Even though middle-stage adolescents typically have developed intellectually to a degree comparable to adults, their erroneous beliefs and perceptions often contribute to high-risk behaviors that can include experimenting with drugs, breaking laws, and engaging in frivolous or dangerous sexual encounters (such as sex without protecting against sexually transmitted infections and/or pregnancy). Also during these times, life events such as family problems of divorce, separation, and drug abuse can further impact the experiences and behaviors of the adolescent (Meadows-Oliver, 2019) Emotional Domain Adolescents typically experience more frequent high- intensity emotions and fewer low-intensity emotions compared to adults. Adolescents begin to assert their independence and interact less with parents and family and more with peers. Family conflict also increases during this stage of life. The intensity and fluctuations of various emotions contribute to the risk of developing emotional stress and mental health disorders. General characteristics of emotional development of the adolescent encompass the following issues (Meadows-Oliver, 2019). ● Early adolescence: The young teenager begins to develop interest in the opposite sex. However, the peer group is typically composed of same-sex friends. ● Middle adolescence: Self-assurance increases. Independence in making decisions is valued. Of critical importance is conformity with the adolescent’s peer Assessment Screening Tools Youth who are using substances, whether or not they are using addictively, tend to be guarded about the subject and are likely to share accurate information only if they trust that the healthcare professional genuinely cares about their well- being. A nonjudgmental attitude is critical when building a therapeutic relationship with youth. The following evidence-based assessment tools are frequently used with adolescents who are using substances. ● The Problem-Oriented Screening Instrument for Teenagers (POSIT) is a 139-item, self-administered, holistic tool for use with 12- to 19-year-old adolescents. It is composed of yes/no questions under the following 10 subscales: Substance Use and Abuse; Physical Health Status; Mental Health Status; Family Relations; Peer Relations; Educational Status; Vocational Status; Social Skills; Leisure and Recreation; and Aggressive Behavior and Delinquency. The POSIT is appropriate for adolescents with at least a fourth- to fifth-grade reading level and can be completed in 20 to 30 minutes. No special training is required to administer the tool. One of the advantages of POSIT lies in its comprehensiveness; while the POSIT is recommended especially for evaluating adolescent substance use and abuse problems, the screening results can identify potential problems in various areas. Such comprehensiveness may help mental health professionals make better referrals for further assessment or necessary services based on the patient’s particular needs. Those wanting to use the POSIT may do so without training or permission and at no charge (Alcohol and Drug Abuse Institute [ADAI], n.d.). A computerized administration and scoring version of the POSIT has been developed by PowerTrain, Inc., in Landover, Maryland. This version is designed to reduce administration and scoring time. This computerized tool automatically prepares a summary bar graph that compares individual scores with normative cut-points. This summary may be
Healthcare Professional Consideration: When assessing adolescents, it is critical to consider the pubertal development of transgender and gender-nonconforming youth. Individuals who are gender nonconforming may identify as transgender, genderqueer, gender fluid, gender expansive, or nonbinary. Puberty for this population can be especially stressful. The development of secondary sexual characteristics that do not correlate with an adolescent’s gender identity can be overwhelming and intense (National Academies of Sciences, Engineering, and Medicine, 2019). group. The peer group has more influence and leverage compared to parents and other family members. The middle stage adolescent often questions parental and other adult authority, which can lead to rebellion and undesirable behaviors. Risk-taking behaviors, such as substance use and engaging in activities that are dangerous (e.g., driving very fast with a disregard for safety) may appear, especially if the peer group encourages such behaviors. ● Late adolescence: During late adolescence, rebellion typically diminishes. As a young adult, there is a sense of self and preparation for establishing and meeting life goals. Although specific commitments to a particular role or career may not be made, the young adult is exploring and determining what such commitments might be. printed out and used to initiate a discussion between the adolescent and provider (ADAI, n.d.). ● The Drug Use Screening Inventory (revised; DUSI-R) is a 150-item, multidimensional instrument created to assess the severity of an adolescent’s problems in areas such as substance abuse, psychiatric disorders, social functioning, family systems, peer relationships, and leisure activities. The screening not only assesses for drug and alcohol problems but can also help with comprehensive treatment planning (eINSIGHT, n.d.). ● The Substance Abuse Subtle Screening Inventory for Adolescents (SASSI-A2) is a 67-item instrument validated for the assessment of both substance dependence and substance abuse among adolescents. The unique aspect of this tool is that it includes both direct questions and more subtle questions to reduce defensiveness and extract more accurate responses. This instrument is available from the SASSI Institute at www.sassi.com (SASSI, n.d.). ● The Screening to Brief Intervention (S2BI) and Brief Screener for Tobacco, Alcohol, and other Drugs (BSTAD) are screening tools launched by the National Institute on Drug Abuse (2019a). These tools are brief and available online. They are designed to help healthcare professionals swiftly and easily introduce brief, evidence-based screenings into their clinical practices. Adolescents are asked about frequency of substance use within the past year, and the results are triaged into one of three levels of SUD: No reported use, lower risk, and higher risk. The BSTAD and S2BI can be administered in less than 2 minutes and are scientifically validated in adolescent samples. Both tools can be either self-administered or provider administered using a tablet or computer. In addition to risk scores, healthcare professionals receive information about the implications of results, recommended actions, and additional resources compiled via subject matter expert consensus.
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Book Code: SWUS1525
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