Module 2-Responding to the Adolescent.pptx

1. RESPONDING TO THE ADOLESCENT ADOLESCENT HEALTH CARE FOR PRIMARY SERVICE PROVIDERS Foundational Course Module 2

2. MODULE 2 SESSION 1 Module 2: Responding to the Adolescent 2

3. Learning Objective Discuss HEEADSSS tool being used to identify protective factors and to detect risks in adolescents’ social, educational and home environment. Module 2: Responding to the Adolescent 3

4. ACTIVITY 1.01 Module 2: Responding to the Adolescent 4

5. Screening Tool Home Education and Employment Eating and Exercise Activities and Peer Relationships Drug Use/Cigarettes/Alcohol Sexuality Suicide and Depression Safety • A screening tool for conducting a comprehensive psychosocial and health risk assessment • Provides and ideal format for a preventive health check. • Provides information about young person’s function in key areas of their life Module 2: Responding to the Adolescent 5

6. Rapid HEEADSSS Form • Psychosocial triaging • Self-administered questionnaire • To increase the uptake of psychosocial screening for early identification of risk-factors to prevent unfavorable health outcomes • Not a replacement to the comprehensive psychosocial assessment (HEEADSSS) Module 2: Responding to the Adolescent 6 of 46

7. Self-Administered Rapid HEEADSSS Form 7

8. Interventions Psychosocial Evaluation (Guidance counselor/ psychologist, school nurse, guidance designate, homeroom teacher) Fill-out the questionnaire Assess need for urgent evalua tion YES to any other items No Yes SCHOOL - Homeroom - Enrollment - Annual PE - throughout the school year Intake Process - Fill-out registration sheet - Provide short orientation on the process - Discuss privacy and confidentiality - Assign a control number/ student number YES to any items concerning safety Yes NO to all items Immediate Within the next month Within the school year Preventive counseling, Health education session/s Two-way referral - Provide audio- visual privacy - Issue the tear- away section - Submit form directly CHIILD PROTECTION Psychosocial concerns Physical health Concerns Homeroom Adviser ARH Coordinator Guidance Counselor/ Designate School Health & Nutrition Personnel Parental Notification Using the Rapid HEEADSSS

9. Non-Health-related Referral (Secure referral form) 9 Internal referral Health-related Referral (Secure referral form) Primary Barangay/SK DSWD PNP Secondary Primary Private facilities/ specialized care CSO/NGO Others ARH Coordinator Receiving Agency Parental Notification Two-way referral External Referral

10. Using the Rapid HEEADSSS Module 2: Responding to the Adolescent 10 of 46 COMPREHENSIVE HEEADSSS/ Full Psychosocial Interview Fill-out the questionnaire Assess need for urgent evaluation YES to any other items YES to any items concerning safety NO to all items Immediate Within the next month Within the school year REFERRAL

11. ACTIVITY 1.02 Module 2: Responding to the Adolescent 11

12. Interview Flow Introduction • Describe the set-up • Discuss Confidentiality • Ask the parent/guardian to step out Interview Proper • Information gathering Summary • Issues • Addressing the issues • Plans Module 2: Responding to the Adolescent 12

13. TIPS: Prepare as an interviewer • Be yourself • Be approachable • Be good listener • Be professional • Be caring • Exhibit non-judgmental attitude

14. TIPS to engage adolescents o Liking the adolescent o Involving the family o Establishing rapport o Ensuring confidentiality o Acting as an advocate o Listening and displaying interest o Discovering the hidden agenda o Use a developmentally oriented approach

15. • Introduce yourself • Direct questions to the adolescent • Talk about their interest • Treat their concerns seriously • Explore issues that concern the teen - not only the concern of the parents TIPS to establish rapport

16. Ensuring Confidentiality ◊ Discuss limits of confidentiality: abuse, harm to self or others, breaking the law ◊ Parents and teens should be made aware of confidentiality guidelines ◊ Strong determinant for health seeking behavior of adolescents

18. Strengths-Focused • Strengths based questions seek to identify young people’s strengths • Use open ended questions, asking for descriptions, “how come” rather than “why”. • Practice using open ended questions throughout the HEEADSSS interview • Opportunity to work with the adolescent to maximize their strengths and mitigate risks

19. HEEADSSS Module 2: Responding to the Adolescent 19 Home Home Situation, Family Life, Relationship and Stability Education/ Employment Explore sense of belonging at school/work and relationship with teachers/peers/workmates/changes in performance Eating and Exercise Explore how they look after themselves; eating and sleeping patterns

20. HEEADSSS Module 2: Responding to the Adolescent 20 Activities and Peer Partnerships Explore social and interpersonal relationships, risk taking behavior and attitudes about themselves Drug Use/Cigarette/ Alcohol Explore context of substance use (if any) and risk taking behavior Sexuality Explore their knowledge, understanding, experience, sexual orientation and sexual practices - Look for risk taking behavior/abuse

21. HEEADSSS Suicide/Self Harm/ Depression/Mood Explore risk of mental health problems, strategies for coping and available support Safety/Spirituality Explore history of accidents, physical or sexual abuse or bullying; violence in home, school or neighborhood; belief system, religion and faith Module 2: Responding to the Adolescent 21

23. Appropriate Interview Practice Module 2: Responding to the Adolescent 23 DOH ADEPT Module 2 Appropriate Practice Video

24. MODULE 2 SESSION 1: BREAKOUT SESSION Module 2: Responding to the Adolescent 24

25. Breakout Room Mechanics • The participants will be assigned to 4 breakout rooms • An adolescent guest will be joining each group • The group will conduct a MOCK INTERVIEW ‐ Each adolescent guest was given a (fictional) case to portray ‐ The case will not be disclosed to the participants, except for the age ‐ The case will unfold during a psychosocial interview to be conducted by the participants ‐ This set-up is for the purpose of demonstration, psychosocial interviews are best conducted one-on-one ‐ The group is allotted 45 minutes for this run Module 2: Responding to the Adolescent

26. Conducting the HEEADSSS Interview • The adolescent, interviewer and facilitators will keep their cameras open • Parents are already informed and out of the room • Rapport building will only be for the first person assigned • Each assigned person will only ask 3 questions • Participants should be able to connect to questions and relate it to the next section of HEEADSSS • Summary of findings shall be discussed to the adolescent Module 2: Responding to the Adolescent

27. Role Assignments Module 2: Responding to the Adolescent INTERVIEW PARTICIPANT Introduction/Discussion of confidentiality and its limits Home Education and Employment Eating Behavior and Exercise Activities and Peer Partnerships Drugs and other Substances Sexuality Suicide, Self-harm, depression, mood Safety, Spirituality Summary of findings and plans

28. INTERVIEW PROPER Module 2: Responding to the Adolescent

29. PROCESSING Module 2: Responding to the Adolescent 1. How did you feel about the interview? 2. Do you think, this interview can help teens? 3. Any lessons learned? FOR OUR ADOLESCENT LEARNER

30. PROCESSING Module 2: Responding to the Adolescent For the interviewer, how did you feel about doing the interview? FOR OUR PARTICIPANTS

31. PROCESSING Module 2: Responding to the Adolescent 1.What are your realizations about the teenagers? 2.What did you find easy during the interview process? 3.What was difficult during the interview process? 4.What could you have done better? FOR OUR PARTICIPANTS

32. Take Home Messages -Conduct of psychosocial screening should be ROUTINE -Improving our skills in interviewing is not just through this activity, PRACTICE is key -To overcome the difficulties and to make the interview process more comfortable for the adolescent and the interviewer PRACTICE is KEY -The psychosocial screening is NOT FAULT FINDING, it is an opportunity to highlight their strengths and identify the risks so we can minimize the possible health risks -Exercise being -NON-JUDGMENTAL Module 2: Responding to the Adolescent

33. Module 2: Responding to the Adolescent 33

34. Definitions • Privacy is “the right and power to control the information (about oneself) that others possess” (WHO 2000b). Privacy also commonly refers to respecting the rights of individuals not to be physically exposed against their will. • Confidentiality is “the duty of those who receive private information not to disclose it without the patient’s consent” (WHO 2000). • Informed Consent is usually in the form of a document signed by the clients, relays all pertinent and relevant services, such as risks and benefits, to the potential clients, allowing him or her to make an informed decision regarding participation. Module 2: Responding to the Adolescent 34

35. Ensuring Privacy •Does the clinic have enough private space? •Can patients be seen or heard from outside consultation rooms? •Do staff members protect adolescents’ right to privacy in practice? •Do adolescents have the opportunity to see health workers without parents, family, partners, or friends? Module 2: Responding to the Adolescent 35

36. Private Space •For providers to consult with adolescents individually? •For information about the adolescent collected in a private room rather than the reception area? •Review and use available space more efficiently (e.g. clearing out “dead space” or storage space •Adjust patient flow, wherein collecting information is transferred from a receptionist to a different provider Module 2: Responding to the Adolescent 36

37. Sound of Silence • Are the walls and doors of consultation rooms solid enough to prevent adolescents from being seen or overheard from outside the consultation room, such as hallways, adjoining rooms or reception areas? • Are curtains used to separate any consultation areas? • Ideal scenario: strengthen walls and doors of consultation room. • Second best: Use curtains to separate consultation areas. • Speak softly. • Ask colleagues to vacate the room • Develop policies re sensitive information are private Module 2: Responding to the Adolescent 37

38. Staff Members • Do receptionists or any personnel at the receiving area ask adolescents to state the reason for their visit in front of other patients in the reception area? • Do staff members collect intake information in the waiting room? • Do staff members routinely interrupt or walk in on consultations or counselling sessions • Ensure no one else is around when taking personal information from the patient. • Have staff understand that the breech of privacy and confidentiality puts the adolescent health and safety at risk. Module 2: Responding to the Adolescent 38

39. No “Bring Parents” Do/are providers or health workers: - know creative strategies for getting a moment alone with adolescents to ask whether she/he would like to discuss anything without the parents, family members or friend present? - ask adolescents about sex, sexuality, or violence in the presence of partners, parents, family members or friends? - aware that the person who accompanies the adolescent may reveal information to other people or to perpetrator of violence for example? - know how to distract a family member or friend long enough to ask an adolescent about abuse when they suspect that the adolescent has been a victim of violence or any related sexual and reproductive health concerns? Module 2: Responding to the Adolescent 39

40. Confidentiality •Are medical records secure? •Are there policies and procedures ensuring confidentiality? •Are the staff trained in the policies and procedures? Do they have the basic knowledge and awareness of the importance of confidentiality? Module 2: Responding to the Adolescent 40

41. Policies and Procedures • When, how and why staff are allowed to share information with: ‐ Other staff members? ‐ Parents of minors / family members? ‐ Local law enforcement authorities? • When and how staff should obtain consent from adolescents before sharing information about her situation to a third party? • Informing adolescents about any limits to confidentiality? Module 2: Responding to the Adolescent 41

42. Staff Training • Does the staff understand why a breach of confidentiality can put an adolescent at great risk? • Are the staffs trained not to reveal client information without permission? • Does the staff know what kinds of information, if any, it is legally required to report to the authorities, for example, evidence of physical or sexual abuse of adolescents, or physical violence against girls, boys, or LGBT? • Does the staff know how to handle HIV counselling and testing? • Is there a mechanism in the health center for getting feedback from staff about how well the health center policies are working? Module 2: Responding to the Adolescent 42

43. SYNTHESIS •Trust •Privacy •Confidentiality •Informed Consent Module 2: Responding to the Adolescent 43

44. A Case Study Module 2: Responding to the Adolescent 44 Module 3B Appropriate Video

45. CELNA A. DUMDUM

46. MODULE 2 SESSION 4 Module 2: Responding to the Adolescent 46

47. Jacqueline Kitong, MD, MPH Technical Officer for RMNCAH-Nutrition Office of the WHO Representative in the Philippines

48. During adolescence, kids need their parents more than ever. • Research shows that a positive family environment including fun family activities: ‐ opens parent-child communication ‐ Encourages adolescents to participate in positive extracurricular and community activities, Because of such: ‐ teens are able to navigate these years with relative ease.

49. There is no doubt that for most families, the teen years present a challenge for both parents and children.

50. • Understand that the child has grown up and respect the right to have an opinion different than yours • Be extremely friendly with them to be able to understand them better • Be a Facebook contact of your child • Consult a psychiatrist (as needed)

51. •Encourage the entrepreneur quality of your child ( nurture the entrepreneur quality in the child, giving room for exploratory “do-it- yourself behaviors”) •Provide career guidance •Meet your child’s monetary needs

52. • Address habits and vices • Facilitate building of their esteem and self- confidence • COMMUNICATE WITH THEM  Communicate about their infatuations and relationships

53. http://hrweb.mit.edu/worklife/raising-teens/five-basics.html

54. Good luck to all in your parenting!

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