PARENTAL DISCLOSURE OF CHILD PSYCHOSOCIAL CONCERNS - RELATIONSHIP TO PHYSICIAN IDENTIFICATION AND MANAGEMENT

BACKGROUND. Physician identification and management of psychosocial pr oblems in children is related to parental disclosure. The purpose of t his research was to evaluate a method of prompting parental disclosure of such problems and to determine the impact of parental disclosure o n family physicians' identification of and intervention for childhood psychosocial problems. METHODS. Participants were parents and physicia ns of 60 children between the ages of 3 and 10 years attending an ambu latory care clinic of a community-based, university-affiliate family m edicine training program. Parents completed the Child Behavior Checkli st and also indicated whether psychosocial problems were discussed or managed. Physicians completed a checklist about the psychosocial statu s of the child and potential interventions for identified problems. On e half of the participating parents formed the experimental group and were also asked to note their concerns on a Psychosocial Checklist for Children and to discuss these concerns with their child's physician; the other half of parents received no such checklist and acted as the control group. All interactions between parents and physicians were vi deotaped. RESULTS. The number of parental psychosocial disclosures, bu t not the number of parents who disclosed them, was significantly high er for the experimental group. Physicians were three times as likely t o identify a psychosocial problem and 10 times as likely to intervene when parents discussed psychosocial concerns. CONCLUSIONS. Parents' di sclosure of psychosocial concerns to their child's physician increases the likelihood of physicians identifying and intervening for these pr oblems. The finding that physicians intervened for psychosocial proble ms even when they failed to record these problems suggests that resear ch needs to focus on measuring both intervention and identification.