Paeds Cases · adolescent-and-young-adult-medicine
Adolescent consultation OSCE — time alone, confidentiality, HEEADSSS and a safety plan
Observed structured encounter testing negotiation of time alone, conditional confidentiality, structured HEEADSSS interviewing, same-visit response to a positive screen, and shared safety planning.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a preventive visit with a parent who resists leaving the room. Station B is a private disclosure of low mood with possible self-harm risk requiring a same-visit safety assessment and plan.
Station objectives
- Negotiate time alone and explain conditional confidentiality. [2] [4]
- Conduct a structured HEEADSSS with open, non-judgemental questions. [1]
- Respond to a positive screen with a same-visit risk assessment and safety plan. [5]
- Close with a shared plan that protects confidentiality and sets follow-up. [4]
References7ShowHide
- [1]Cohen E HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth. Journal of adolescent health : official publication of the Society for Adolescent Medicine, 1991.PMID 1772892
- [2]Ford CA Delivery of confidentiality assurances to adolescents by primary care physicians. Archives of pediatrics & adolescent medicine, 1997.PMID 9158445
- [3]Miller VA Adolescents Spending Time Alone With Pediatricians During Routine Visits: Perspectives of Parents in a Primary Care Clinic. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2018.PMID 29887486
- [4]Chung RJ Confidentiality in the Care of Adolescents: Policy Statement. Pediatrics, 2024.PMID 38646690
- [5]Mangione CM, Barry MJ, Nicholson WK, et al. Screening for Depression and Suicide Risk in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. JAMA, 2022.PMID 36219440
- [6]Knight JR Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of pediatrics & adolescent medicine, 2002.PMID 12038895
- [7]Katzman CL Adolescent Time Alone With a Provider: Adolescent-Mother Dyads' Perspectives on Its Role to Support Emerging Autonomy. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2025.PMID 40838902