The initial conversation should ...

The initial conversation should be conducted in conjunction with rditelem and adolescents. At this time, can be identified and discussed the boundaries of confidentiality. Joint participation allows the clinician to observe the parent-adolescent relationships and evaluate the quality of their relationships. During the first interview is useful to ask parents about what causes the greatest concern. For example, a parent can ask whether or not he is concerned about the fact that symptoms may indicate the presence of a particular violation. This information will enable the physician to focus on this concern and dispel the previously unspeakable fear of parents for serious life-threatening disease. If the parents expressed their concerns is important to talk with your teen alone, yet it is desirable to hold a final meeting on the type of feedback with parents and teens to ensure their understanding of the diagnosis and recommendations. History and overview of the symptoms complete medical history should be obtained from a teenager, including a thorough review of systems. It may be useful to know the perception of a teenager anamnestic facts before stated parents. Any discrepancy between the perception of the problem parents and adolescents may indicate a family conflict or poor understanding of family that should be investigated. Description of onset of symptoms and any associated signs or situations can reveal important reasons relating to the cause of stressors. Level of emotional distress teenager can be observed and evaluated during the interview. Psychosocial origins should be considered with special uduleniem vnimniya the possibility of recent events in my life that could cause stress. A list of life events may be useful in gathering such information and to clearly identify stressful events in a teenager or his family. Such a list may also indicate areas requiring intervention to reduce stress. While the relationship between stressors and psychosomatic symptoms may be apparent to an objective observer, many teens may not recognize the stressful nature of their circumstances. This situation is somewhat similar to the old Chinese proverb: "Do not intelligently ask a fish, what kind of water." The teenager, like a fish, can adapt to the conditions and do not recognize their stress. For example, an adolescent with chronic tension headaches may say that he is never in contact with his neveryaschimi parents and he does not receive from them any financial support. Typically, patients in such circumstances, they say that they are accustomed to them and that they will not interfere. When a teenager sees that he ignored his biological parents, such behavior usually causes parents to psychosocial distress, whether conscious or unconscious. Pressive feelings about stressors may play a role in somatic complaints and should be explored. It is important that the clinician examined daily routine adolescent including areas of potential stress.