Healthcare professionals (HCP) frequently report that communicating with adolescents and young adults (AYA) is problematic. They often attribute the difficulties to the AYA themselves, while AYA report that the responsibility to facilitate communicate effectively with young people lies with the adult. Young people (YP) repeatedly express the value of engagement in their own healthcare and their struggle to ensure their voices are heard. These difficulties are multifactorial but are likely to stem from lack of training on the part of healthcare professionals, neurobiological development of young people, the development of identity/autonomy, parental style/support, the structure of healthcare consultations and the training of healthcare professionals. This chapter reviews the factors affecting successful engagement with young people and offers suggestions for improving communication in clinical consultations.