Author: Jennifer Salerno

No Fear: Youth Risk Screening

Connecting with teens is tough, especially when you’re a professional looking to discuss serious topics like mental health, substance abuse or sex. In short: risk screening can feel overwhelming, even scary—but that shouldn’t hold you back. According to the CDC, risk behaviors are responsible for 3 out of 4 (75%) preventable deaths and illness in youth. Having a trusted adult to confide in is one of the single most important mitigating factors in reducing youth risk.

Luckily, Rapid Assessment for Adolescent Preventive Services (RAAPS) is here to help. RAAPS is a reliable and validated assessment and coaching tool that identifies risk behaviors in youth and provides simple health messages to support behavior change.

Instead of letting your fears of comprehensive youth screening become barriers, let them be your guide! Here are a few examples:

  • Fear of not having the resources to address risks that may be identified. In addition to helping you identify key risks, RAAPS provides built in health education and national resources to help you navigate conversations around risk topics that may be uncomfortable. This opens the door for youth to connect with you as a trusted adult without you having to be an expert on every risk behavior or situation.
  • Fear of not having enough time. Finding practical solutions that minimize impact on time and workflow was at the heart of the development of RAAPS. In less than 5 minutes the 21 RAAPS questions identify the risk behaviors that contribute most to preventable illness and premature death in young people aged 9 to 24. Even in the tightest of workflows, in organizations that run like clockwork, finding a 5-minute window of time for risk screening could save a life!
  • Fear of upsetting parents. We get it, parents may be uncomfortable with the idea of their child being asked about risk factors and behaviors. You can help parents understand the importance by explaining that standardized risk screening is an opportunity to stop an uptick in bullying, prevent a potential suicide, or identify incidences of sexual abuse. Additionally, RAAPS technology provides a suite of resources to use when talking with parents that can help these conversations go a little smoother.

Remember, just by being present and starting the conversation you are helping. If you want to take your skills even further, Possibilities for Change offers Adolescent-Focused Motivational Interviewing workshops to help you better connect with the youth you serve. We’re excited to offer a training with open registration for the first time—taking place on June 3rd in Ann Arbor, MI! This in-person workshop will help you to learn and translate new MI knowledge into effective practice through a dynamic and engaging experience. Only 20 spaces available, so register today!

…And When I Get That Feeling, I Want Sexual…Health Coaching!

Valentine’s Day is nearly here and that means love is in the air. For many teens, that may mean more than just candy adorned cards.

Fast fact: 30% of 12-14-year-olds have had sex with 4 or more people—that number climbs to 48% for 15-17-year-olds and 59% for 18 and over.

Sexual health has always been a hot topic—pun intended—but it’s not the easiest to talk about. Whether it’s parents feeling just as embarrassed as their son or daughter about “the talk” or professionals trying to elicit honesty from youth who aren’t open to sharing. Barriers to having these much needed conversations are common. And even when you do get youth to share, many of us feel overwhelmed when talking with them about the risks they have identified. Adolescent Counseling Technology (ACT) for Sexual Health can help!  ACT-SH functions as a virtual health educator providing interactive and engaging, evidence-based counseling to guide youth in identifying sexual health risks and creating personalized safer sex action plans. ACT-SH can be a powerful tool to help understand the needs of our youth:

Like RAAPS with Adolescent Counseling Technology (ACT), youth respond to a set of questions that identify risk behaviors, in this case specifically on sexual health, but ACT goes one step further by providing motivational interviewing based feedback to youth as they are completing the assessment. And when used in tandem with RAAPS, ACT-SH is automatically launched when youth respond positively to the sexual activity question, creating no extra step in workflow!

Here’s what a current user of RAAPS and ACT SH had to say: “I am a big proponent of RAAPS! The patients generally are honest and able to complete RAAPS quickly. We initiated ACT-SH a couple of years ago and having RAAPS automatically direct sexually active patients to ACT-SH has worked SO well. Although most of my patients are pretty open with me, I do feel ACT-SH has helped the more timid ones share behaviors they otherwise would not. The benefit? I then can better address, counsel, do necessary testing, etc. Thank you!”

For more information on the implementation of ACT SH in a community based setting, check out this case study from Spartanburg, South Carolina.

2018 RAAP UP!

Here at Possibilities for Change, we believe all organizations serving adolescents and young adults should have access to the tools they need to provide quality care and affect positive change. When you implement youth risk screening practices with RAAPS, you’re doing so much more than simply administering an assessment; you’re opening the door to endless possibilities to change lives. And our stats from 2018 are here to prove it. Together with our network of professionals we helped identify and prevent more risky behaviors than ever!

Me, Me, “MI” – The Language of Teens

Test your Teen Speak skills.  Which of the following are true statements?

  1. Teens don’t like being told what to do.
  2. Teens don’t learn from our experiences.
  3. Sometimes teens resist our advice just to be resistant!
  4. All of the above.

Yes, it’s obviously “D”.  But why?

The answer is not because teens choose to be difficult.  (Although it can definitely feel that way.) Yet the answer does lie within their wonderful (and maddeningly) hard-heads…

Brain development during adolescence deeply affects what a teen can understand, how they hear and respond to information, and their decision-making about risky situations.   Resisting advice, not learning from our experiences and not responding positively to being “TOLD” what to do are all 100% normal for teens.  Unfortunately, risk taking and experimentation are also a normal part of adolescent development.  So, if our usual communication strategies are not working, how can we help teens avoid situations that may influence them to make risky decisions and instead engage in more positive risks that encourage personal growth and development?

Here’s one more quick quiz…

Data shows that the most effective strategy for helping teens reduce risk and change behavior is:

  1. Raising your voice until they hear you (or at least you feel heard)
  2. Locking them in their rooms until they turn 30
  3. Bribing them with clothes and/or screen time
  4. Using Adolescent-focused Motivational Interviewing (MI) techniques

We’re sticking with the obvious response of “D” (but couldn’t resist having a little fun with it along the way…) Adolescent-focused MI helps anyone (providers, professionals and parents) connect with and communicate more effectively with teens.  MI strategies create the opportunity for meaningful, two-way dialogue, increase engagement, and has been proven to increase the efficacy of behavior change and risk reduction efforts with teens.

So how does Adolescent-focused MI work?

The heart of an adolescent-focused MI approach is respect.   The success of this approach relies on enabling teens to drive the conversation.  With a mix of changes to your communication strategies (some big and some small) – Adolescent focused MI can successfully change the dynamic of your discussions with teens.  While some of these strategies can take years of practice – there are LOTS of simple changes that will immediately improve your “Teen Speak”.

To learn more about Adolescent-focused MI, it’s as easy as 1, 2, 3:

  1. Download this infographic for some straight-forward techniques you can start using today.
  2. Watch our webinar for a guided introduction to adolescent-focused MI, led by nationally-recognized expert and educator: Dr. Jennifer Salerno.
  3. And check out our suite of adolescent-focused MI trainings that can be tailored to the specific needs of your organization.

Creating a judgement free zone…

Most professionals who work with youth try to approach each interaction with an open mind.  Research shows this is an important step to making youth feel comfortable.  What else goes into creating a safe place for youth to share?  Some of the steps are obvious – but we think a few may surprise you!  Here are 5 critical steps to creating a truly judgement-free zone…

  1. Know the law! Confidentiality laws and minor consent vary from state to state.  The first step to ensuring a youth-friendly approach is understanding the confidentiality laws in your state.  Next is implementing a workflow that integrates and accommodates these laws (including processes for everything from notification of test results to insurance billing).  It is imperative that youth understand their rights, and what will or won’t be shared with their parents.  Explaining and sharing this information goes a long way towards building trust.
  2. Be non-verbal! Well – just for the assessment, anyway.  When a risk assessment is delivered verbally, it’s our nature to jump in and talk about each risk as soon as it is identified – making it hard to get to every question.  More importantly, it’s just not in a teen’s nature to be forthcoming about risk when asked questions face-to-face.  Research shows youth respond most honestly when screened with technology – but if that is not an option, then old-school pen and paper is the next best thing.
  3. Standardize your approach! There’s a reason why every leading youth health organization recommends a validated, standardized risk assessment. As humans we have subconscious biases and deeply held personal beliefs that can influence our approach to risk screening.  This can be especially prevalent with home-grown risk assessments that are cobbled together with “select” questions pulled from a number of different tools.   A validated, standardized screening tool eliminates individual (or even organizational) culture bias and ensures all youth are screened the same way, every time.
  4. No shoulder surfing! It catches many parents off guard when their “baby” is suddenly old enough to complete a risk assessment on their own.  You may find them peering “helpfully” over their tween or teen’s shoulder.  It’s important to provide youth with a private space to complete a risk assessment.  This is an essential step in increasing honesty in youth response.  Engaging and educating parents is also important. They need to be reassured of the importance of this step in their son or daughter’s development.
  5. Watch your body! It’s easy to get so focused on youth that we forget what’s happening with our own body language.  Young people are very sensitive to non-verbals – and they are looking for any signs that you might be judging them (however unintentional those signs may be on our part!)  So avoid little things like crossing your arms, narrowing your eyes, or raising an eyebrow.  (And the same rules apply to your tone and speech.)

For more information, the Society for Adolescent Health and Medicine has some helpful resources on confidentiality and this case study highlights effective adolescent workflows across three very different settings.

Click here to learn more about RAAPS – a standardized, validated, and technology-based risk screening system developed especially for youth (and the providers and professionals that work with them)