Paeds Cases · preventive-and-community-paediatrics
Adolescent preventive visit OSCE — confidentiality, HEADSS and safety planning
Observed structured encounter testing time alone, conditional confidentiality, HEADSS interviewing, positive-screen safety action and shared planning.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Station A is a well-adolescent visit with a parent who resists leaving the room. Station B is private disclosure of low mood with possible self-harm risk requiring safety assessment and plan.
Station objectives
- Negotiate time alone and explain conditional confidentiality. [2] [4]
- Conduct a structured HEADSS/HEEADSSS interview. [1]
- Respond safely to mood/self-harm risk. [5]
- Integrate substance and sexual-health inquiry without judgement. [6] [4]
- Co-create a follow-up and transition-aware plan. [7]
References8ShowHide
- [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]White PH Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home. Pediatrics, 2018.PMID 30348754
- [8]McKay EA Parents' Perspectives on Confidentiality in Clinical Preventive Services for Adolescents. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2025.PMID 40580168