Lesson 5: ETHR Framework

Alright, so now we're gonna dive into the framework that sort of drives ETHR. So ETHR is a universal education and resource provision intervention. So what I mean by this, we provide a universal education and resources around healthy and safe romantic relationships to all families of adolescents, ages 11 to 15.

So both the parent, patient, and their caregiver. So what you may find interesting is that there's actually no screening component to ETHR. So what I mean by that is you will never ask the adolescent, are you experiencing unhealthy relationships or are you dating? There's no questions like that for them.

And so we'll talk a little bit about why we framed it this way. So ETHR is rooted in this idea of healing centered engagement. So this is a holistic trauma-informed approach. And it talks about healing incurs within relationships. So this is a very relationship driven intervention, thinking about the relationship between the caregiver and the adolescent, and also between the caregiver and the clinician and the adolescent and the clinician.

So it's like a traumatic intervention, and part of healing centered engagement is to be very strength-based. Really think about what is right with you and how can I get you to where you want to go? And so you may have seen this sort of in the, the part that at the bottom you may have seen sort of this idea from going from what is wrong with you to what happened to you, which is sort of what trauma informed care talks about.

And then healing centered engagement takes it a step further to what is right with you, where do you wanna go, and how may I help you get there? So that's really the underlying sort of approach to this is to create healing centered spaces where, um, par where caregivers and adolescents know that healthy and unhealthy romantic relationships.

It's safe to talk about that within pediatric primary care. And this is what you all do all the time, is create these healing therapeutic relationships and spaces. So that's really what we're trying to do here. And so the goal is to really shift us from a disclosure driven. Um, intervention or process to universal education about safe and healthy relationships, unhealthy and abusive relationships, and really, again, pediatric healthcare settings are a safe place to talk about this.

And this is a very like different or unusual, um, strategy, but it's one that we strongly recommend, um, because really we need to think about why are we so focused on disclosure. So especially for this prevention intervention, um, there may be so, so many reasons that an adolescent ages 11 to 15 may not wanna tell us if they are experiencing an unhealthy relationship or may not wanna share that information with us.

Um, and so it's really important to provide everybody information on this topic, which we know is so pervasive, right? We know that many young people experience unhealthy relationships and then they have this information. They're equipped with it, not only for them, but also to help their friends, to help their siblings, to help people in their life.

And so it's a very, um. Relationship focused intervention where we're pro providing both the adolescent and the caregiver, the tools and skills that they need to help themselves to support themselves and other people in their life who

may be experiencing unhealthy relationships. So this intervention uses accused approach.

So Q stands for confidentiality, universal education and empowerment and Support. And so as we dive into the actual [00:15:00] intervention, you'll see how it kind of follows this script. So in accused intervention, we provide to all teens, and in this case caregivers, affirmation, education and resources. And if they were to disclose, remember we don't ask them to disclose, but if they were to disclose, we also provide them support after disclosure.

So ETHR has all of these components, not just for teens, but the caregiver as well. And why do we use Q? So I sort of already talked about this, but a universal education approach avoids all the limits of disclosure based intervention. And so one of the things that happens with disclosure based intervention is only the adolescents that disclose to you will get resources.

And in this case, everybody gets resources because we know that this is so common. So it's really great for a prevention focused intervention. And like I said, this equips adolescents to help a friend who may be experiencing something like this, or in this case, it also helps the caregiver who's at the visit with the, with the adolescent to share this information with other caregivers or their friends or anybody in their life who they think may want this information.