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Chapter: Medicine Study Notes : Paediatrics

Talking with Adolescents - Adolescent Health

Keys to effective intervention: o A positive relationship o Thorough assessment

Talking with Adolescents


·        Keys to effective intervention:

o  A positive relationship

o  Thorough assessment

o  Inclusive of family and young person

o  Plans made with the young person and family

·        Building a trusting relationship: introductions

o  Friendly, confident welcome but still professional

o  Introduce yourself directly to the teen, „And is this your mum?‟

o  Clear introductions: yourself, your role, what you‟ll be doing and why

o  Clear boundaries: explain that you see young people alone and with family and why: 

§  „You‟re on your way to being an adult. Want to support that process. But your parents also still have a role‟

§  Allows them both to say things they might not in front of the other

o  Outline confidentiality: 

§  „I want to talk about confidentiality. Do you know what that means?…. Want to keep your information private‟ 

§  „There are 3 things I can‟t keep a secret: if someone‟s harming you, if you‟re harming yourself or if you‟re harming someone else. I need to do something about it – but will tell you what I‟m doing‟ 

§  „Will talk to my colleagues for review – to check I‟m doing the best I can‟

§  Consider what you put in notes (they get around).  Use standardised abbreviations. 

o  If adolescent doesn‟t want you to tell parents (and you think it‟s in adolescents best interests for them to know): 

§  Why doesn‟t teen want parents to know („You seem worried about your parents knowing this. Can you tell me about that?‟)

§  Attempt to persuade the teen to tell her parents

§  Offer to tell them yourself

·        Keys to building the relationship:

o  Be keen to get to know this young person now

o  Accepting atmosphere

o  Respect

o  Non-threatening explanations

o  Give adolescent some control – encourage normal independence

o   Reveal hidden agendas

o   Give them time to talk – hold off asking questions

o   Make plans with the young person and family 

o   If they don‟t want to talk, probably anxious/frightened. “It seems you‟re pretty angry about being here. Did someone make you come?”

·        Communication:

o   Use language that is understood (no medical or adult jargon).  Check understanding

o   Listen

o   Move from less sensitive to more sensitive topics

o   Move from third person approach to the personal


·        Set clear boundaries: It is appropriate to identify what is and is not acceptable behaviour (eg creating risk of harm to themselves or others). Middle adolescents still require the security of clear boundaries. However, try not to be judgemental


·        Beware:

o   Transference: person projects their feelings about someone else (eg parents) onto you 

o   Counter-transference: You transfer feelings appropriate to someone else (eg your own kids) onto the adolescent (eg act as though you were their parent)

o   Objectivity: understand the most likely reason they won‟t talk is that they‟re frightened


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Medicine Study Notes : Paediatrics : Talking with Adolescents - Adolescent Health |

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Medicine Study Notes : Paediatrics

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