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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
Child and Adolescent Psychiatry

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Minerva Pediatrica 2014 February;66(1):77-87

language: English

Talking to adolescents about alcohol, drugs and sexuality

Bagley S. 1, Shrier L. 2, Levy S. 3

1 Section of General Internal Medicine Boston University School of Medicine Boston, MA, USA;
2 Division of Adolescent/Young Adult Medicine Boston Children’s Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA;
3 Division of Developmental Medicine Children’s Hospital Boston and Department of Pediatrics Harvard Medical School, Boston, MA, USA


A discussion of alcohol, drugs and sexuality is an important part of routine health advice and guidance for adolescents. It is important for providers to use a systematic approach that includes building rapport and asking standard screening questions using non-judgmental and gender-neutral language. This strategy minimizes the chance of omitting key questions and increases efficiency of the interview, while being respectful of the adolescent’s autonomy and choices. During adolescence, some of the health visit will occur with the adolescent alone. As part of that transition, clinicians should explain conditional confidentiality to both the adolescent and the parent. When discussing alcohol and drug use, clinicians should have information about the epidemiologic patterns in their practice area, use standard tools for screening and be familiar with local resources for treatment. Similarly, when discussing sexuality, clinicians should use a standard approach such as the “5 P’s.” Clinicians can provide adolescents with a safe environment to share sensitive information and risk taking behaviors using a clear and consistent approach.

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