By Russell Viner
The well-known ABC sequence, as serialised within the BMJ
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Extra info for ABC of Adolescence
Asked in a non-judgmental manner—can be helpful in deciding whether further assessment is needed. An adolescent’s distress about being asked about weight and food should heighten concern. If the concern is equivocal, a further appointment within a month is advisable. Body mass index Males After an eating disorder is identified, direct challenge or confrontation is unlikely to be helpful. At first presentation aim to (a) feed back findings from physical examination, including degree of underweight if relevant; (b) establish weight monitoring plus a plan to follow if weight falls; (c) discuss psychiatric risk as needed; and (d) provide the family and young person with information about the nature, course, and treatment of eating disorders.
Topics for motivational conversations in drug and alcohol work with young people Increasing motivation to change and therefore progress from precontemplation to contemplation can occur through exploring: x The advantages and disadvantages of the misuse (for example, “Drinking can make you feel relaxed and at ease in company, but sometimes being drunk can be an ugly look. ”) x The factors that bother them most about potential behaviour change (for example, girls often worry that they will gain weight if they stop smoking) x Their reactions to the adverse consequences of which they are currently at risk (for example, unwanted pregnancy or sexually transmitted disease through having had unsafe sex while intoxicated) Harm reduction strategies may include encouraging moderation as well as abstinence; providing information on safe levels of alcohol consumption; advising on hazards of drinking and driving; providing information on health risks of drugs; advising not to share needles; and giving phone helplines and and other information sources Further reading x Hawkins JD, Catalano RF, Miller JY.
The clinician can improve his or her examination by using a semistructured assessment. The natural starting point is inquiry about the events leading up to the act. It is essential to establish whether the young person had a high degree of suicidal intent. As denial of intent is sometimes a problem, it is important to get as detailed an account of the circumstances as possible and compare these to factors known to be associated with high intent. Sometimes the reasons for self harm seen unclear because the act may seem highly impulsive.
ABC of Adolescence by Russell Viner