Providing Private Time with Clinician in Adolescent Healthcare

It is important that the clinician/healthcare provider be responsive to the need for adolescents to be afforded the opportunity to visit with them privately concerning more personal healthcare matters. Adolescence is a transitional period of development during which the individual should gradually begin to take greater responsibility for their own needs, including healthcare needs. This point is often overlooked by healthcare providers and parents who may be reticent to see the adolescent as an individual who is quickly reaching sexual and physical maturity.

Adolescence is traditionally a time of exploration and experimentation as the young person tries out their new "wings." It is also a stage which evokes many questions for the maturing individual. During this transitional period, relationships with parents may become tentative or volatile as the teen struggles for independence. These normal interactions may result in the adolescent feeling uncomfortable with discussing certain concerns, such as sexual or at-risk behaviors, in the presence of a parent or guardian.

It is just as important for clinicians in the healthcare setting to offer time alone within the context of the office visit to adolescents with developmental or other disabilities. This practice often may be omitted by some clinicians who focus on the disability, and/or varying degrees of caregiver dependence, rather than on the individual. Adolescents with developmental disabilities experience similar issues as more "typical peers" and thus should also be afforded the opportunity to visit with the clinician in private.

Factors surrounding confidentiality should be discussed not only with the adolescent but with the parent/guardian prior to beginning the private portion of the visit. Types of information which may result in a mandatory breach of confidentiality must be outlined clearly with all parties before beginning this portion of the visit, and periodically at subsequent visits.

Koller, L.M. (2002). Common adolescent concerns. In J. Fox (Ed.), Primary Healthcare of Infants, Children, & Adolescents (chap 20). St. Louis: Mosby, Inc.