Dealing with Teens &

the Accompanying
Adults
Objectives
 To familiarize oneself with dealing with
adolescents and accompanying adult or
parent/s.

 To be able to communicate with

adolescents and transmit health messages
to adolescents.
Ideal qualities of a service provider

 Communication and listening

skills (training as communicator)
 empathy, respect, genuineness,
concreteness
 comfortable with own sexuality

 strength to do counseling

 having a sense of humor

Dealing with the Adolescent
 If the parent is with the
 Greet the adolescent, entertain their
adolescent in a concerns and allow them to
friendly manner verbalize this
 Get all general data that
You may stand up may be needed from the
from behind your parent –
desk and sit facing – family history
the patient – past history
– developmental history, and
– immunization history.
Dealing with the Adolescent

 Good eye to eye

contact relaxes
the patient

 Establish rapport
Dealing with the Adolescent
 Explain the  Assure them that you will
issue of not share any information
confidentiality to that they have trusted
both the you with, unless they
adolescent and give you permission to do
the parent. so

 Also explain conditions

when confidentiality can
be broken
Dealing with the Adolescent
 Inform the parent  The parent should not
that you will now feel isolated
interview the – assure them that
patient alone…. interviewing the
adolescent alone is not
….and that you will a reflection of them as
parents.
call them back to
discuss your
assessment and
plans
When taking the history
 Ask adolescent  Allow adolescent to
express feelings of anger,
of his/her
sadness, injustice, or
concerns exploitation

 Allow patient to state his

problem as freely as
possible
 When taking the history
 REMEMBER: the adolescent is the primary
client.
– Address the patient directly and ask open-
ended questions.
 Listen attentively without interrupting

 Observe nonverbal communication (e.g.,

posture, hand and eye movements).
 When taking the history
 Avoid making judgments based on adolescent’s
appearance.

 Ask for clarification regarding unfamiliar slang

terms that the patient uses
When taking the history
 Do the  Ask questions first on the less
sensitive parts of the
psychosocial
HEADSS history.
history using
HEEADSS  Use the dialect that they are
comfortable with.

 If dealing with very sensitive

issues, avoid asking directly
on this issue.
When taking the history
 Do the  Pay attention to behavioral
patterns, feelings, and
psychosocial
attitudes surrounding any
history using concern or problem
HEEADSS
 Offer the adolescent a
definition of the problem/s
and issues involved as he or
she sees them
Example:
Health provider:
“You seem to have started in some risky behavior
like drinking alcohol, skipping school, and engaging
in unprotected sex”
“The reason I am bringing this up is because you
are exposing yourself to a lot of danger to your
health”
“Do you agree?”
“I would like to help you if you will allow me.”
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When taking the history
 Do the  Prioritize issues depending on
psychosocial the urgency and seriousness of
history using the complaints.
HEEADSS
 Allow for feedback, exchange,
and modification from patient’s
perspective
When taking the history
 Do the  With the patient, identify
psychosocial options and alternatives to
history using change the situation
HEEADSS
 Provide sufficient information
on which to base the most
rational possible choice
Example: Having unprotected
sex
Health provider:
“Have you thought what could happen if you had
unprotected sex?”
Adolescent:
“Well, I don’t want to get pregnant but it is hard to
refuse when he asks me.”
Health provider:
“You can always refuse. But sometimes you have to
practice ways to make excuses. Firstly, avoid
situations where you cannot anymore refuse. (you
can role play scenario where this could occur)
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Health provider:
“Have you heard of ways to prevent pregnancy? I
could also teach you ways to protect yourself when
you are caught in that situation.”
Adolescent:
“Yes, I have heard of the condom but my boyfriend it
makes him feel I don’t trust him.”
Health provider:
“There are other choices that I can explain to you and
then maybe you can make a better choice.”
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When taking the history

 Determine  Let the adolescent explore the

acceptability and non-
options
acceptability, and ultimate
selection or course to take
While carrying-out the physical
examination …
 Always explain to adolescent
what you are going to
examine, before you do it.
Seek their permission before
carrying out the procedure.

 Give the adolescent privacy to

undress or change into a gown
While carrying-out the physical
examination …
 If you are a male health
provider, always request that
the adolescent have a
chaperone in the room.

 Wash your hands before and

after examining the patient.
 Cover the patient with a sheet.

 Continue to talk and to reassure

them if your findings are normal.

 Use this opportunity to educate the

adolescent about normal growth
and development

 Any abnormal findings should be

pointed out and questions
pertinent to this may be asked
 Making a Diagnosis
 Based on the findings of the history
(Ask) and the results of the physical
examination (Look, Listen, and
Feel), decide on a classification as
per the algorithm.
 Inform the adolescent of the
diagnosis and its implications.
 Discuss with the adolescent- patient
what your plans are.
 Make sure that the adolescent patient
understands what your plans are.
– Make them summarize and repeat what they have
heard from you.

 Discuss with the adolescent what information

he/she would want to be discussed with the
parent or guardian.
– If there are issues that are important to discuss with
the parent/guardian, the patient must understand the
reason why it should be discussed.
 Managing the Condition
 Based on the guidance provided in
the algorithm, explain how you
propose to manage the condition.

 Explain arrangement for follow-ups.

 In case you have to refer cases that

you cannot handle, always write a
referral note.
 Managing the Condition
 Instruct the adolescent and family to
secure from the referred facility the
receipt of response.

 Respond to questions that they may

want to know using the information
provided in the Frequently Asked
Questions section of each algorithm
of AJA manual
 Follow-up patients
 Give the patient a date when he/she should come
back.
 Make sure the patient agrees to the date.
 If necessary, ask for patient’s contact numbers
– make sure AY agrees to receive calls or reminders
from your office, esp. if they do not want their parents
to know
 Give AY-client your clinic contact numbers where
they can call for emergencies and confirm
appointments.
Do’s in Dealing with Parents &
Accompanying Adults

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 Demonstrate respect and empathy for the
parent, through your words and actions.
– Tell them that parents have important roles to play
in supporting their sons/daughters.

 But also demonstrate to the parent/s that you

respect the views and perspectives of their
son/daughter

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 Try to identify the nature of the relationship
between the parent and their son/daughter.

 Try to identify whether the parent (or parents)

could contribute meaningfully to the solution, or
whether one or both of them might have
contributed to the problem.

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 Explain to the parent that you want to develop a
good working relationship with their
son/daughter

….. and that you will need to be able to deal with

them directly,

….. also to speak to them alone as well as in the

presence of the parents.

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Don’ts in Dealing with Parents &
Accompanying Adults

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 Do not ask the adolescent potentially
embarrassing questions in front of his/her
parent.

 Do not make decisions/ agreements with parents

on issues concerning their son/daughter ‘over
the head’ of the adolescent.

 Do not share information with the parent on

anything that the adolescent has confided in
you, without his/her consent.
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 Other Pointers!

 Avoid rapid fire, cross-examination type

inquisitions which pressure the patient

 Ask permission if you have to take down notes

but avoid writing everything he states

 Periodic re-evaluation is a continuing process

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Thank you

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