Older Children and Adolescents
Older children and adolescents are usually at a stage where they can participate in the client interview in a more active way and articulate their experiences, emotions, and needs. Thus, it is important to address them as the client first, as opposed to the care partner. Care partners are often still involved, but you should offer the child/adolescent the opportunity to speak with you privately at times. For example, you might say to the client: “At this age, I often like to provide time to speak with you alone. Are you okay if I ask your mom or your dad to step out for a few minutes?”
You should continue to use a combination of non-verbal and verbal language and communication strategies. In terms of non-verbal communication, use eye contact with a relaxed and open posture that demonstrates interest in what they are saying. Smiling may be appropriate depending on the topic. You should also facilitate the interview using strategies such as nodding and statements that encourage the client to continue sharing (e.g., “uh huh” and “tell me more”). Be aware of your facial expression and vocal intonation to ensure you are conveying empathy, acceptance, and a non-judgmental attitude. You may want to include fun objects or games, or include the child in the assessment process (e.g., “would you like to try tapping on your own knee with this reflex hammer?”).
Adolescents are in a transitional stage where they are still children but are moving closer to adulthood. It is important to recognize and respect their self determination. Additionally, emotional and cognitive capacity will vary from adolescent to adolescent and from situation to situation. Therefore, your communication strategies will need to shift based on the adolescent and the situation. Overall, you should convey acceptance, honesty, and respect. Avoid talking to them as a child, as this is often interpreted as demeaning. Some adolescents are old enough to make their own decisions regarding some aspects of their health care: in many jurisdictions, this capacity to consent, which includes being able to understand and weigh risks and benefits, is determined by maturity level rather than by age.
When discussing sensitive and intimate topics, it is important to recognize that adolescents often feel self conscious, embarrassed, and have a fear of being judged. Your communication strategies should convey acceptance and understanding of what they are experiencing. You should have an open and non-judgmental attitude so that you can cultivate a trusting relationship with the client. Permission statements can be particularly useful as they can help normalize what an adolescent may be experiencing.
