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Every Adolescent Deserves a Good HEADS History

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Dr Harish Pemde, New Delhi    16 January 2018

  1. Adolescents are very different from a child or an adult. They need to be treated differently, whether in OPD or in Adolescence is a stage of life where an individual moves from dependency on parents to independent life. This transition is smooth for most adolescents but can be difficult and tumultuous in some. The needs of an adolescent, as our client or patient, are very different from a child. They need to be involved in all aspects of healthcare, i.e., right from history taking to explaining the treatment and prognosis of the illness.
  2. They need privacy, i.e., both audio and video privacy, and an assurance of confidentiality of discussions. This assurance of confidentiality should be very clear and visible. It is a good practice to have it written somewhere as a poster in the clinic. Adolescent needs to be interviewed alone too and parents should be asked to wait outside during this conversation.
  3. The psychosocial history should proceed from nonsensitive issues like home, education, activities after school, to more sensitive issues including drugs/depression, spirituality/suicide/sexuality (HEADS). This is often very helpful in establishing communication with an adolescent. Remember, this history may not be complete in one sitting and may require several sessions. However, it is very important to complete this in ALL adolescents including those coming to clinic for minor illnesses like cold, cough, headache or pain abdomen, etc. Clinician needs to find an opportunity for this psychosocial history. This is rather more important when an adolescent has a chronic illness like asthma, diabetes, celiac disease or thalassemia, etc.
  4. This is the minimum every adolescent deserves from a medical consultation. Very often this rewards you to find an issue related to the current presenting complaints and also for planning for future care and vaccinations.

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