counselingcorner Communicating with adolescents harmacists are often in contact with adolescent patients and must be able to effectively communicate with them about medication-related issues, drug abuse, and wellness and prevention strategies. Communication strategies Adolescents often need or desire more independence, which often translates into less communication with parents and adults. Some teens may seem unwilling to interact, so gaining and maintaining their trust is key. Small talk can be an important ice breaker and is a way to understand your schedules and interests and what is important to them. Small talk also can lower resistance and make adolescent patients feel connected. When communicating with adolescents, ask them nonjudgmental, openended questions to assess a situation and try not to over-identify with them, even if had a similar situation. You can say something such as might know a little of what feeling because been through a similar situation in my In addition, listen and using empathic statements, such as I hear you saying is or you feel Elicit their perspective on their illness and the purpose of their medications. Pharmacists must respect patient privacy. If dangerous behavior is noted during a counseling session, try to get permission from the adolescent to share important information with his or her parents. Tell young patients, will do my best to keep this conversation private, but I will share information in order to keep you Encourage teens to also talk to their parents. with chronic illnesses may feel different from their peers and be reluctant to take medications in public, especially at school. Pharmacists can recommend longer acting formulations to minimize the need for dosing during the school day. In addition, pharmacists can help build by telling them they are doing a great job managing their health conditions. To engage peer support, suggest that adolescents educate their peers about their illness and what it is like to live with it through a classroom presentation or project. When counseling adolescents on medication use, direct all education and demonstrations to the teen, even if an adult is present. If teens are learning device technique, have them demonstrate back and reinforce every step positively, in order to build their and self-esteem. Ask them questions such as will you this into your Some may still rely heavily on parents to tell them when to use their medications, rather than assuming this important responsibility for themselves. the home, such as babysitters. Parents should avoid stockpiling medications and should keep them in a secured location. Educate parents and caregivers to be alert for signs of drug abuse such as disappearing medications; unusual drugs in their room, purse, or backpack; and alterations in the behavior or physical appearance. The Partnership for a Drug-Free America has numerous tools for parents and caregivers aimed at preventing drug abuse in adolescents; these resources can be accessed at www. drugfree.org. Preventive health Many adolescents have a sense of immortality and fail to recognize the dangers of risky behaviors such as smoking and practicing unsafe sex. If pharmacists identify these behaviors when counseling adolescents, they can help modify the behaviors. If adolescent patients are smoking, you should refer them to a smoking cessation program that includes behavioral counseling and pharmacologic treatment. Counsel adolescents on effects of smoking that may be more meaningful to this young population, such as premature aging, staining of teeth and nails, and breath. Pharmacists can play a role in educating adolescents about sexually transmitted diseases and how to prevent transmission of these diseases. In addition, adolescents and their parents should be educated on the of obtaining the human papillomavirus (HPV) vaccine series for the prevention of HPV-associated genital warts in both girls and boys and for the prevention of cervical cancers in girls. Determine if patients need other immunizations such as the yearly vaccine or meningococcal vaccine, and administer these vaccines when needed. G. Tanzi, PharmD Drug abuse Approximately one in every teens has abused OTC or prescription drugs. Adolescents are often enticed and recruited by their peers to abuse drugs such as OTC dextromethorphan and prescription pain killers and stimulants. Pharmacists can help reduce adolescent drug abuse by limiting the amount of products sold to teens, preventing them from purchasing products likely to be abused, being alert for altered or forged prescriptions, and educating adolescent patients and their caregivers. Counsel adolescents about the dangers of abusing drugs and educate parents about the potential misuse of products by their adolescent children, their friends, or others coming into Medication-related issues Adolescents tend to be sensitive about their body image and sexuality. Those CONTRIBUTING EDITOR Beth Martin, BPharm, MS, PhD, Assistant Professor (CHS) at the University of Wisconsin School of Pharmacy, is Contributing Editor for the Counseling Corner column during 2010. 22 PHARMACY TODAY APRIL 2010 www.pharmacytoday.org