Talking to Teens - Advice for Health Care Providers*

Colorful graphic of 4 adolescents.

Talking to teens about prevention and risk reduction can be difficult. Sometimes it is even hard to get them to talk. Here are some suggestions.

1. Clarify privacy issues:
Be specific, with both parents and teens, about what you share with parents or others. Time with parents out of the room is important, and it often works better not to give either parents or teens a choice. This takes the pressure off the teen. Also offer to invite the parent back in, since some young people prefer an adult presence when talking about matters not related to sexuality and drug use.

2. Negotiate the agenda:
As with any patient, teens usually have something they want to discuss. Clarify that you can address that, and that you also feel it is important to talk about [smoking, violence, sex, or whatever other topic is key for this patient]. This builds trust, and avoids surprises for either of you.

3. Explain your role:
It can help set the tone to let the teen know that you want to help him or her be healthy, and that getting to know his or her health history and current concerns can help the two of you work towards that goal. Sometimes it helps to be specific about the advantages of having one main clinic and one main doctor.

4. Use simple language:
Since teens may be hesitant to ask for explanations when they do not understand, translate medical terms that may be confusing, using common expressions or phrases. Once you've explained the term, don't hesitate to use it.

5. Be direct:
Young adults may be hesitant to say what they mean, especially if the words that come to their minds are slang. The questions they have may be considered impolite in regular society. It may be up to you to ask gentle, but direct questions to help identify the area of concern.

6. Normalize:
Educate teens about what "average" or "normal" is. This applies both to your questions and to the teen's response. Remember, one of the central concerns of adolescence (especially for young teens) is normality.

7. Listen:
Do not interrupt (if you can help it). Visits with teens may take longer, but don't skimp on this one. If you run out of time, acknowledge that and offer to continue the conversation at another time.

8. Be respectful of the adolescent's experience and autonomy:
Lots of teens feel that people in positions of authority do not give them enough credit. Don't let yourself be put in that position. Like all patients, adolescents have a wealth of life experience. We can help them use it wisely. When obtaining consent, talk to the teen first and then the parent (if present) after it is negotiated with the teen. This also applies to obtaining a history and answering questions.

9. Consider emotional content:
Some life experiences adults take for granted may be more emotionally charged for teens.

10. Offer an opportunity for questions:
If your patient has none, sometimes you can volunteer answers to common concerns. This may generate more discussion.

11. Leave the door open:
Give your card, schedule a follow-up visit, suggest a time frame for checking in again, and recommend an annual visit. Offer to talk by phone if coming to clinic is a problem (transportation, money, and privacy can be barriers). Things can change fast in the life of an adolescent. You may want to schedule follow-up sooner than you would for an adult.

12. Offer options:
If a young person seems hesitant with you, offer (in a non-threatening way) the option of seeing another provider, or even of receiving certain services in a different setting. You may want to write the name of one or two other providers on your card and say, "I'd be happy to see you again if anything else comes up, but if you would feel more comfortable with [a man, a woman, someone else], then here are some other health care providers' names."

* Adapted from the work of Amy J. Elliott, MD, Winter, 1999.

 

Minnesota Health Improvement Partnership Adolescent Health Services Action Team in partnership with the Minnesota Department of Health, Updated 2006