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  • Title: Adolescent sexual counseling.
    Author: Shen JT.
    Journal: Postgrad Med; 1982 May; 71(5):91-3, 96-7, 100. PubMed ID: 7071042.
    Abstract:
    The physician provides a much-needed service to teenagers by counseling them regarding sexuality. A series of conferences during adolescence and use of questionnaires can facilitate discussion and point up potential problems. When the patient is confronted with a problem such as a need for contraception or an unwanted pregnancy, the physician should present all the options available and leave the final choice up to the patient. The physician is not obligated to participate in a solution that is counter to his or her moral values. Guidelines for adolescent sexual counseling are presented on the basis of this physician's experience in the practice of adolescent medicine. Attention is directed to the following: characteristics of the counselor, counseling of parents, general guidelines for counseling adolescents, and counseling for the specific problem areas of masturbation, sexuality and decision making, homosexuality, premarital coitus and contraception, and abortion. To counsel adolescents about sex, the physician must be knowledgeable about the developmental psychodynamics of adolescent sexuality, with its biologic, psychosocial, and moral implications. The physician must also understand his/her own sexuality and should feel comfortable about discussing sexuality with the patient and parents. The physician should help the patient to analyze the pros and cons of all solutions to the problems relating to sexual activity. The patient should be assured that the discussion is strictly confidential. Many parents require clarification and advice regarding their own sexuality, and they should be instructed in techniques for initiating discussion of sexuality with their children. In regard to counseling teenagers, a series of conferences during adolescence and use of questionnaires can facilitate discussion and identify potential problems. When the patient is faced with a problem such as a need for contraception or an unwanted pregnancy, the physician should present all the options available and leave the final choice to the patient. Decision making concerning sexuality is the same as any other decision making that involves coping and adaptation. To make a decision one has to consciously or unconsciously evaluate on the following levels: autonomic (instinctive) level, biosensory level, intellectual level, philosophic-moral-religious level, and total intuitional awareness level. All these levels of evaluation have their developmental and hierarchical positions in decision making, and they interact with one another and jointly and independently influence the self (ego). Will is the most important part of self in decision making and decision implementation. Contraception for sexually active teenagers can prevent unplanned pregnancy and subsequent abortion. The risks and effectiveness of different methods of contraception should be explained, and the patient's religious beliefs should be considered before a final decision is made. Ongoing counseling of these patients is essential.
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