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



RAAPS versus GAPS and other homegrown risk screening tools

People pose the “why?” question every day. Why should I invest the time, energy and resources into an adolescent risk screening and counseling technology? We may be biased, but our answer is simple: why not?

Before we dive into the several reasons why thousands of sites nationwide find tremendous value of integrating RAAPS into their practice or program, here is the 140-character, tweet-friendly definition of RAAPS: a standardized, validated risk assessment and behavior change counseling tool to support health professionals working with adolescents.

In simplified language, we make it easy for health professionals to do their job. We partner with clinicians, counselors and other providers who are passionate about improving adolescent health. Our partners—like school-based health centers, pediatric offices, sexual health clinics, schools, etc.—operate within a preventative-oriented culture (not crisis-oriented) and genuinely care about identifying risks, improving outcomes and changing lives. It’s not for the faint of heart.

RAAPS can make you money

“Say what?!” (Please excuse our language. Sometimes we find the way teens speak kind of catchy.) Yes, our leading risk assessments can save you money. How?

  • RAAPS dramatically improves the productivity of your existing staff and the effectiveness of your operations. You will no longer have to sit face-to-face with your patient, ask the sometimes-awkward questions, record the data, then figure out how to best counsel the patient to promote positive behavior change. RAAPS saves a provider’s time by flagging potential risk behaviors and offering health message talking points to guide the conversation.
  • By using a standardized, validated tool (RAAPS) to screen adolescents each month, the cloud-based system may be able to pay for itself. Assuming an average insurance reimbursement rate of $5 per administration, your sites would need to use the system with only 10 patients per month in order to recover the cost of using the system. #winning

RAAPS’ real-time tracking and easy to use reporting measures outcomes

Can your risk screening tool do this? If it’s not RAAPS, the answer is likely no. Access to individual and population data allows you to identify trends and assess your intervention effectiveness. Plus, data gathered can be helpful when applying for grants and gaining additional funding.

RAAPS asks the right questions

The risk landscape is always changing and unfortunately widening, which is why we continue to update or modify our questions to elicit honest responses from teens. Other risk screening tools, such as GAPS, hasn’t been updated since the early 2000’s. The way teens speak and the risks they’re involved in have changed drastically since the era of Boy Meets World and Backstreet Boys. At Possibilities for Change, we continue to identify issues and areas that are harmful to a teen’s health and well-being. One of the many beautiful things about RAAPS is that all questions are scientifically validated—and we used teens to help us refine the actual questions so that they were more understandable and relevant! Unlike most homegrown tools, the RAAPS youth-friendly patient portal includes audio and bilingual health messages features to increase health literacy.

The 21-question RAAPS assessment falls within seven risk categories identified by the CDC as contributing to adolescent morbidity and mortality. The Society for Adolescent Health and Medicine has our back, citing RAAPS as one of their important resources, handouts, toolkits and treatment protocols for healthcare providers to use in their practices.

In our fast-paced, technology-driven world, the manner and method of how we ask is just as important as what we ask. When it comes to discussions around things like sexual behavior and alcohol use, teens are more honest and comfortable answering to a tablet or other technology than an adult. The assessment takes about 5 minutes to complete—a better alternative to other assessments out there that take more than a half hour. Ain’t nobody got time for that! (We warned you.)

Learn more about RAAPS at or drop us a line at

Top 5 Reasons to Invest in Adolescent Health

Global investments in adolescent health harvests significant economic gains

Recently headlines broke across all consumer and health media outlets that signified the importance of investing in teen health from a global financial perspective. Like any other professional who is in the landscape of improving adolescent health, this kind of global attention and correlation between teen health and the economy gets me excited!

The news referenced a study that highlighted a small investment in “empowering and protecting the world’s 1 billion adolescents can bring a 10-fold return.” Here’s what it said:

“Improving the physical, mental and sexual health of kids aged 10 to 19 – at a cost equivalent to US$4.60 per person per year – could result in a 10-fold economic return by preventing 12 million deaths and more than 30 million unwanted pregnancies.”

I can think of 1,000 reasons to invest in adolescent health, but here are my top 5:

  1. With fewer teens giving birth each year, a country’s young dependent population grows smaller in relation to the working-age population, creating a window of opportunity for rapid economic growth.
  2. Keeping teens safe and encouraging them to make smart decisions can help to break the spread of poverty and disadvantage across generations.
  3. The rapid physical, cognitive and psychosocial growth and development that takes place during adolescence influences an individual for the rest of his or her life.
  4. In three out of four cases of serious injury or death in adolescents, the common causes are preventable. Support in healthy decision-making will help set a pattern of healthy lifestyles and reduce morbidity, disability and premature mortality later in adulthood.
  5. This generation of adolescents will transform all our futures!

How you can take action!

  • The key to improving adolescent health is operating from a prevention mentality versus a crisis approach. Investing in a risk identification assessment tool will address the early onset of behaviors that can grow to be potentially harmful. Plus, RAAPS, a globally-recognized, evidence-based, standardized risk screening and behavior change counseling tool can pay for itself with the proper reimbursement codes.
  • When it comes to talking with teens about sexual health, things can get awkward. That’s why we developed ACT Sexual Health, a virtual health educator where teens respond to assessment questions on a tablet or other technology device and receive sexual health education specifically tailored to them. Upon completion, ACT generates a personalized safer sex action plan, health messages and customized referral sources.
  • Risk behaviors account for the majority of teen injury and premature death. In the face of these challenges, health professionals and parents need concrete, actionable strategies for productive discussions about risky behaviors. Teen Speak is a how-to guide for real talks with teens to foster strong relationships and trust-building during the most formative time in their lives.

Netflix’s Hit Show 13 Reasons Why – How Do I Respond?

Critical next steps for adolescent health professionals and parents of teens


If it seems like everyone is talking about the hit Netflix show, 13 Reasons Why, it’s because they are. The bestselling book turned Netflix series produced 3.5 million tweets—more than any other Netflix show. Its overnight buzz among teens and young adults is leaving parents and professionals feeling troubled and conflicted on how to respond.

From the beginning of the show, we know the fictional character, Hannah Baker, has already taken her own life—an unfortunately relevant issue in our society. Suicide is the second leading cause of death among teenagers in the U.S. While 13 Reasons Why brings to light the intensity and darkness of suicide, it is also a raw encounter of the hardships teens deal with—from bullying, peer pressure, betrayal, and sexual assault.

Hannah Baker wasn’t showing signs of depression that we often associate with suicide, but she was experiencing common hardships that can lead to unhealthy behaviors. To make matters worse, Hannah felt that no one listened to her cries for help.

How to identify at-risk teens

No teen is immune to risks—from the biggest troublemaker in school to the straight-A-student, all teens deal with pressures that they may not be equipped to handle on their own.

How can you ensure they will come to you if they’re struggling? The key is two-pronged:

1) Establish a strong relationship that sets the foundation for real talks.

Establishing that strong relationship—whether you’re a parent or an adolescent health professional—takes time, energy and practice—but it’s worth it. A recent study surveying more than 63,000 youth in the U.S. reveals that teens with a trusted adult to talk to are 2.2 times less likely to engage in risky behaviors, and 3.1 times less likely to report thoughts of self-harm or suicide, compared to teens who reported not having an adult to talk to.

2) Apply proven communication strategies that foster open, real conversations about issues that could affect a teen’s safety and health.

How to have real conversations

Understanding exactly what is happening (and why it is happening) during adolescence can help you support the teens in your life during this physically and emotionally challenging time. Talking to teens about common issues that may lead them to a state of helplessness is a critical next step.

There are evidence-based techniques and communication strategies that are proven to help break through a teen’s silence about the stressors in their life. Those strategies can be explored in Teen Speak, a how-to guide for real talks with teens. Teen Speak provides a detailed road map on how to get the conversation started, using real-world examples of teen-adult interactions and sample responses to common scenarios to support positive change and safer decision-making. In this book, you’ll gain practical strategies for connecting with teens to reduce their risks.


Learn communication strategies for real talks with teens at

Download resources to support parents in building strong relationships at