ADOLESCENT GUIDANCE

1. ADOLESCENT GUIDANCE SERVICE CENTRE AT NIPCCD Dr. Dinesh Paul & Team

2. Problems Encountered in Adolescents Adolescence is characterized by conflicts of values, emotional stress and readiness to extreme attitudes, which invariably leads to several psycho-social problems of adolescents. • Personal and social problems. • Problems of health and physical self-esteem. • Sex and reproductive health problems. • Home and family related problems.

3. Adolescents : Some Facts and Perceptions • Adolescents between 10-19 years make up one fifth of India’s population and also a potential group for contracting HIV. • Adolescent girls constitute a disproportionate (25%) portion of the 5 million abortions performed annually. • Teenagers lack easy access to contraceptives and feel guilty and embarrassed to use them. • Cultural practices often involve sexual abuse or exploitation, and act as barriers to responsible sexuality. • Boys and girls reveal a poor understanding of their sexuality and information sources seem to be media and peers.

4. Adolescent Health and Guidance Services - proposal Broad Objective • To provide health and psycho-social services for adolescents through a comprehensive Adolescent Health Programme. Specific Objectives • To assess health and psychological needs and problems of adolescents through differential diagnosis; • To support adolescents to cope with problem behaviour, by providing psychotherapy, guidance and counselling; • To promote positive attitudes and values in adolescents for healthy sexual behaviour; • To enhance adolescent’s potential through various strategies of life skills education; • To establish linkages with schools, PTAs and civil service organizations in order to strengthen services for the adolescents; and • To provide referral services for adolescents with specific health related problems.

5. Adolescent Guidance Services Centreat NIPCCD (Proposed) Objectives • Need Assessment of adolescents. • Provide psycho-social services. • Development of training modules. Clients Adolescents from South Delhi Government & 5-6 private schools identified as high risk and referred by school Principals, Counsellors, Social Workers etc. Services • Counselling • Psycho-therapy • Behaviour modification • Parental counselling

6. Who can Visit? • Adolescents/students referred by • Schools • Parents • Peers • Professionals Walk-in-clients are also welcome.

7. OUR POLICY We maintain the professional ethics extending the best of every possible support to achieve success of every adolescent and his/her family. Confidentiality is assured.

8. EXPERIENCE CHILD CARE CENTRE CHILD GUIDANCE CLINIC ICDS Training - Addition of Adolescents

9. Process of Establishment of AGSC at NIPCCD Head Quarter

10. STEP I- PREPARATORY WORK OF AGSC • Survey of Existing AGSCs at Delhi-for designing a better Adolescent Guidance Service Centre. • Proposal submitted to Department of family welfare for WHO support. Constraints- Lack of Information regarding existing voluntary organizations working in this area.

11. STEP II-STARTING UP OF AGSC Formation of An Advisory Committee- Who will be recommending on various issues and also monitor the progress of the work etc. Dissemination of Information A brochure describing special features of AGSC – prepared and sent to all schools. Few knowledge based pamphlets on various issues of adolescence for persons visiting AGSC Constraints Meetings could not be organized due to busy schedule of experts

12. Infrastructural Development Client Friendly Centre • Waiting room. • Well equipped therapy room. • Cubical for multi disciplinary team of AGSC. • Appropriate furniture for storing documents. Constraints Difficult government procedures for construction and procurement of furniture

13. Staffing- Recruitment of Multi-Disciplinary Team • Physician • Clinical Psychologist • Behavioural Psychologist • Social worker • Data entry operator • Psychiatrist ( Shortage of Psychiatrists and not willing to come as consultants on part time-Yet to be appointed)

14. STEP III-COLLABORATION AND NETWORKING WITH PRIVATE AND GOVT. SCHOOLS OF SOUTH DELHI • Out of 400 Delhi based private schools, 50 schools were selected .The inclusion criteria include: • Schools without any facility for mental health services. • Those schools who have not been associated with any Adolescent Health and Guidance Centre. • Senior Secondary Co-Education Schools.

15. Education Department has been contacted for seeking permission on to have liaisoning with Govt. schools. • Meeting with school principals, counsellors, and senior teachers. Constraints • Did not receive any consent from principals of schools. • Delay in getting the permission from Govt. schools, for data collection, which further delayed the research work. • Non- cooperation from private schools.

16. STEP IV- INDUCTION OF RESERCH WORK • An explorative study was conducted with following objectives : • Identifying adolescents with problem behavior. • Identifying major factors affecting adolescent mental health. • Identifying needs and problems of schools going adolescents. • A Standardized Youth Self Report (YSR) questionnaire by Achenbach for the course of data collection was selected & applied. • Pre-testing of Youth Self Report (YSR) in Hindi was done in one of the Private schools of South-West Delhi.

17. STEP V- COMMENCEMENT OF WORK AT AGSC • Research Study • Data collection from various schools ( 3 Govt. and 1 Private School). • Data processing and Interpretation of data. • Awareness generation programme on various psychological problems among adolescents were conducted in various schools for parents, teachers as well as for students. • Health check-ups and Health talks etc.

18. Clinical Activity • Clients started visiting AGSC • Various psychological tools have been applied on the clients depanding on the requirement of the problem. • Adjunct Therapies are being used • Nutritional counselling. • Relaxation therapies. • Parental counselling. • Referral services. Constraints Clients did not come as per appointment Principals and Parents did not cooperate initially Only after Health Check up was arranged in schools through PGDMCH students.

19. MAJOR FINDINGS OF THE STUDY • Sources Of Daily Stress • Too many things to do. • Concerns about weight / physical appearance. • Doing Home Work / Assignments. • Parental nagging • Frequent scolding • Meeting deadlines • Making many decisions. • Attending Tutions/ Tutorials • Responsibilities outside home. • Arguing with friends and family.

20. Major Identified Problem Behaviour. • Withdrawn Behaviour • Somatic complaints • Anxious/ Depressed • Social Problems • Thought Problems • Attention Problems • Delinquent Behaviour • Aggressive Behaviour

21. Multi-Disciplinary Service Delivery Team Physician Clinical Psychologist Counsellor Social Worker Psychiatrist (Referral) Nutritionist Gynecologist (Referral) Child Development Expert

22. SEX WISE DISTRIBUATION OF DATA

23. CLASS WISE BISTRIBUTION OF DATA

24. AGE WISE DISTRIBUTION OF DATA

25. Psychiatric Morbidity of the Total Respondents

26. Services

27. Health check-up and Nutrition Counselling

28. THERAPY

29. LEARNING OUTCOMES STRENGTHS • Non-medical training and research institution • Multi-disciplinary team • Support from education department • Nutrition counselling • Procurement of tools and recruitment of staff • Screening and other Psychological tests are adapted & suitable to our situation • CGC in position for more than 2 decades. • Development of Modules for Holistic Development of Adolescent Girls, Adolescent Health and HIV/AIDS, Trafficking of Children & Women, FLE etc. for Voluntary sector and ICDS Training. WEAKNESSES • High demand of Psychiatrists • Lack of awareness at all levels for adolescents problems • Social Stigma – Poor response from girls school even for counselling services

30. THANK YOU