TOWARD EFFECTIVE DISCUSSION OF DISCIPLINE AND CORPORAL PUNISHMENT DURING PRIMARY-CARE VISITS - FINDINGS FROM STUDIES OF DOCTOR-PATIENT INTERACTION

Corporal punishment is widely practiced despite evidence of its harm t o children. Clinicians can more effectively counsel alternatives if th ey: are clear in their own minds about the risks of corporal punishmen t and its boundaries with reportable child maltreatment; appreciate pa rents' justifications for corporal punishment and offer corresponding alternatives; demonstrate their interest and expertise in matters of c hild behavior and family dynamics; practice communication techniques t hat elicit discussion of psychosocial topics and facilitate mutual pro blem solving; let parents take the lead in tailoring alternative disci plinary strategies to the family's unique needs; start early helping p arents understand child behavior in general and their child's temperam ent and development in particular. Clinicians as a group should demons trate a united stand against the use of violence within families. Both undergraduate and continuing medical education should involve trainin g in communication skills in general and problem-solving techniques in particular.Pediatricians need more time during their training to lear n about child behavior and family dynamics.