Talking to teens about family problems. An opportunity for prevention

Most pediatricians do not screen for family problems as part of routine adolescent health care. This study documents fears, worries, and concerns about family issues expressed by 147 teenagers on a confidential questionnaire during consecutive initial visits to an adolescent medicine clinic in a university hospital setting. Among the salient findings, 44% had thought about running away from home, 42% reported having been subjected to some form of abuse, and 33% had felt like hurting themselves or someone else. Twenty-eight percent reported conflict in their home, 27% were having problems with their family, and 20% were concerned about their parent's relationship. In addition, 27% worried about the physical or mental health of family members and 22% believed that a family member had a problem with alcohol or other drugs. Twelve percent did not have a confidant with whom to discuss their innermost concerns. The data demonstrate a high frequency of stressful and anxiety-provoking family situations as reported by adolescents on a confidential questionnaire. Pediatricians who wish to provide comprehensive services to their young adult patients must be prepared to discuss such issues on a routine basis.