 第一章(5)：青少年​​窘境
  • 第一章(6)：维吉麦研究，尊重更可能让青少年遵循指示
  • 第一章(7)：重新思考青春期激素
  • 第一章(8)：贝尔奎斯特的倡议 (本文)

Dr. Steven Alexander hadn’t heard about the recent scientific revolution in adolescent neuroscience. When I told him about it, he was excited to learn that the incompetence model promulgated by the MacArthur network wasn’t the whole story. He asked: What if we took adherence to medication and turned it from something where you’re punished if you don’t do it to something that makes you feel respected? He was asking, in effect, how to give medication nonadherence “the full Bogusky.”

史蒂文·亚历山大博士没有听说过最近在青少年神经科学方面的科学革命。当我告诉他这件事时，因为了解到麦克阿瑟网络推广的无能模型并不是全部真相,他感到兴奋。他问道：如果我们把药物依从性问题，从一件不依从就会受到惩罚的事情，转变为一件让你感到被尊重的事情会怎样？也就是说，他是在问如何给药物不依从现象“来个彻底的博古斯基式转变”。

Interestingly, the start of an answer to Dr. Alexander’s question could be found just a few doors down at Stanford University’s liver-transplant clinic. They have one of the best teen organ-retention rates in the country. Dr. Bill Berquist’s group educates their pediatric patients thoroughly, like any other clinic, but that’s only part of what they do. “There’s also a social aspect to not taking your medication,” Berquist acknowledged. He adds a twist by telling the transplant recipients they have a “special gift” that makes them unique. Every time they take their medication as prescribed they are doing their part to honor the memory and life of the person who donated a liver to them. They are honoring the work of the medical professionals who sacrificed so much to get them out of the intensive care unit and into a normal life. Berquist doesn’t guilt or shame his patients. He gives them identities as people of worth, high-status people who make a difference. Berquist and his team reframe the pill-taking decision from one that pits short-term social well-being against long-term physical well-being to one that lets an adolescent feel like a socially worthy person right now.

有趣的是，亚历山大博士问题的一个答案，就来自于几扇门之外的斯坦福大学肝脏移植诊所。他们拥有全国最好的青少年器官移植存活率。比尔·贝尔奎斯特博士的团队像其他诊所一样彻底地教育他们的儿科病人，但这只是他们工作的一部分。“不服用药物也有一个社会方面的因素，”贝尔奎斯特承认。他会更进一步，告诉接受移植手术的人，他们拥有一种“特殊天赋”，使他们与众不同。每当他们遵照医嘱服用药物时，都在尽自己的一份力，来纪念和尊重肝脏的捐赠者；他们也在尊重医疗专业人员的努力，那些人为了让他们从重症监护室走向正常生活而牺牲了自己的大量时间。贝尔奎斯特不会让他的病人感到内疚或羞愧。他赋予他们有价值的身份，让他们成为有影响力、地位尊崇的人士。贝尔奎斯特和他的团队，改变了服药决策的问题框架：从一种短期社会福祉（不服药，显示自主性）与长期身体福祉（服药）的对立，变成（服药）让青少年当下就感到自己有社会价值。

To pull this off, Berquist’s liver-transplant team takes great care in how they talk to patients. They avoid the pitfalls highlighted by the parental-nagging study or the Vegemite study. Berquist’s team educates the adolescent patients directly, separately from their parents, so doctors aren’t awkwardly talking to parents about how to get their child to listen to them in front of the child. Berquist’s clinic also invites the transplant patients together at summer camps, so they feel like a part of a community. Finally, Berquist’s team takes a very respectful approach in their communications with patients, one that I call collaborative troubleshooting.

为了实现这一点，贝尔奎斯特的肝脏移植团队非常注重他们与病人的沟通方式，因此就避免了父母唠叨研究或维吉麦研究所强调的缺陷。贝尔奎斯特的团队直接教育青少年病人，而不是通过他们的父母，这样医生就不会在孩子面前尴尬地与父母讨论如何让孩子听他们的话。贝尔奎斯特的诊所还邀请移植病人在夏令营中聚集，让他们感到自己是社区的一部分。最后，贝尔奎斯特的团队在与病人的沟通中采取了非常尊重的方式，我称之为协作排难。

They say, “What are the things that will get in the way of you honoring this gift by taking your medication? Okay, let’s talk about those and troubleshoot.” They are direct and clear—they aren’t pushovers—but they never dismiss or invalidate the young person’s feelings or barriers. They mimic the respectful instructions in the Vegemite study. Their tone is collaborative, not condescending. The attitude they exude is respectful, effective, and empowering.

他们会说：“有哪些事情会妨碍你服用药物，因而浪费了这份天赋？好吧，让我们谈谈这些并解决问题。”他们直接而明确（不是软弱的），但从不忽视或否定年轻人的感受或障碍；他们模仿维吉麦研究中的尊重指示；他们的语气是协作的，而不是居高临下的。他们所展现的态度是尊重的、有效的和赋能的。

Berquist’s team is tough but supportive. They take the young people seriously, they don’t baby them, they don’t look down on them. They understand the adolescent predicament. They listen to the constraints young people are under and don’t act like they are invalid or irrational. And their approach works.

贝尔奎斯特的团队既严格又能提供支持。他们认真对待年轻人，不把他们当孩子看待，不轻视他们。他们理解青少年窘境。他们倾听年轻人，理解后者所面临的限制，并不认为这些限制是无效的或非理性的。他们的方法奏效了。

There’s a word I like to use for adults who successfully pull off this kind of interaction with young people. They are mentors. Berquist’s team might not think of themselves that way, but I do. Like any great mentor, they align their communication style with a young person’s needs, and set them up for long-term success. It’s not always easy to be a mentor, but it’s a role that anyone can fill if they communicate in ways that are attuned to the adolescent predicament, and that satisfy young people’s appetites for social status and respect.

我喜欢用一个词来形容那些成功与年轻人进行这种互动的成年人。他们是导师。贝尔奎斯特的团队可能不这样认为，但我是这样认为的。像任何伟大的导师一样，他们调整自己的沟通方式以满足年轻人的需求，并为他们长期成功奠定基础。成为导师并不总是容易的，但只要他们以适应青少年窘境的方式沟通，并满足年轻人对社会地位和尊重的渴望，任何人都可以胜任这个角色。