Improving communication with adolescents.

Communication with young people (YP) can be problematic. However, effective communication can improve health outcomes and there is randomised clinical trial-level evidence that communication skills can be learnt. Key issues when communicating with YP: (1) The young person should be central in the communication, with discussions primarily focused on him/her; (2) The young person should be offered time alone with the clinician; (3) Conditional confidentiality should be discussed, and does not reduce rates of disclosure; (4) Ambivalence is normal--techniques can be learnt to help the young person resolve ambivalence and change behaviour; (5) A psychosocial history is a key part of the adolescent consultation, and should include resilience factors as well as risk. We also discuss pragmatic techniques to use in busy consultations to improve communication and promote behaviour change in YP.