A 15-year-old girl is alone at home and a stranger comes and says he is a distant relative. Should she open the door? Another girl's relative makes her uncomfortable with his behavior. Should she discuss this with her parents?
During her home tuition sessions, a 14-year-old girl is left alone in a room with a young male teacher; in the recent past she has been uncomfortable with his behavior. What should her approach be? A boy is showing undue interest towards Neha, 15. She likes him as a friend, but doesn't want their friendship to go any further. How should she handle the situation?
A 16-year-old boy is travelling by bus; a man sitting next to him touches him inappropriately. Is this possible and if so, how should he react?
As these and many other casebook scenarios that confront adolescents in everyday life come under scrutiny at a recent workshop in the Delhi, the audience leans forward as one, eager for answers. As workshops go, the subject is not new. What makes it a unique event is that the participants are not, as one might assume, youth in the 11-19 age group, but, rather, child specialists or pediatricians who admit they could use a few pointers on how to counsel adolescents.
As a practicing pediatrician at the Northern Railway Hospital in central Delhi, Dr D P Pandey deals with adolescents all the time. "But there are certain psycho-social issues of adolescence which we do not come across all the time, especially issues related to sexuality," he points out. "So we were not aware of this problem."
Dr Pandey was among the 100 pediatricians - from various hospitals across the country - who participated at the workshop organized by the Indian Academy of Pediatrics (IAP). On the occasion, the IAP released a 'Module for Adolescent Care', a training manual to assist doctors in counseling teenagers.
The module discusses the characteristics of adolescence, the physical changes that boys and girls experience, and teen issues such as emotional changes, scholastic backwardness and body image concepts. Sexuality issues are handled in a skilled and adroit manner - in the garb of "family life education" instead of sex education.
In terms of content presentation, the module subscribes to the traditional moral values applicable to a large majority of teenagers and their parents in India. At the same, it allows child specialists to interact with adolescents on issues like HIV/AIDS and high risk behavior within the concept of family life education, says Dr Harish Pemde, Secretary of IAP's Delhi Branch and the IAP Adolescent Chapter in Delhi.
Over the past four years, more than 1,000 doctors across the country have been trained by IAP to incorporate the module in their practice. The IAP proposes to conduct health check-ups in schools drawing heavily from the real life examples and frequently asked questions of adolescents documented in the module. "We have already started such partnerships with both government and private schools in Delhi. We are also enlisting the help of local NGOs such as Salaam Balak Trust, Butterflies, Prayas and Mobile Crï¿½ches so as to reach a larger number of adolescents living in slum and rural areas", says Dr Pemde.
The Academy's program to sensitize pediatricians towards the special needs of adolescents is a comparatively new one. "We first started our training programs for doctors four years back. We have a total of 15,000 members all over the country, of whom 800 are members of the Adolescent Chapter and not many are trained in adolescent health," says Pemde. The manual is a direct result of feedback received from participants at IAP training programs requesting for more information and understanding to help them address adolescent issues and offer counseling both in schools and hospitals.
Notes Dr Pandey: "Both parents and school authorities have shied away from talking about sexuality issues. But this book gives a new dimension to the issue by incorporating sexuality as an integral part of physical and emotional development." Pandey hails the manual as an invaluable guide to child specialists in their dealings with teenagers.
Professor Sangita Yadav of the Department of Pediatrics in Delhi's Maulana Azad Medical College agrees. Life skill management for adolescents is a very urgent need today, and pediatricians have a great role to play by learning and teaching this course, she says.
Dr Yadav made a presentation on life skills management at the workshop; she says pediatricians can apply their training and knowledge in various situations and needs related to adolescents. This could be to do with relationships, with HIV/AIDS and STD prevention, drug abuse, teenage pregnancy, or counseling and suicide prevention. Life skills management, according to Dr Yadav, also includes environment education, consumer education and peace education. All of this, she says, is aimed at empowering people to take positive action to protect themselves and to promote health and positive social relationships.
At the workshop, another important issue raised was the whole question of parenting and parent's role in dealing with adolescents. Traditionally, Indian society has believed that the wisdom of parents is enough for the raising and development of teenagers. "But now people are realizing more and more that adolescents need special help in these changing times," states Dr T S Jain of Employees' State Insurance hospital in Okhla, west Delhi.
Citing an instance in his own hospital, Jain recalls a case in which a woman sought his help regarding her adolescent son; she suspected he had begun taking drugs. "She asked me to talk to him about it as she felt she couldn't handle the situation herself," he explains.
In this context, the manual becomes all the more relevant because it also provides guidelines to parents on the different challenges facing teenagers and how these can be approached and managed. Adolescents, too, could benefit from reading the manual.
Says IAP National President, Dr M K C Nair, who authored the manual: "This training manual is meant for the (benefit of the) average Indian child and parent with an Indian mind. I have tried to adhere to the traditional moral values as applicable to the large majority of teenagers and their parents. I believe that once we get access to this group of teenagers and their parents and both start perceiving this as a real need, we may add more (to the manual)."