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Teenagers have long been looked upon as 

confused,

lazy and just plain hard to get along with.

This lack of emotional and social stability can 

make the in hospital handling and treatment of 

adolescents a problem in itself.

The medical community has for the most part 

ignored.

The unique situation presented by the 

hospitalized youngster at M 

CV.

We try and deal with every aspect of 

adolescent care.

For example,

first slide please.

David P was admitted to MCV suffering 

from abdominal pains,

vomiting and the recent onset of jaundice and 

associated tea colored urine.

A preliminary history revealed heavy use of 

alcohol and repeated intravenous use of 

narcotics.

David's illness was diagnosed as serum 

hepatitis complicated by his withdrawal 

from narcotics and alcohol.

David himself described as unworkable his 

existence at school and his relationship with his 

high powered parents.

In such a case,

it is not enough to simply treat.

David.

David is not a unique case.

Often the medical treatment of adolescence is made 

more difficult as a result of underlying 

social and emotional problems.

It is vital that the medical world consider the need 

for a vastly expanded program designed 

specifically for adolescents 

at the medical College of Virginia.

Such a program is already underway.

M CV has combined a specially staffed 

adolescent ward with an existing outpatient 

clinic to provide the consistent and ongoing 

care.

These 12 to 20 year olds need 

patients are assigned to one of nine semi private 

rooms.

According to age the ward 

has in it.

A large day room used for recreation and 

tutoring.

This area contains a pool table,

a television,

a record player,

as well as a small library.

Teenagers are always hungry and the adolescent 

ward provides patients with a pullman kitchen snack 

bar.

A nutritionist is available to explain the value of a 

proper diet and also to teach individual patients 

about any special diets that might be required 

following discharge.

The ward also contains several conference rooms 

where patients can meet with their parents and or 

their doctor in private.

In addition to medical and nursing personnel,

a clinical psychologist,

a social worker and a chaplain are 

available to help the patient and his family adjust to 

hospital life three times a week,

the entire staff or team meets to 

discuss each patient's progress.

Ok.

What about David's medical condition?

He seems to be managing the detoxification program.

Satisfactorily we started David on 10 mg of 

methadone to stabilize his withdrawal symptoms.

That dose will be reduced by two mg daily until this time 

next week.

Regarding his hepatitis,

there isn't much we can do except to replace lost fluids and 

control his diet.

That's about all barring unforeseen complications and 

staying in the hospital should be routine.

What's happening at home,

Joe?

Have you had a chance to talk to his parents?

Yeah,

I talk to them.

Both are college educated,

academically oriented and extremely negative 

about what the kid has gotten himself into 

when he turned 16.

They wouldn't let him get his license because his grades had been 

dropping.

They were and are putting a lot of pressure on him to 

perform.

A lot of the kids',

negative feelings are reinforced by his parents.

It might be interesting to see what would happen if they gave him a little 

responsibility.

The academic tests I ran on David show no lack of 

ability to do his school work.

He seems unmotivated and very negative about those 

things.

His parents are pushing him to do.

His grades were good until about six months ago and his teacher at 

school reported that he had been associating with a different 

peer group the past several months and during this time,

his grades have dropped sharply.

He doesn't have any problems with the assignments I give him here.

So I'd have to guess that at least part of his problem is the 

group of people.

He's associating with the drug group.

When I first talked to him,

he seemed positive about one thing at least.

And that was his athletics.

Have you talked to him about what he wants to do?

He said he would like to be a coach.

I have already talked to Pinewood about his being a counselor 

there next summer.

They said no problem.

And he seemed to like the idea.

It will be hard for him to get there.

If I though,

maybe we can talk his parents into letting him get his license.

What do you think,

Joe,

from medical care to scholastic evaluation,

from social work to occupational counseling?

Every aspect of the patient's problem is looked at 

discussed and the alternatives weighed 

if at the end of the patients stay in the hospital,

serious problems remain,

he will be referred to the outpatient clinic where treatment 

can be continued.

The aim of the clinic is to provide for the adolescent.

On the one hand,

a physician who is interested in him as an individual 

and on the other to make available facilities and 

counseling which will help him get over his particular 

problem.

Patients may also be referred to the clinic through the courts 

or one of the juvenile homes in the area.

Each time the patient comes in,

he is seen by the same doctor appointments are 

long enough to avoid the hurried and 

impersonal treatment common in many clinics.

Today.

The most common problems at the clinic are infectious 

diseases,

drug abuse failure at school 

and lack of physical or emotional development.

The staff of the clinic uses the same team approach 

as the adolescent ward in an effort to explore 

every alternative.

The youngster may have not only is there 

psychological testing,

educational evaluation and vocational 

counseling,

but there are also special therapeutic activities.

The patients may become involved in one 

of the most popular of these activities is what is called 

spontaneous group.

Art several times a week.

These troubled teenagers are given the opportunity 

to express themselves with paints,

charcoal pastels and clay 

under the accepting eye of an experienced art 

therapist.

And in the security of a group,

each patient is given the freedom to choose his own 

materials,

develop his own style and release his 

emotions in a relaxed atmosphere.

Other special activities at the clinic include poetry,

swimming,

and macro,

whatever the activity,

the goal is the same to help the 

adolescent adapt to the physical and emotional 

changes he must make.

In order to enter adult society 

lights,

please.

If one examines closely the popular belief that 

teenagers today are more sophisticated,

better educated and better able to deal 

with their problems than youngsters of the past,

one will find that such reasoning is not consistent 

with the facts.

Adolescents should not be overrated.

They are not adults and yet they are not Children.

Adolescents are in a category all by themselves 

and that uniqueness should be respected.

Thank you.