Adolescent Medicine by Gail B. Slap, MD, MS (Auth.)

By Gail B. Slap, MD, MS (Auth.)

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Patients with suicidal ideation or intent who are unable to contract for safety (see Chapter 36) must be held under protective watch until hospital admission or another safe, therapeutic environment can be arranged. Interim Visit Whether the care is acute or routine, every visit can be used to screen for and educate about violence. The parent who expresses concern about an adolescent’s obsession with violent media or video games may be describing an inappropriate coping strategy in which violence has become escapism, fantasy, and desensitized.

The parent who expresses concern about an adolescent’s obsession with violent media or video games may be describing an inappropriate coping strategy in which violence has become escapism, fantasy, and desensitized. The patient so used to violence that it is seen as normative or who sees it as the appropriate way to handle stress or conflict is clearly at risk. A parent who had been disciplined violently may know no other way to raise children and will not be prepared to handle the disagreements of adolescence.

Thus, instead of opening with a statement about the fight, the clinician might respond, “Thank you for sharing this with me. It takes courage to stand up for something you believe in… But I am worried that fighting may get you hurt or get in the way of your success. I would like to be someone who can help you get to a place where it doesn’t happen again and your future is as good as you deserve. ” A statement such as this expresses concern without assigning blame. It allows the adolescent to join with the clinician in exploring safer coping strategies through either problem-focused or emotion-focused responses.

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