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Re: Horrible case From: Arthurfree@aol.com Sat Nov 30 10:45:58 1996 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: John Robertson: "Re: The less you know the better" Previous message: HMarchbein@aol.com: "Re: Bone density mafia" Maybe in reply to: Richard Chudacoff, MD: "Horrible case" In a message dated 96-11-27 14:45:52 EST, you write: > Someone needs to sit down with this girl >and talk with her. Is this my place to talk with her? Please speak with her. It is important that someone demonstrates that they care about her very survival. However, though your words carry more weight per amount of time spent than most folks, that is not enough. >Do I inject my own moral and ethical belief? Yes and no. It is very important that your counseling not be in the slightest judgemental, only couched in terms of helping her to find ways to survive adolescence and become an independent adult. That is what a good moral structure does (as well as engender values that contribute to self esteem) but keep in mind that adolescents are very sensitive to being viewed through other people's values. >I feel that someone needs to take over raising >this kid because she seems like a basically nice and intelligent child that >is looking for love in all the wrong places. Or, do i just send her to a >social worker, minister, priest, and just keep my job on a medical level? >How do I approach it, if I do take on this task? You cannot do this by yourself unless you intend to become a foster father (bad idea, you would have to cease being her doctor and would lose clinical objectivity). It is certainly appropriate WITH HER PERMISSION to discuss her situation with support personel already peripheral to her situation (i.e. school counselors, an independent counselor if she is willing, priest/minister is rarely available in this type of family). The somewhat oversimplified summary of her situation is that she has only been able to get male attention by acting out sexually and knows no other way. Her mother has probably even inadvertently modelled this for her. Do not hesitate to get child protection agencies involved, but be careful, if this is not with her explicit permission it can lose you her confidence. Last and most importantly, do not get sucked in personally. Trips to the zoo and such are not appropriate, and especially with her flirtacious mixed messages can be interpreted as more than inappropriate by outside parties. She is at a stage where, though what she is lacking is appropriate male attention (non-sexual) a strong female role model can often be more helpful (and less dangerous). >This was not taught in residency. Sorry. Tertiary centers teach us to refer and be done, it is rarely that simple and it tends to make humans into flotsam. It is also more complex than subjects that can be taught simply, and much of it comes from the heart. The fact that you asked the question indicates you have the heart. Arthur Freeland Family Practice Warrensburg, Missouri Next message: John Robertson: "Re: The less you know the better" Previous message: HMarchbein@aol.com: "Re: Bone density mafia" Maybe in reply to: Richard Chudacoff, MD: "Horrible case"

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