4 practical ways to better engage with adolescents

Rosalyn Page

writer

Rosalyn Page

Rosalyn Page

From staring at the ground and refusing to make eye contact to barely saying a word, adolescent behaviour can sometimes feel rude and frustrating—so it’s not surprising that some doctors find it challenging to engage.

But Headspace GP Dr Sonya Morrissey says that by considering adolescent behaviour through the lens of their developmental stage and seeking to understand the many psychosocial factors which may impact their presentation, doctors can help transform the experience.

Dr Morrissey says adolescents are in a unique phase of life. “They’re at the stage of transitioning between being a child, who’s completely dependent on their parents, and establishing independence and their own identity,” says Dr Morrissey, who will be co-presenting at the upcoming Australian Society of Psychological Medicine’s annual conference in May.

Reframe how you think about seemingly annoying behaviours

Adolescent behaviours, such as being moody, being on their phones or not wanting to talk to adults, are part of this transition period where they’re establishing who they are, wanting their own space and to have some independence, while also still needing family support.

“The important thing is to view what’s going on with them and some of their behaviours through that developmental lens of establishing their own identity and their own independence,” she said.

Focus on building trust first

GPs need to be aware it’s often not the teen or young adult’s idea to come in for a consultation, so it’s important to establish engagement and trust from the start.

“Sometimes that’s the key task of the consultation, not necessarily establishing a clear diagnosis or having a very clear management plan completely worked out, but making the young person feel that they’re heard and respected and that it’s a safe space for them and that you’re trying to help,” she said.

Be up front about confidentiality

A consultation will sometimes involve seeing the young person for a period of time on their own, if they’re happy for that to happen. When it comes to managing confidentiality, DrMorrissey recommends that GPs are very clear with the young person and their parent about confidentiality, but also the limits to it. “I have that conversation early in the consultation about when you may need to disclose information, such as if you think the young person is not safe,” she said.

Wherever possible, particularly for younger adolescents, it’s important for GPs to work with the family as well to help support them, she said.

Take a holistic approach

Dr Morrissey says it’s helpful to follow the HEADSSS model, where GPs look at the person in context with what’s happening at home, school or work, eating and exercise, peers, substance usage, sexuality, suicide and depression and safety.

The challenge in general practice is that this takes time. But where possible when treating a young person, Morrissey suggests that GPs have a longer appointment and be prepared to have a few appointments to get a really full picture of what’s going on.

“There can be information that’s key to an issue that doesn’t come out until the second or even third appointment,” she said.

Dr Sonya Morrissey and Dr Christina Sasse of Headspace will be presenting at the upcoming ASPM conference, where they will share practical strategies for GPs working with young people in the mental health context, covering scenarios such as ASD, gender diversity and complex trauma. The conference will be held on Hamilton Island in May. Register here to attend.

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Rosalyn Page

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