The Adolescent Patient: Building Trust and Rapport

David is a 15-year-old male who presents for his annual physical exam. When the provider asks if there are any issues or concerns, David’s mother states that he is irritable all the time, has occasional outbursts, and recently began spending more time alone in his room and less time with his friends. She also states that she has noticed that David is staying up later and is difficult to awaken for school. When asked, both David and his mother admit that his grades have gone from A’s and B’s to mainly D’s. When interviewing David, you noticed he does not maintain eye contact and gives you short answers, mostly, “yes,” or “no,” responses.

Answer the following questions in 2–3 pages, excluding title and reference page.

How will you approach taking a more detailed medical and psychosocial history?

When obtaining the social history, what are the important questions to ask?

When obtaining the family history, what are the important questions to ask?

What if anything in David’s medical history is important to know?

What other information about David’s recent behavior should be obtained from his mother?

The provider asks David’s mother to step out of the room. What questions should David be asked when alone?

Discuss one evidence-based screening tool (should be age-appropriate) you will use to gather more information about David. In your discussion, please include the validity and reliability of the tool, how it is administered, and how it is scored and interpreted.

Suppose David’s result is significant based on the screening tool, what are appropriate referrals for David and his mother? Discuss your rationale.

As part of David’s annual physical examination, discuss health promotion and screening recommendations.

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