İnterviewing with adolescents
Prof Dr Müjgan Alikaşifoğlu
Cerrahpaşa Tıp Fakültesi
Çocuk Sağlığı ve Hastalıkları Anabilim Dalı
Adolesan Bilim Dalı
Developmentally oriented approach
• In the course of interviewing and evaluating
the adolescent, the health care provider
should be conscious of the adolescent’s
developmental process and tasks.
• Evaluative expectations should be based on
the stage of emotional development the
adolescent has attained.
• Early or middle adolescents, certainly cannot
be expected to think and behave as logically
as adults.
• These are sample questions regarding various
adolescent tasks:
Body image
• “Do you have any questions or problems with
the physical changes you are experiencing?”
• “Do you like yourself as you are?”
Peer relationships
• “Who is your best friends?”
• “How many close friends do you have?”
• “What do you do for fun?”
Independence
• “Do you get along with your parent?”
• “Over what issues do family arguments
occur?”
Identity
• “Are you satisfied with the way things are
going for you?”
• “If you could change certain aspects of your
life, what would you do and why?”
• “What are your plans for the future?”
Sexuality
• “Are you dating?”
• “Do you have questions or concerns about
sexual activities, contraception….?”
• We use HEADSSS interview to obtain
psychosocial/developmental information
It covers:
• Home
• Education
• Activities
• Drugs
• Sexuality
• Suicide
• Safety
• An advantage of this approach is that the
practitioner moves from less personal
questions to more personal and potentially
threatining questions.
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Home:
“Where is the teen living?”
“Who lives with the teen?”
How is the teen getting along with parents
and siblings?”
• “Have there been any recent moves?”
Education
• Is the teen at school?
• What is the teen good and bad at in school?
• What classes are particularly interesting or boring?
• What grade average the teen maintain?
• Has the teen repeted or failed any classes?
• Has the teen received any suspansion?
• How is the teen getting along with teachers?
• What goals does the teen have when he or she finishes
school?
• If the teen is older or out of school, the
practitionaire should ask about employment
Activities
• What does the teen do after school?
• What does the teen do to have fun and with whom?
• Does the teen participate in any sports activities?
• Community activities?
• What reading does the teen do?
• What music does the teen like?
• What are the teen’s hobbies?
• Does the teen have friends?
• A best friend?
• How much time does the teen spend watching TV or
playing computer games or searching internet?
Drugs
• What types of drugs are used by the teen’s
peers?
• What types of drugs do family members use?
• What types of drugs does the teen use and in
what amount and frequency?
Sexuality
• Is the teen dating?
• What are degree and types of sexual
experiences?
• Is the teen involved with another individual in a
sexual relationship?
• Has the teen had sexual intercourse?
• If yes: ow old was the teen in his or her first
sexual intercourse?
Suicide
• Has the teen had any prior suicide attempts?
• Does the teen have any current suicidal ideation?
• It is very appropriate to ask direct questions
about suicidal ideation, such as “Have you ever
thought about killing yourself? Or have you ever
tried? Or Would you kill yourself? Or Do you have
a plan?
• Direct questions do not precipitate suicidal action
and are the best way to obtain such information.
Sexual or physical abuse.
• In any teen who has significant problems in
any of the previously mentioned areas, it is
critical to ask about physical or sexual abuse
This includes:
• Individual with run away behavior
• Significant family disfunction
• Change in school grades
• Lack of friends
• Substance abuse
• Early onset of sexual activity
• History of suicide attempt
Physical examination
• The physical examination provides an
excellent opportunity to educate the
adolescent about his or her changing body.
For example, female adolescent may be
taught to performe routin breast examinations
• or young male adolescent may be reassured
about genital development
• Who should be present during the physical
examination?
• Some adolescent prefer to have the parent
present
• The teen could be asked first whether he or she
prefered that the parent be in the room during
the examination.
• Particularly younger adolescents and
developmentally delayed adolescents may wish
to have a parent with them.
• Male doctors should use a chaperon during
the breast and genital examination of female
patients.
• Theoritically, the same concept would hold for
a female examinner during genital
examination of a male, although this usually
has not occured in clinical practice.
Closure
• At the close of the initial or follow-up visit, the
health care provider should address the following
issues:
• Provide a brief summary of the proposed
diagnosis and treatment, addressed primarily to
the adolescent.
• Parent who accompany the adolescent to the
visit should be included in a final discussion of
the nonconfidential issues, so that they can help
support the plans.
• Discuss any other resources available to the
adolescent
• Allow the adolescent time to discuss any final
questions or concerns
• Schedule any follow up appointments
• Inform the adolescent that the health care
provider is available at other times.