Adolescents and external stressors: contemporary issue paper

Two words in the first sentence decide whether the paper is on task at all: *choose one issue (**besides teen pregnancy**)*. It is a parenthetical exclusion in a brief that otherwise reads as an open choice, and it is exactly the kind of clause that gets skimmed past by a student who already had a topic in mind. Choose deliberately — vaping and nicotine dependence, social media use and sleep, food insecurity, bullying and cyberbullying, parental incarceration, caregiving responsibilities, substance use, or the mental health consequences of any of these. Pick one that has a real screening literature behind it, because the second bullet asks for assessment strategies and an issue with no validated screening approach makes that section very hard to write. Naming the issue in the first sentence also lets a marker confirm the exclusion was respected before reading anything else.

The brief distinguishes the **issue** from the **external stressors associated with it**, and collapsing them is the most common structural error. The issue is the phenomenon; the external stressors are the conditions around the adolescent that generate, sustain or worsen it — household instability, school environment, economic pressure, neighbourhood safety, peer dynamics, caregiver mental health. Keeping them apart matters downstream, because the assessment bullet asks you to screen for *this issue **and** external stressors*, which is two screening tasks. A paper that treats the stressors as a restatement of the issue ends up with one screening strategy where two were asked for. A useful test: a stressor should be something you could ask a different question about, and something that would still exist if the issue resolved tomorrow. Anything failing that test is part of the issue rather than around it.

The clause that makes this assignment distinctive is buried in the middle bullet: *define the ethical parameters regarding what you can and cannot share with the parent or guardian*. That is a genuinely difficult question and it has a real answer. Adolescent confidentiality is not absolute and it is not nothing: minors can consent to certain categories of care independently in many jurisdictions, which creates a protected space; and that space has explicit limits at suspected abuse, at imminent risk of harm to self or others, and at whatever the law where you practise requires. The professional move is to state those limits to the adolescent *at the start of the conversation* rather than to discover them mid-disclosure. Saying it up front is also what makes the disclosure survivable, because an adolescent who was told the limits in advance experiences a mandated report as a rule being followed rather than as a betrayal.

Two practical complications are worth a sentence each because they are what separates a textbook answer from a clinical one. Confidentiality can be broken by the record and the bill rather than by the clinician — an explanation of benefits sent to a parent, or a portal a parent can access, discloses what a careful conversation protected. And the conversation itself has to be structured: time alone with the adolescent is a precondition for honest answers, which means the parent has to be asked to step out, and how you frame that request to a parent is part of the skill the bullet is asking you to demonstrate. Both points belong in the paper because both are things a clinician decides rather than things a policy handles, which is what the word parameters is pointing at.

Note the shape of the third bullet, which asks for two layers: *support options for adolescents encountering external stressors*, and then *specific support options for the contemporary issue you presented*. General and particular, and papers usually supply one. The general layer is the infrastructure — school counselling, primary care follow-up, family involvement where safe, crisis lines; the particular layer is what exists for your chosen issue specifically, which will be different for vaping cessation than for food insecurity. With 500 to 750 words across three bullets and their sub-parts, use headings taken from the bullets and keep the introduction to two sentences. Naming the referral route rather than the service type is what makes this section assessable, since a marker can tell whether you looked something up or listed what sounded plausible.