Transitional age youth (TAY), also referred to as adolescents and young adults (AYA), refers to the demographic spanning older adolescence (15-16 years) to young adulthood (24-26 years). This is typically a period of significant physical and psychological development that encompasses the developmental tasks of identity formation, increasing autonomy and creating intimacy with others. This can be a challenging group to manage with regard to chronic illness and transitions in medical care. In addition, this is a vulnerable time for the new onset of major psychiatric disorders.
Consultation Liaison providers can improve their understanding of the challenges in working with TAY including understanding when to integrate parents/family in the care of TAY. Clinicians can use help deciding when (or when not) to involve family, what the limits of confidentiality are, and how to manage the ethical issues that arise when working with AYA whose decision-making may conflict with their family’s decisions. This symposium strives to enhance interviewing skills in the assessment of TAY with medical and neurodevelopmental disorders and to provide a discussion on the role of family and specific issues around transition of care around eating disorders such as obesity. There are several models to transition from pediatrics to adult medicine. Method: In this 90-minute session, each speaker will review (15 minutes with 5 minutes for questions) best practices for working with TAY through a developmental lens as informed by evidence-based literature and clinical wisdom. Dr. Pao will begin by reviewing interview techniques with TAY including when to begin with the patient first and when to include the family. She will touch on ethical issues around confidentiality such as around substance use/abuse and other risky behaviors. Dr. Raza will build on AYA assessment techniques particularly around those AYA with neurodevelopmental delays. She will provide questions that may help identify autism spectrum and other developmental disorders in milder, previously undiagnosed adult patients seen on Consultation-Liaison Services. Dr. Sockalingam will focus on treatment concerns for TAY transitioning with obesity. To conclude, Dr. Ihle will present different model programs for transition of care available to medically ill youth moving into adult care to maintain wellbeing throughout their healthcare trajectory. Results: Participants will be able to 1) integrate family in the interview process, 2) appreciate TAY decision-making including non-compliance from a developmental perspective, and 3) describe 3 approaches for transitioning care for chronically ill youth. Conclusions: TAY are a special group of patients that require an expanded set of knowledge, skills and attitudes on the part of providers to promote well-being through enhancing help-seeking, autonomy, safety, and accountability. This program prepares Consultation-Liaison psychiatrists working with TAY to identify and address common clinical challenges in the service of maximizing long-term well-being and functional outcomes.