Adolescent health care for young people in out-of-home care — branching viva

Viva — Branching structured oral

Stem. A 15-year-old in statutory foster care is referred for an entry health assessment. She has had two placements in nine months. Her caseworker attends and expects a full report. ^[1]

Branch 1 — Classification and consent authority

Examiner: How do you classify this young person's placement and legal status, and what does that mean for who can consent to her care? ^[1]

Model answer. Placement is family-based foster care; legal status is statutory or court-ordered, which means the child-protection authority holds placement decisions and may share or hold parental responsibility. Before any assessment or treatment, I clarify and document who holds parental responsibility — parent, guardian or the state — and assess the young person's own capacity for each decision under the mature-minor principle. The placement type sets the intensity and risk profile; the legal status sets consent authority. ^{[1] [3]}

Examiner follow-up: The caseworker expects a full report. What do you tell the young person? ^[1]

Model answer. I state conditional confidentiality aloud: what we discuss privately stays private unless I am worried she is not safe, someone else is being hurt, or the law requires me to act. I am explicit about what the caseworker and carer will and will not receive, sharing the minimum necessary and lawful, and I tell her before I share anything that crosses a threshold. ^[1]

Branch 2 — Mechanism of the health burden