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Victoria Pascoe is a project associate at JSI where she works on issues relating to family planning and reproductive health. She is interested in sexual health and education and teaches a school-based health curriculum on puberty and adolescent development to 6th graders in Massachusetts.
The somewhat wary yet energetically charged group of 12-year-olds responds with a resounding “pituitary gland!” The chorus dies down a bit and predictably becomes interspersed with giggles as we progress to body parts and reproductive anatomy in this “parroting” game we use to break the ice. When I ask if they know what the pituitary gland does I’m met by blank stares. I explain that it is a small gland at the base of the brain; it releases hormones that trigger changes that occur during adolescence. For this brief overview of puberty, that’s as far as we delve into the role of the brain in the complex reaction of physical, cognitive and social changes that adolescents experience.
However, advances in neuroimaging technology over the past decade have shown that hormone production is just the tip of the iceberg in what is the complex and dynamic adolescent brain. Research* suggests that the prefrontal cortex — which is responsible for functions like impulse control, planning and decision-making, and risk assessment — continues to develop and mature throughout adolescence. These insights into the neurobiology of the adolescent brain are improving our understanding, shifting our conversations and informing how we relate to adolescents. This new knowledge is important for us to have about a stage of life that can be confusing for teens, who are weathering these changes, and also for their parents, who often struggle to understand and relate to them during this time.
Many resources have been produced to help parents and educators understand the implications of the new findings. Less has been said, however, about how this information translates in the health care setting. How can this information better inform the work of health care providers working with teens? To address this need, JSI Research & Training Institute, Inc. (JSI) developed “Inside the Adolescent Brain: New Perspectives for Family Planning Providers,” an online course on the neurobiology of adolescent brain development to improve reproductive health care for adolescent patients.
Family planning providers sometimes feel mystified, discouraged, or frustrated in their work with young clients, and communication barriers threaten the open and honest dialogue that is essential to minimizing risky behaviors. This course guides providers though the interplay between sexual and neurological development, adolescent risk-taking behaviors and decision-making, and effective approaches for counseling and educating adolescent clients. For providers to successfully interact with teen clients, it is crucial that they reorient their expectations of adolescents, create a safe environment for care, and use adolescent-specific counseling and communication techniques.
JSI’s online course prepares family planning practitioners to support adolescents and effectively provide them with the health information they need to navigate this often tumultuous period. Facilitating improved communication and strengthening relationships in this way will not only result in improved health outcomes but also will foster positive experiences in the health care setting, for both practitioners and teens alike.
* For more information on this research, refer to The National Campaign to Prevent Teen and Unplanned Pregnancy’s Report – The Adolescent Brain: A Work In Progress
This course was funded by Office of Population Affairs/Office of Family Planning, U.S. Department of Health and Human Services and Centers for Disease Control and Prevention.)
The course is available for FREE on JSI’s eLearning Management Platform here
IYWG: What were you like as an adolescent?
I remember that as a teenager I was both thoughtful and cheerful. I enjoyed moments of solitude but also spending time with friends enjoying music and dancing. I was very active in my school and was a member of many different clubs and activities, including Brazilian dance, painting, theater, music, and foreign languages. I also loved to participate in the community outreach activities that the school did with the poorer communities nearby.
IYWG: How did you first learn about sex? What were you told? Who gave you this information?
I first learned about sex from reading magazines, books, and talking with other girls. But, overall I received very little information about sex from adults or even from books and peers. Most of the information I received was about how exciting it was to have a boyfriend and the “things that happened” when you grow up. When I was a young adolescent, about 13 or 14, girls talked about the “romance and excitement that you could feel when you kissed a boy.”
What else do you wish you had been told?
I wish I could have discussed sexuality and romance in a more open way, not only dry explanations and discussions about the “female reproductive system.”
IYWG: What challenges do you think young people face in accessing information about sexual and reproductive health?
Young people face challenges in both accessing information and in having real and unbiased discussions about sexuality. They need clear and simple information about their sexual and reproductive health without the weight of the conservative and moralistic society in which we live and they need the opportunity to discuss sexuality – which means discussing feelings, sensations, fears, and expectations.
IYWG: Why is comprehensive school-based sex education so important?
First we must ensure that comprehensive school-based sexuality education is truly comprehensive and participatory and not just the same old information about how to be abstinent, how the reproductive system works, and so forth. If the school-based sexuality education is really designed so that young people have the space and time to discuss the ways they experience sexuality, then it is absolutely critical to help them navigate adolescence in a healthy and positive way.
IYWG: How did you get started in the field of youth sexual and reproductive health?
Professionally I started in the field of youth sexual and reproductive health as a psychology professor and as a school psychologist in Brazil. After some years of practicing in this area, I went into clinical psychology work at the university and did some work in the private setting as well. After this, I worked for a long time with the public health sector in Brazil, focused on young people. In 2007, I joined Pathfinder International in Mozambique as a youth technical advisor for the multisectoral, national adolescent and youth sexual and reproductive health and rights program – Geração Biz. I recently left Mozambique and now work with Pathfinder as the senior technical advisor for youth on the Evidence to Action project.
IYWG: Why is the health and well-being of young people especially important to you?
It is particularly important to me because young people will have the chance to dream and build another better world. And, they can only do it if you create the appropriate space and time for it. I really love to be with young people – to work with them, talk with them, and learn from them.
IYWG: What do you think is the biggest issue young people face today?
The biggest issue? I would say they face multiple issues – the violent environment, the lack of work opportunities, the exposure to unrelenting consumerism, and weak engagement in collective social-rights movements. All of this can lead young people to a cynical or selfish way of living and being.
IYWG: What do you think is the most important thing that could be done to improve the health and well-being of adolescents today?
Much has being said about the importance of the participation of young people in the solutions to the problems they face. However it [youth involvement] has become a buzzword and it is rarely recognized that this is not trivial and it is not easy to do. I think that it’s extremely important to foster youth-led networks engaged in collective problems and youth forums that allow for serious discussion and enable young people to bring ideas and actions to advocate for and ensure their own sexual rights. These types of efforts form a foundation for improving the health and well-being of adolescents. Without these youth-driven initiatives, efforts are not sustainable or responsive to the real needs of young people. In addition, of course, we should continue to increase access to quality service delivery, support youth-led outreach programs, and tailor programs to address girls and gender inequality, among other initiatives. We must focus our efforts on the most underserved, those who live in countries/regions/areas where there is nothing but poverty, hunger, and no future. All young people deserve and have the right to dream and to fight for a better world for all.