|INTERVIEWING TIP OF THE MONTH
# 8 October 2000
Helping Teenagers Feel More Comfortable Sharing Confidential Material in a Primary Care Setting
TISA Description of the Problem: It can be quite difficult for a teenager to share openly with a primary care physician. There are many fears concerning what material will be passed on to parents or other authority figures. The very topics where teenagers may need information and guidance ? drug abuse, sexuality, domestic violence ? are the very topics in which teenagers do not know what is okay to share.
Tip: When alone with the patient, the following question, said with a gentle informality near the end of the first meeting may open doors:
Physician: Now that you have a doctor captive, you don't get that chance all the time, is there anything else you wanted to talk about?
Another technique that I have found useful, after having explained the importance of confidentiality to the patient's parents, is to say the following in the presence of both the teenager and his parent or parents, "There may be a time when you want to talk with a doctor alone, and your parents and I feel that you can talk with me about things in confidence, about your friends or yourself, just give me a call anytime."
TISA Follow-up: Such approaches often help teenagers to feel more at ease with the idea of sharing difficult material with their physician. Sometimes they call first about friends "in trouble" with suicidal ideation or drugs and, at other times, they call about their own concerns. In either case, statements such as the above often help to forge the first steps towards a trusting relationship, that may last for many years to come.
Tip provided by:
James Lynn Casey, M.D., Pediatrics/Endocrinology at the Medical Center of Hutchinson, Kansas.