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Chapter: Paediatrics: Child and family psychiatry

Paediatrics: Communicating

Children’s anxiety is often decreased if first interviewed with an adult they trust.



Tips for communicating with children


·Children’s anxiety is often decreased if first interviewed with an adult they trust.

·Assume children do not fully understand why they are being seen.

·Often children assume they are ‘in trouble’.

·Often children equate doctors with physical illness, often with painful procedures such as injections. Rarely have they met a ‘talking doctor’.

·Be prepared to see a child several times to gain trust and rapport.

·Learn and/or practise child-appropriate communication, i.e. drawing, colouring, storytelling, pretending, building, making, exploring, appreciating tall tales, talking about current TV, technology, books. Do not take over play; follow the child’s lead and still behave like


a sensible adult.

·Practise age-appropriate language.


·Do not undermine the parents’ efforts by appearing too competent.


Tips for communicating with adolescents


·Don’t assume they have chosen to be there.


·Understand they may be ambivalent about recognizing they have a problem, dealing with, or denying it. They may see you as a source of help or as a threat—or both.


·Discuss the context of your conversation—why are you meeting?


·Discuss what you will do with what she/he tells you (confidentiality and its limits may be crucial).


·It may be helpful to ask about neutral areas first.


·Be prepared to ask closed questions accepting a yes or no answer.


·Speak plainly. Avoid talking like an adult pretending to be a teenager.


·Convey your desire to understand by checking whether you are getting it right. ‘I am hearing that unless something changes pretty quick you are not going to be able to go to school any more. Have I got it right?’


·Do ask the adolescent what she/he would like to happen, but as above accept they may have mixed feelings.


·Be patient. Unless it is an acute situation consider continuing your assessment over more than one session.


Do see the adolescent alone as well as with his/her parents.


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