Teen engagement with healthcare providers

Dr Asha Pemberton

[email protected]

AS CHILDREN embark on the physical changes of puberty, the transitional stage of adolescence begins. With that comes several psychological, emotional and social behavioural shifts which may wax and wane in severity.

Adolescents require a unique approach to healthcare. This is best served when young people are provided the opportunities and environment to engage with trained providers, who are cognisant of the needs of tweens, teens and young adults.

During earlier childhood, parents naturally take the lead during healthcare visits. When children are unable to articulate their symptoms or experiences, parents serve as a proxy to facilitate the exchange of information.

As they develop and have the capacities to do so, parents should encourage tweens and teens to become more autonomous in their healthcare. This includes preventive care, acute care and chronic illness management visits.

Children and adolescents with chronic conditions comprise a particularly vulnerable population. They will have frequent clinic and other care visits, often with multiple providers. They will be required to eventually claim the responsibility of managing their health as they transition into the adult healthcare system.

The earlier children and teens learn to confidently and honestly communicate with their doctors and care providers at visits, the more efficiently they learn how to advocate for themselves and make decisions about their health.

It is understandably difficult for parents to navigate the burgeoning emancipation of their children. As they grow, physicians or nurses may request parents to allow older children and teens to be met alone.

Some parents are instantly surprised, suspicious or hesitant. While this will be a change from previous, it is essential that youth learn the skills and confidence to engage with providers on their own, even if only briefly.

The communication skills required to articulate changes in symptoms, life stressors or challenges with adherence to treatment do not emerge naturally. Areas of misinformation lead to disruptions in care provision, errors or delays in appropriate interventions.

In order to fully connect with youth patients, providers need the opportunity to connect and create a solid therapeutic alliance. When parents overly helicopter and micromanage this process, even though well meaning, it creates the context in which growing and developing teens are less functional at their personal agency and self-management abilities.

The health of older children and adolescents should involve counselling and exploration into the many social and behavioural risk factors and exposures around them. This is simply the reality.

While parents may prefer to protect themselves from this unsettling truth, young people are exposed to online and in-person content that can potentially affect their health.

It has been long established that both teens and providers report that private one-on-one time enables them to be more forthcoming about such issues. This is especially true if there is enquiry about potentially sensitive topics, such as substance use, sexual health, and mental health.

Getting accurate information about these topics is important to ensure appropriate and timely interventions. This does not mean that parents will be intentionally excluded if concerns are unearthed.

When young people trust their providers, they are better able to mediate the parent-teen relationship. This supports young people in disclosing areas of concern with their parents. This is the basis of strong family-based interventions which are much more likely to be successful in the long term.

Having one-on-one time with doctors during consultations has several benefits for teens. While some teens may feel nervous or intimidated when invited to meet privately with their doctor, others jump at the opportunity.

Overall, the ultimate goal is that adolescents and young adults feel safe and empowered to take charge of their well-being. This includes not only the decisions that they make day-to-day, but the ability to honestly interface with care providers, to share honestly about their physical, mental and emotional lives so that they can access and accept quality treatment as required.

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