COLLAPSE
When obtaining a health history, it is important to build a rapport with the patient and create a safe space for communication (Ball et al., 2019). Using a patient-centered approach, as discussed by Ball et al. (2019), increases the opportunities to keep the conversation going and obtaining the information needed to treat the patient.
In the case of 16-year-old BK, the clinician must take into account the patient’s age and socioeconomic factors. BK lives with her grandmother and her mother is a drug addict who is incarcerated. The grandmother is concerned about drug abuse by BK, stating that BK has been “acting strange, staying in her room all the time and refusing to do all the things she used to enjoy”.
The priority of the clinician is building a relationship with BK in order to get the information needed to provide optimal treatment (Ball et al., 2019). Using the HEEADSSS assessment tool would be beneficial for this situation (Ball et al., 2019). The HEEADSSS acronym stands for home environment, education/employment, eating, activities/affect/ambition/anger, drugs, sexuality, suicide/depression, and safety from injury and violence (Ball et al., 2019).
An interview utilizing this assessment tool would consist of the following five questions:
“How are things at home?”
“How are things at school?”
“Are you feeling angry or upset about anything lately?”
“Are any of your friends pressuring you into things you’re not comfortable with?”
“Have you had any thoughts of harming yourself or others?”
Another approach that could be beneficial is an electronic screener, such as YouthCHAT (Thabrew et al., 2019). Thabrew et al. (2019) discusses the use of YouthCHAT as a screening tool and alternative to the HEEADSSS assessment, stating that it is more cost-efficient and time saving.
Using the electronic screening process can be beneficial when assessing adolescents because many adolescents nowadays are more comfortable reporting their symptoms to a computer rather than in person. An on-screen assessment may not be as intimidating as a clinician’s questioning.
In conclusion, there are many different approaches to consider when assessing adolescents. Considering their background, age, gender, and socioeconomic status plays a major role in which specific tools to use (Ball et al., 2019).
Practitioners must be keen on identifying questions that may trigger the patients in order to avoid causing a barrier between them. Building a healthy practioner-patient relationship is the first step in creating a foundation to build a health history.
