Preventing Sexual Violence
An Educational Toolkit for Health Care Professionals
WEB VERSION

Introduction
What Is Sexual Violence?
How Do I Prevent It?
Overview of Web version

Tools

Conclusion


YOUNGER ADOLESCENT VISIT

Objectives

  1. Be able to assess adolescent patients’ peer relationships and health/risk behaviors.
  2. Be able to discuss healthy and unhealthy peer relationships with adolescents.
  3. Understand and be able to implement prevention and intervention strategies for teen dating violence.

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In adolescence, it becomes critical to take a complete psychosocial history because an adolescent’s behavior, family, peers, school, and community have a tremendous effect on his or her health. HEEADSSS is a useful mnemonic for such an assessment; it stands for
Home
Education and employment
Eating
Activities with peers
Drugs
Sexuality
Suicide and depression
Safety

Note that while discussion of sexual violence may be mostly likely to occur while discussing sexuality or safety, the topic could arise during any part of the HEEADSSS assessment (eg, discussion of domestic violence in the home, discussion of eating eliciting concerns about body image, discussion of drugs leading to counseling on personal safety and rape prevention). It is important for the practice to provide a teen-friendly environment where teens know that they can talk about sexual violence or other problems.

Tools


Clinical
HEADSS/HEEADSSS
Quick reference guide

Parent/Patient
Expect Respect
Talking With Your Teen About Sex English Spanish
Teen Dating Violence

Community Resources/Advocacy
Choose Respect

Practice Management
Tips for Making Your Practice Teen Friendly


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Peer relationships are a key part of shaping adolescents’ sexual development, but teens also need trusted adults they can turn to for guidance. A more detailed violence-related history (using the FISTS [Fighting, Injuries, Sex, Threats, Self-defense] mnemonic) can help identify risk for involvement in violence and areas in which teens may benefit from having additional prevention strategies.

Tools

Clinical
FISTS

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The relationships and conflict resolution styles teens see at home have a powerful influence on how teens approach dating and conflict in their own relationships. When potential problems with sexual violence are identified with teen patients, it is important to consider the context of the family environment, while navigating the complexities of ensuring the privacy and confidentiality of teens and their parents.

Tools

Community Resources/Advocacy
The Pediatrician's Guide to Community Collaboration on Sexual Violence Prevention

Practice Management
Privacy and confidentiality tool


Quiz Case

A 16-year-old girl is seen for a health maintenance visit and reluctantly tells you she is worried about a vaginal discharge she has noticed. You ask about sexual contact and she tells you she has had sexual contact with one boy, also 16, last month. In discussing the relationship, she mentions that she did not want to have sex, but did because he threatened to break up with her if she didn’t.

1. A good next question would be
        1. “Why did you give in to him?”
        2. “Has he threatened you in any other ways?”
        3. “What do you like about him?”
        4. “Does your mother know about this?”


    2. She tells you he has slapped her a few times when he became jealous that she was talking with another boy. You tell her

        1. “If it left a mark when he hit you, you should leave him because it will only get worse.”
        2. “Have you asked him to get some counseling? If he cares for you he would do it.”
        3. “If he’s done this to other girls, he probably won’t stop. Talk to your friends about what he’s like.”
        4. “I am worried about the way he treats you, and from my experience in talking with other teens in similar situations, he is not likely to change.”

        Answers