A number of office approaches can be used to seeing an adolescent in the office. It is, therefore, important for the physician to adopt a technique that the teenager feels they are best comfortable with. Confidentiality forms the foundation of any therapeutic relationship with an adolescent. Without proper clarification of the confidentiality limits, the physician may end up getting incomplete or incorrect information during the history taking process (Batanova & Loukas, 2012). My preferred approach when dealing with an adolescent is seeing the teenager alone first and later asking the parents to join the conversation. However, before the day of the appointment, I would ask both parents to write a letter about their child’s concerns before the actual day of the office visit. This will allow me to address these concerns during my interaction section with the adolescent. The appointment should be 30 minutes long to avoid boredom. This approach is useful because it helps the adolescent feel that their concerns will be heard, the adolescent learns how to speak directly with the physician building their confidence, and as well, the healthcare provider is able to speak about confidentiality in an effort of increasing their trust with the youth (Reif & Warford, 2006). It is also important to set the examination room appropriately in a way that will make the adolescent feel comfortable without limiting privacy and confidentiality. Educational materials to be used should entail both print and visual sources to be able to draw the adolescent’s attention. Among the health maintenance topics to discuss involves healthy eating habits, safe sex practices, alcohol, and substance abuse (Kovacs, Piko, & Keresztes, 2014).
The adolescent phase is one of the most dynamic human development stages that mark the transition from childhood to adulthood. The period is characterized by intellectual, physical, relationships, emotional, social roles and expectations changes. In the middle adolescent phase, peer pressure is a significant influence on the adolescent's life (Chulani & Gordon, 2014). It is, therefore, important for the healthcare providers to recognize this and address issues that the teenager is likely to face in an effort of promoting their optimal health. One health promotion topic that needs to be addressed exhaustively during this stage is on sexual and reproductive health, advocating for safe sex practices. This should occur on nearly every visit with the adolescent and the parents depending on the confidentiality level required. The number of middle adolescent pregnancies and sexually transmitted infections at this stage is on the rise (Kirby, 2008). It is thus, important for the healthcare provider to promote abstinence sex education advocating for teenage abstinence as the only way of preventing HIV, teenage pregnancy and other sexually transmitted infections.
The 16-year-old child needs to understand the importance of education and safe sex practices as an adolescent. The healthcare provider should provide this during every office visit, as teenagers are susceptible to undesirable behaviors as presented in the case. As discussed earlier, the rate of sexually transmitted infections and teenage pregnancies in the country is on the rise. It is, therefore, important to educate the child on the risks associated with having multiple sexual partners. The child needs to understand that the only way of having safe sex is by abstinence as other forms of sexual activity carry some risk (Kirby, 2008). The child’s grades at school are also dropping due to school absenteeism as the child has missed over ten days at school in the last couple of months. It is important to educate the child on the importance of school education, as the child needs to concentrate on his studies to get good grades that will help him in his future career. A good education offers students the fundamental framework required to build their life (Germeijs & Verschueren, 2007).
References
Batanova, M. D., & Loukas, A. (2012). What are the Unique and Interacting Contributions of School and Family Factors to Early Adolescents’ Empathic Concern and Perspective Taking? Journal of Youth and Adolescence, 41(10), 1382–1391.
Chulani, V. L., & Gordon, L. P. (2014). Adolescent Growth and Development. Primary Care - Clinics in Office Practice. http://doi.org/10.1016/j.pop.2014.05.002
Germeijs, V., & Verschueren, K. (2007). High school students’ career decision-making process: Consequences for choice implementation in higher education. Journal of Vocational Behavior, 70(2), 223–241. http://doi.org/10.1016/j.jvb.2006.10.004
Kirby, D. B. (2008). The impact of abstinence and comprehensive sex and STD/HIV education programs on adolescent sexual behavior. Sexuality Research and Social Policy, 5(3), 18–27.
Kovacs, E., Piko, B. F., & Keresztes, N. (2014). The interacting role of physical activity and diet control in Hungarian adolescents’ substance use and psychological health. Substance Use & Misuse, 49(10), 1278–1286. http://doi.org/10.3109/10826084.2014.891623
Reif, C., & Warford, A. (2006). Office practice of adolescent medicine. Primary Care, 33(2), 269–284. http://doi.org/10.1016/j.pop.2006.01.008
