The health needs of adolescents differ from those of younger children. The adolescent struggles with independence. With greater independence, adolescents have more opportunities to engage in behaviors that place them at risk for health problems, including drug use and sexual activity. A behavioral assessment is essential in caring for adolescent patients. Addressing adolescent behaviors is often difficult for the medical provider. Among the reasons for difficulties are the practical limitations of effectively communicating with the adolescent and also concerns regarding the legal and ethical dimensions for providing care for this age group. Providers of medical services to the adolescent patient must create a welcoming environment for the patient so that she or he feels comfortable discussing problems. A nonjudgmental approach will encourage adolescents to disclose information about their behavior. Although the goal of the provider may be to perform an assessment of the adolescent’s risk-taking behaviors, this is best done after establishing a rapport and the patient feels like the provider cares about him or her as an individual.

Providers should routinely interview their adolescent patients both with their parents in the room and also after asking the parent to leave the room so that the patient has every opportunity to discuss sensitive issues. Talking individually with adolescents is important because many adolescents want to talk about sensitive health information but fail to do so because of the lack of opportunities for private discussion.

Many pediatricians find it awkward to ask parents to leave the room during part of the interview, but most families respect the adolescent’s need for privacy. Adolescents and their parent(s) should be informed of the right of adolescents to confidentiality and to consent for their own medical care. By communicating clear guidelines, there will be less room for confusion and increased chances that adolescents will seek the advice of medical personnel regarding sensitive issue in the future.

State and federal laws have been developed to provide protection to adolescents who are concerned about health problems but do not want to
disclose the information to their parents and who may forgo medical care as a result. It is important for practitioners to be familiar with the laws of consent and confidentiality in their own state, because variability between states exists.