Adolescent psychiatric emergencies

The adolescent in a psychiatric crisis is best seen alone first, to preclude observer bias. Emotionally charged areas of discussion must not be avoided. Suicidal and homicidal threats or attempts are challenging emergencies. Working with parents is essential for effective management. Is the fire-setter retarded or psychotic? Family therapy is often the treatment of choice in sexual "emergencies." Bizarre behavior should suggest drugs, severe anxiety or psychosis. School phobia is a particularly complex problem.