Sex Ed 101: Here’s what we’ve learned so far…

The last year and a half has been very eventful here at P4C – we launched RAAPS 2.0 with a complete platform upgrade…  AND we released our first new product since our company was founded: the Adolescent Counseling Technology or “ACT” for Sexual Health (and our release of ACT for Tobacco is just around the corner).

With over a year of youth completing ACT for Sexual Health – we took a moment to analyze the data and reflect on what we’ve learned so far.  We were shaken at some of the findings and wanted to share them with you!

Our first ‘schooling’ came in the data.  We expected higher rates of risk among sexually active youth – but the levels are honestly staggering (and disquieting).

Among sexually active youth who were assessed and counseled by the ACT for Sexual Health system:

  • 19% have been in an abusive relationship in the last 12 months and 16% report being forced to participate in unwanted sexual activity
  • Nearly 1 in 4 (23%) had a partner who refused to use condoms or prevented the youth from using birth control
  • And 16% of youth report having bartered sex (for a place to stay, phone, alcohol or drugs, money or something else) – this number was much higher than any of us involved in the research and development of ACT had anticipated – and a growing trend that should be on the radar of all providers and professionals working with youth.

Schooling number two?  ACT solves different problems depending on the setting. We reached out to the providers and professionals using ACT – ranging from experienced sexual health gurus to novices and newbies.  We were interested in finding out the different ways organizations are using ACT SH to solve their problems related to engaging youth and supporting them in healthy decision making:

  • SBHCs are using ACT to open the door to more in-depth, in-person dialogue and counseling with sexually active youth and they are using the population-level data for reporting and to guide programming
  • Primary care and pediatric practices are using the electronic counseling to ensure sexually active youth are provided evidence-based, standardized education (a challenge in time-crunched practices where providers often have varying levels of experience and comfort levels with sex-related risk topics)
  • Health Departments are leveraging the technology to provide STI counseling and follow-up on a sustainable scale that wasn’t previously possible with lean staffing and limited funding
  • Youth and school programs use ACT to identify the myriad of sexual health services youth need and provide appropriate referrals and resources.

And finally – when it comes to adolescent sexual health:  standardization, scalability & sustainability really matter.  Building on the previous points – for providers and professionals working with youth to reduce sexual health risks ACT provides the ability to provide evidence-based, standardized counseling across a broad population, essential in today’s time-crunched, underfunded world.  For many of the organizations we work with who depend on grant-funding, ACT for Sexual Health is providing an affordable, sustainable intervention to bridge funding fluctuations.

Are you using ACT for Sexual Health?  If so, please weigh in and tell us your Sex Ed story!

Want to learn more?  Click here to schedule a call to find out more about ACT SH works in organizations like yours.

Getting to “Why?”

How boot-camp took us back to the future.

Our team recently went through a strategic planning “boot-camp” as part of a grant requirement.  A mandatory part of the exercise was justifying our value…what do we bring to the table, how do we help?

This was definitely a test.   Our short answers, in rapid succession:

  • “Because 75% of serious illness and death in youth is preventable…”
  • “Because nearly half of all youth who commit suicide visited a healthcare provider within the previous month…”
  • “Umm…because it’s the right thing to do?”

We were pushed further: “What is in it for your users – the healthcare provider, the professional working with youth?  How are you helping them?”

Ahhh – there it was, the lightbulb moment!

Preventing avoidable illness and death in youth is our mission – it’s the reason why we do what we do.  It’s the same mission that drives most of us in this work.

But making it as easy as possible for providers and professionals, to identify and counsel youth on the risky behaviors that drive our mission…making it painless…THAT is the reason behind WHY we’ve created every single solution and service we offer.

It’s the reason why RAAPS was created in the first place.  It was our first “tool”. RAAPS was developed to solve all of the workflow and practice management issues that get in the way of your mission:

  • Validated, short-format. Why? Your time is short – RAAPS has been proven to identify the most significant risks – in minutes.
  • Why? To ensure every youth is screened the same way – with the same questions – every time.
  • Tablet / smartphone delivery. Why? Youth engage honestly with technology – you don’t have to “ask” all of the questions – instead you can use your time to follow up on the risks identified.
  • Prioritized, evidence-based talking points. Why?  To make it easier to get the conversation started specific to the risks identified – we all have different experience and comfort levels with risk topics.

Yes, we could go on…  but back to boot-camp.  It was a great experience – if for no other reason than it reminded us of why we continue to develop our technology… facilitate the adolescent-focused MI trainings… write the books…. Why we got started and where we are going into the future – as we achieve our mission together with all of you!

Be the Change: Identifying Sexual Abuse in Youth

From the #metoo movement to the heart wrenching testimony against Larry Nassar – the news lately has been filled with one story after another of things we wish we could have changed.  But how?

Early identification is key for young victims of sexual abuse. These victims have a higher incidence of inter-related risks and risk behaviors, including: depression, disordered eating, drug and alcohol use – as well as sexual health risks.

Young victims of sexual abuse need a safe place to disclose – and a trusted adult to disclose to. 

Systematic risk screening by professionals caring for youth help to ensure risks are identified early – while also providing an opportunity for intervention and counseling in a safe environment.

Yet, sexual abuse is an extremely difficult conversation to initiate with youth – even for the most experienced professionals.  It is also an especially difficult conversation to broach for the affected youth who are struggling with fear, anger, and embarrassment.

Research and practical experience has shown us that technology can help bridge the gap between adults and youth – starting a meaningful conversation on even the most difficult of topics. It’s not a surprise that young people are comfortable with technology.  What may be surprising is the increase in honesty and self-reporting of risk behaviors with technology-based screening.

Youth will reveal information in a technology-based assessment that they will not reveal in a verbal Q&A…even a verbal conversation with a professional they are familiar with.  Using the technologies offered through Possibilities for Change (P4C), professionals have experienced this benefit first hand, effectively identifying youth who are victims of sexual abuse and inter-related sexual health risks – and connecting them with much needed counseling and services.

Over the last 2 years, among youth (13-21 years) provided the P4C technology-based assessment and counseling system as part of a healthcare or other visit to a professional:

  • 15% report being forced to participate in unwanted sexual activity
  • 18% have been in an abusive relationship within the last year
  • 23% have had sex with partners who refused to use birth control
  • 16% have bartered sex for a place to stay, substance use, money, or something else

While recent headlines have ignited a national dialogue on sexual abuse and the risks facing our youth –  for the healthcare providers and professionals we work with this is already part of a conversation that is happening daily.  One conversation at a time, hundreds of conversations a month, and thousands of conversations a year.

Possibilities for Change was founded with a single mission: to help professionals and parents connect with youth to identify and prevent risky behaviors.  Please join our mission:

Learn more about technology-based risk assessment and counseling.

Best present for Mom or Dad…EVER

It’s the holiday season again (wasn’t it just yesterday?)  And for parents of teens, presents made of macaroni or popsicle sticks may be a thing of the past.  However, there’s one homemade present every parent will still treasure:  better communication with their teen.

Granted – it’s more of a present to yourself.  But we deserve it.

The hustle and bustle of holidays combined with changing schedules and time away from school can quickly remind us of the differences in parent-teen communication styles and highlight stressful family dynamics.  Why not start your new year’s resolutions early this year and use the holiday season to build a better relationship with your teen?  It’s the gift that will truly keep on giving.

Here are 3 quick tips to get you started:

  1. Resolve to ask only open-ended questions. These are questions that can’t be answered with a simple “yes”, “no”, or one word answer. Like instead of “How was your day?” (Answer: “Fine.”) Try:  “What did you do today?” It might seem or even feel silly at first. But this is a tip that will quickly reward you with information and insight into your teen’s (often mysterious) daily life – and may even lead to genuine two-way dialogue!
  2. Create one-on-one time. Sure, this can be a dinner, but finding dedicated time for a one-on-one dinner over the holiday might be more stressful than not!  Embrace small moments as an opportunity to engage – and find out more about their latest interests.  Ask for help wrapping presents and have them bring the playlist.  Take them shopping to pick out a small present for their friend.  Test out their favorite video game on the store’s big screen or maybe just have them pick the video and snack for movie night.
  3. Use reflections. No, we’re not talking about pulling out the family photo album. This is a communication strategy that helps your teen feel “heard” and defuse emotions when tensions run high.  Here’s an example – your teen shouts at you “I can’t believe you won’t let me go to my friends to spend the holiday.  You don’t care about my feelings at all.”  Instead of immediately explaining the fault of their logic (e.g., you’ve spent the last 16 years dedicated to their safety, happiness and success, and you are only asking for one day of their time in return…), try this instead: “You want to spend the holiday with your friend.  Your friendship is very important to you.”  Then pause and really listen to their response.  You may follow-up with something along the lines of “Spending time together with you on the holiday is very important to me.  Let’s think through some ideas that will get both of us at least some of what we want.”

Perhaps the most important strategy: don’t forget to take it easy on yourself this holiday season.  These communication techniques take practice – resolve to try them out, and don’t expect perfection the first time around.  Parenting a teen is hard – but ultimately rewarding – work.  Give yourself the gift of patience and permission to make mistakes on the path to building a strong relationship with your teen.  The best homemade gift…(for)ever.

For more effective strategies to build strong relationships with your teen (and a great stocking stuffer for yourself) check out “Teen Speak” by Dr. (and mom) Jennifer Salerno.

Wishing all families everywhere a very happy (and stress-free) holiday season from Possibilities for Change!

Teen Depression and the Holidays. The Struggle is Real.

Teen depression grew by 37 percent over the last decade.

Self-Harm Increasing Among Adolescent Girls.” – HealthDay News
Smartphones May Increase Risk of Depression Among Teens.” – TIME Magazine
Teen Depression On Rise In US” – Chicago Tribune
Rise in teen suicide, social media coincide; is there link?” – Chicago (AP)

These are just a few of the headlines in the news today and frankly they feel daunting, especially if you are working closely with or are the parent of a teen that suffers with depression. Too often the signs go unnoticed or worse ignored because we don’t know what to do to help. Professionals and parents struggle with questions like, “Where do I start? How can I open discussions to help teens understand and process their feelings? When do I need to seek help from a professional?”

According to The National Institute of Mental Health, an estimated 3 million U.S. teens aged 12 to 17 had at least one major depressive episode in the past year and as the holidays fast approach, these feelings often worsen. The holiday season can be difficult for teens with the onslaught of social media posts, school parties, and other social gatherings. Feelings of depression can cause teens to avoid social interactions, which can be especially difficult during the holidays. Unfortunately, withdrawing from holiday festivities often worsen their feelings of loneliness and symptoms of depression.

Teens are learning to explore and find their way through their emotions and thoughts. Creating opportunities for honest disclosures and discussion is critical. These 3 tips can help you get started:

Identify the struggle.

Start by noticing teen behaviors and watching for red flags (those warning signs that may point to depression):

  • Excessive moodiness and tears
  • Anger and irritability
  • Excessive sensitivity to criticism
  • Difficulty concentrating
  • Changes in sleep patterns
  • Feelings of worthlessness and/or helplessness
  • Changes in eating patterns that result in dramatic weight gain or loss
  • Unexplained aches and pains
  • Social isolation or abandonment of peer group
  • Isolation from family members

Risk assessments like RAAPS, which use technology to provide a safe way for teens to disclose their feelings and engage honestly in a discussion with a professional, are a must have to identify issues and navigate discussions that may be difficult to approach otherwise.

Educate yourself.

Understand outside stressors affecting teen depression – social media, cyberbullying, academic pressures, substance use, poverty, fatigue, body image, violence, and family issues or loss. Consult your healthcare provider, school health professional or counselor for help. Ask your healthcare provider if they offer risk assessments as part of their routine teen healthcare visits.

Start the conversation.

Communication is key. Open the door to discussions with teens about depression as well as outside stressors that may be affecting their mood. Talk with them…not at them. Dr. Jennifer Salerno, has written Teen Speak: A how-to guide for real talks with teens about sex, drugs and other risky behaviors, to provide parents and other adults with practical communication strategies to help foster strong relationships with the teens in their lives and to support often difficult conversations about risk.

The teen years are not easy for parents or teens, feelings of depression can make it even more challenging. Building strong relationships through effective communication can provide teens with the support they need to navigate the holiday season and beyond.

Possibilities for Change (P4C) equips professionals, parents and youth with tools that unite empowered voices to positively impact youth risky behaviors and health. For more information, visit