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Indian Journal of Community Medicine

Establishment of Adolescent Guidance Centre At NIPCCD – Some Experiences

Author(s): D. Paul

Vol. 31, No. 4 (2006-10 - 2006-12)

D. Paul


The years of adolescence are the years of change of development at the biological, psychological and social level. Psychologically, adolescence refers to a period of identity crisis. Crisis, infact does not mean a breakdown or catastrophe but rather a “crucial” period when development must move one way or another. Moreover adolescents need a supportive environment at home, school and the community to enable them to understand the complexity of challenges of the stage, and be able to respond with a sense of responsibility. When adolescents are deprived of such conducive environment, it may lead to various psychosocial problems like academic problems, truancy, adjustment problems, low self esteem etc. Keeping this in mind NIPCCD has started an Adolescent Guidance Service Centre (AGSC) to help adolescents cope with daily stress, avoid unwanted peer pressure, resolve confl icts, and develop adequate life skills and the like. In order to fulfi ll this goal the major objective of the AGSC is to provide counselling and psychosocial care for adolescents through a comprehensive adolescent guidance programme. Other objectives of AGSC include:

  1. To access and identify the psychological needs and problems of adolescents through functional behavioural assessment.
  2. To promote appropriate attitude and values in adolescents for maintaining healthy relationships.
  3. To help adolescents understand the importance of reproductive health particularly the myths and misconceptions regarding growing up.
  4. To develop adolescents’ potential through various strategies of Life Skills Education.

Preparatory Work: A comprehensive resource directory was developed to identify important voluntary organisations working for adolescent health in prominent states of the country by conducting a survey of the existing Adolescent Centres. This activity was carried out with the purpose of expanding the institute’s networking system for sharing of technical information, identifying strength and lacunae in the existing services and updating information on adolescent issues for referral services.

Development of Information Bank: In order to develop Information Bank on emerging adolescent issues an extensive review of literature was done. Various books, journals, news clippings, annual reports and websites were referred and compiled. In addition, NIPCCD faculty made several visits to the organisations in Delhi working for adolescent welfare and development and also attended various National Consultation Meets on adolescent health and development. The experiences and information thus gained were collated which is also a part of the Information Bank. An advisory committee was formed under the chairmanship of Director NIPCCD. The committee comprises of professionals from Departments of Psychiatry, Psychology, Social Work and Paediatrics. The main function of the committee is to monitor and evaluate the project activities. A brochure describing the mission statement, strategic objectives and services offered at the Adolescent Guidance Service Centre was prepared.

A case history proforma was developed. It covers various dimensions like personal details, mental status examination, psychiatric evaluation, psychological assessment, differential diagnosis etc. A registration card was prepared for eliciting brief personal details of the cases registered at the Centre. Few knowledge-based pamphlets on various issues of adolescents like ‘think like a winner’, ‘building healthy relationships’, ‘Adolescent sexuality’, ‘Knowing your self’ etc, were prepared for distribution to adolescents visiting AGSC.


The AGSC is staffed by both part-time and full time professionals. The full time staff comprises of a Social Worker, a Data Entry Operator, and a Nutritionist. The part time professionals include one Psychologist. Presently the post of part time Psychiatrist is not fi lled up. Whenever the services of a Psychiatrist are required, the clients are referred to SHAAN, Safdurjung Hospital for necessary treatment and intervention.

Infrastructural Development: A separate waiting room for clients, three cubicles for psychological assessment, case history taking and consultancy with Psychiatrist/Psychologist have been developed. A well equipped therapy room for physical examination, psychological assessment/intervention was also developed.

Procurement of Psychological Tests: Around 29 psychological tests to measure different faculties and other parameters like Intelligence, Personality, Neuroses, Psychoses and behaviour problems was procured from various agencies of the country. The psychological tools include both questionnaires and batteries.

Thereafter a major activity carried out was the research study. The research study initiated by the Institute focused on the school going adolescents. Helping these students manage their problems or confl icts through adolescent guidance services and standardising its services (model centre) was the main idea in carrying out the project. The major objective of the study was to assess the magnitude of the problem behaviour as also to identify the clientele for the AGSC initiated by the Institute.

Research Highlights

The sample for the study has been collected from government. and private schools of South West Delhi, due to its proximity to the Institute.

There are around 400 private schools in south west Delhi, amongst these schools 100 senior secondary schools were initially identifi ed and later 50 schools were finally listed based on certain criteria. The inclusion criteria for selection include: Schools without existing in-house mental health services, schools not availing the services of the institute through its Child Guidance Services and Coeducational schools (for homogenous sampling).

Permission from Directorate of Education and Delhi Public School R.K.Puram was sought to conduct the study in three government and one private schools of South-West Delhi respectively.

Around 1302 adolescents studying in VIII-XII classes in the age group 12-19 years with the mean age of 14.5 years were selected for the study. The purposive sampling procedure was followed. A standardised Youth Self Report (YSR) questionnaire by Achenbach, 1991 was administered during the course of data collection. The questionnaire comprises of 112 items which measures problem behaviours of adolescents. The YSR questionnaire was translated into Hindi and a pilot study was carried out to test the reliability of the Hindi version of the questionnaire. Both the English and Hindi versions of the questionnaire were administered to students at an interval of two weeks and a high positive correlation was found between the two (Hindi and English) versions.


The YSR was used to assess eight problem behaviour such as Withdrawn, Somatic Complaints, Social Problems, Thought Problems, Attention Problems, Delinquent Behaviour and Aggressive Behaviour. These problems are further classifi ed as internalisation and externalisation of the problem behaviour.

About 630 adolescents were identifi ed as having problem behaviour (psycho-social morbidity) with 208 adolescents in borderline and 422 in the high risk category. Percentage of adolescents with psycho-social morbidity was highest in Government Boys’ Secondary School, Palam Colony (60.87%) followed by Government Boys’ Senior Secondary School, Raj Nagar (52.07%), Sarvodaya Kanya Vidyalaya, Mahipalpur ( 51.06%) and Delhi Public School, R.K.Puram (35.58%). (Table-I)

Table I: Distribution of Adolescents by Total Problem Behaviour

Palam Colony
Raj Nagar
Delhi Public
No. % No. % No. % No. % No. %
Low Risk 322 48.94 45 39.13 104 47.93 201 64.42 672 51.61
Borderline 109 16.57 22 19.13 41 18.89 36 11.54 208 15.98
High Risk 227 34.49 48 41.74 72 33.18 75 24.04 422 32.41

Table 2 represents type of problem behaviour school wise. The table reveals that Social problems (34.41%) rank the highest compared to the other problems, such as anxiety/ depression (19.74%), somatic complaints (19.12%), thought problems (14.13%), delinquent behaviour (10.75%), attention behaviour (10.52%), aggressive behaviour (8.29%) and withdrawn behaviour (6.91%). (Table-II)

Table II: Distribution of Adolescents by Eight Problem Behaviour

Palam Colony
Raj Nagar
Delhi Public
No. % No. % No. % No. % No. %
Withdrawn 40 6.08 12 10.43 27 12.44 27 8.65 90 6.91
125 18.99 36 31.30 54 24.88 34 10.89 249 19.12
103 15.65 37 32.17 53 24.42 54 17.31 257 19.74
274 41.64 50 43.48 84 38.71 40 12.82 448 34.41
98 14.89 23 20 30 13.82 33 10.58 184 14.13
73 11.09 14 12.17 23 10.59 27 8.65 137 10.52
66 10.03 23 20 35 16.13 16 1.53 140 10.75
48 7.29 13 11.30 12 5.53 35 11.22 108 8.29

Table III: Distribution of Adolescents by Total Problem Behaviour

of Daily
Palam Colony
Raj Nagar
Delhi Public
No. % No. % No. % No. % No. %
Too many
things to do
254 38.60 65 56.52 101 46.54 245 81.41 665 51.08
about weight/
physical appearance
251 38.15 45 39.13 85 39.17 189 60.58 570 43.78
Doing Homework/
289 43.92 60 52.17 90 41.47 249 79.81 688 52.84
120 18.24 28 24.35 34 15.67 114 36.54 296 22.73
187 28.42 41 35.65 68 31.34 107 34.29 403 30.95
319 48.48 68 59.13 121 55.76 107 34.29 615 47.24
many decisions
287 43.62 61 53.04 94 43.32 208 66.67 650 49.92
tuitions/ tutorials
270 41.03 65 56.52 121 55.76 131 41.99 597 45.85
bilities outside home
182 27.66 49 42.61 76 35.02 152 48.72 605 46.47
with friends & family
176 26.75 43 37.39 89 41.01 127 40.71 435 33.41

NOTE: A detailed report of the research study is available.

A checklist comprising of 10 most common sources of daily stress was developed and administered to students along with the Youth Self Report questionnaire. Table 3 reveals that the most common source of daily stress is ‘doing home work/assignment (52.84%)’ followed by ‘too many thing to do (51.08%)’, ‘taking many decisions (49.92)’. Similarly other sources of daily stress is presented in the table given below.

Other Activities

Apart from the research work various other activities are being carried out which includes:

Health check-ups and Awareness Generation Programmes

Various government and private schools were visited by AGSC staff. Principals were oriented about the functioning of AGSC. Health talks and awareness generation programmes were conducted at four selected schools on various relevant topics related to adolescence as also psychological needs and problems of adolescents were touched upon. Also health check ups was done by doctors of PGDMCH course of Safdarjung Hospital.

Sharing of Information and Experiences with other Medical and Non-Medical Institutions

A presentation was made by Joint Director (Health), Child Development Division for World Health Organisation and other medical and non-medical Institutions on the progress of the project that included various processes and major findings of the research study.

Commencement of Work at AGSC

The Adolescent Guidance Service Centre is getting its clientele from schools where needs assessment study is being carried out and students having borderline and high risk behaviour were identifi ed. Consequently a list is sent to concerned school authorities who send the students periodically to AGSC. Few cases are also reported at AGSC on self referral. Presently AGSC’s working days are Tuesdays and Thursdays (between 2.30 – 4.30 pm).

In the final quarter of the project year, the research that was initiated in the second quarter is being continued. As more number of students have to be included for better coverage of schools, few more Government schools are being identifi ed. In this regard the Directorate of Education is requested to allot three more Government schools of South-West Delhi.

Clinical Activities

In AGSC around 46 cases have been registered, till date. These cases were assessed, diagnosed and provided intervention, as also selected cases were provided health services and nutritional counselling.

The YSR questionnaire is readministered for the clients visiting AGSC as the time duration between needs assessment and referral to AGSC is more and several intrinsic and extrinsic factors could have interfered with the client’s behaviour.

An analysis of the cases visiting AGSC revealed that out of 39 cases, 27 cases had high scores. Four cases had borderline scores and 8 cases had low scores on the Youth

Self Report Questionnaire.

During the psychological assessment at AGSC, a detailed case history of each client was taken and the psychological problems were categorised into three categories:

  1. Academic problems
  2. Behavioural problems
  3. Emotional problems

Twenty-four students reported having more academic problems like lack of interest in studies, poor performance in school, lack of concentration in studies and poor study skills habits. Twenty-seven students had behavioural and conduct problems like habits of smoking, drinking, chewing tobacco and gutka; aggression and violent behaviour, truancy and stealing. Fifteen students had socio-emotional problems such as feeling of loneliness, adjustment problems with friends and family, withdrawn behaviour and other interpersonal problems.

Once the problems are diagnosed the therapies are administered upon these adolescents. Also individual counselling programmes are designed according to the needs of the individuals and to bring about an overall improvement. Also, relaxation therapy and study skill training are being given as an adjunct therapy at AGSC to improve concentration, attention and academic performance of students. Moreover a complete health check-up of cases is been done by me as physician.

Progressive improvement was found in most of the students visiting AGSC and both students and families were satisfi ed with their experience at the Centre.

The Centre has started getting recognition from professionals, schools and NGOs predominantly located at South Delhi.


The clientele of AGSC is predominantly of the male sex as most of the schools covered during needs assessment were government Boys’ Senior Secondary Schools. A comparative analysis between government and private schools could not be made as the sample size of the students from private schools was very less.

Suggestions for Future Research

  1. More number of private schools is to be included for a comparative analysis to be made between private and government schools.
  2. More number of female adolescent students could be included so as to identify and compare various concerns infl uencing school going girls and boys adolescent population.
  3. Continuous awareness generation programmes for teachers and students are to be conducted for better coverage and utilisation of AGSC services.
  4. As the number of clientele visiting AGSC is very less during vacation period, an action plan could be designed in order to bring more clientele to AGSC through referrals other than schools.

D. Paul
Additional Director, National Institute of Public Co-operation & Child Development, New Delhi.
Presentation made at 31st National IAPSM Conference,
Chandigarh, on 27-29 February 2004
E-mail: [email protected]

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