By Gail B. Slap, MD, MS (Auth.)
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The second reviews strategies for office-based violence screening. The third section gives specific examples of brief office interventions designed to decrease the likelihood of subsequent violent injury. 28 Approaching Youth Violence in a Clinical Setting Kenneth R. Ginsburg, MD, MEd Resilience-Based Prevention The classic approach to adolescents at risk for violence is to assess their behaviors and educate them about the associated dangers (Box 5-1). This risk approach may work for youth who are highly motivated to change their behaviors but may frustrate, offend, shame, or alienate those who lack the tools or context for such change.
Do people bring weapons to school? ” The adolescent who responds, “I’m fine” or “Don’t worry about me” may be unprepared to divulge his or her behavior or fear of someone else’s behavior. ” Some youth respond, “No, I can fight for myself. ” Others divulge gang affiliation or weapon carrying. Many, however, remain silent. If it seems appropriate, ask “Do you think a knife or gun would make you safer? ” An adolescent who carries a weapon often believes that it confers protection without risk and that his or her life is of value and to be protected.
Immunizations Finally, immunizations are particularly important for adolescents with chronic conditions, as they often are at increased risk for diseases that can be prevented by vaccination. Essentially all adolescents can receive killed or recombinant vaccines. At-risk groups, such as those with kidney failure, diabetes mellitus, asthma, and other pulmonary conditions, should receive an influenza immunization each fall. Those who are immunocompromised should not receive live vaccines, such as measles-mumpsrubella (MMR) or varicella.