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O ne goal of medical training is to provide the physician with the knowledge and skills necessary to perform accurate diagnostic and therapeutic procedures. Frequently, however, interviewing technique is an area in training that receives less emphasis, often being considered "the art of practicing medicine." This designation implies that the physician must either have an innate ability as an interviewer or wait until these skills develop with time and practice. Fortunately, many medical schools are now structuring programs specifically to teach interviewing skills and techniques. The necessity for continuing such programs during residency training is increasingly being recognized.1 Although both talent and experience contribute significantly to the ability to conduct a good interview, there are basic guidelines that can be followed. This article is an attempt to provide an outline for interviewing adolescent patients and includes examples of situations frequently encountered in the interview setting.
Although the primary goal of the interview is to obtain a complete history, there are additional benefits that can be gained from it. One of the obvious ones is the personal interaction it generates between the pediatrician and his adolescent patient. How this interaction is perceived by each will provide the basis for the future therapeutic relationship. The interview also provides an opportunity for flexibility, so that the process of obtaining information can be adapted to the specific needs of an individual patient. Were it not for these additional benefits the interview provides, much of the information needed could be obtained with a questionnaire.
Tailoring the interview to fit the individual patient often is challenging. The intern or medical student usually quickly learns that there is "something different" about obtaining a history from an adolescent compared with obtaining one from the parents of a child or from another adult. It is that "something different" about the adolescent interview that will be specifically addressed in this article.
ADOLESCENT PSYCHOSOCIAL DEVELOPMENT
While puberty refers to physical growth and development of the child, adolescence refers to his psychologic growth.2 The psychosocial stages may be divided into early , middle, and late adolescence. An appreciation of the developmental stage a given patient is in will help the clinician anticipate the form an interview should take. Thus, the purpose of outlining specific developmental stages, as...