Working with Adolescents: Additional Considerations

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Presentation transcript:

Working with Adolescents: Additional Considerations Sebastian G. Kaplan, PhD Associate Professor Psychiatry and Behavioral Medicine Wake Forest School of Medicine Winston-Salem, North Carolina

Adolescent Drug and Alcohol Use 2015 showed overall stable or downward trends over the past 5 years for 8th, 10th, and 12th graders Alcohol use down Marijuana use stable Prescription drug misuse down Opioid misuse down Tobacco use down

SBIRT for Youth (Mitchell et al. 2013) Screening American Academy of Pediatrics recommends the CRAFFT

SBIRT for Youth (Mitchell et al. 2013) Brief Intervention Across settings: Schools, Primary Care, Emergency Departments Across professions: Behavioral specialist, social worker/case manager, peer supports Typically Motivational Interviewing Generally positive findings for application of MI for adolescent substance use (Jensen et al., 2011) Mixed results in context of SBIRT trials Some short-term benefits Evidence for added benefits of family component to intervention

SBIRT for Youth (Mitchell et al. 2013) Referral to treatment No data on referral to treatment in adolescent samples Data also limited in adult populations

NC Minor Consent Laws Age of majority is 18 Emancipated minors and married minors generally allowed to consent for health care Minors allowed to consent for treatment of (N.C. Gen. Stat. §§ 90‐21.5): Pregnancy related care STDs and HIV/AIDS Drugs and alcohol Outpatient mental health services

N.C. Gen. Stat. §§ 90‐21.4 The physician shall not notify a parent…to consent to medical or psychiatric treatment, without the permission of the minor… unless the situation… is essential to the life or health of the minor. If a parent…contacts the physician concerning the treatment or medical services being provided to the minor, the physician may give information.

N.C. Gen. Stat. §§ 90‐21.4 Any minor may give effective consent to a physician licensed to practice medicine in North Carolina for medical health services for the prevention, diagnosis and treatment of (i) venereal disease and other diseases reportable under G.S. 130A-135, (ii) pregnancy, (iii) abuse of controlled substances or alcohol, and (iv) emotional disturbance.