The document discusses adolescent health care and responding to adolescents. It presents the HEEADSSS screening tool for conducting comprehensive psychosocial and health risk assessments of adolescents. The tool covers Home, Education, Eating, Activities, Drugs, Sexuality, Suicide, and Safety. It emphasizes establishing rapport, ensuring confidentiality, and using a strengths-based approach. It provides guidance on conducting interviews, including introducing oneself, asking open-ended questions, and summarizing findings. The document also discusses ensuring privacy, confidentiality, and informed consent when working with adolescents.

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

17. 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 17

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

22. 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 22

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

55. Good luck to all in your parenting!