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 to children. Clinicians can more effectively counsel alternatives if they: are clear in their own minds about the risks of corporal punishment and its boundaries with reportable child maltreatment; appreciate parents' justifications for corporal punishment and offer corresponding alternatives; demonstrate their interest and expertise in matters of child behavior and family dynamics; practice communication techniques that elicit discussion of psychosocial topics and facilitate mutual problem solving; let parents take the lead in tailoring alternative disciplinary strategies to the family's unique needs; start early helping parents understand child behavior in general and their child's temperament and development in particular. Clinicians as a group should demonstrate a united stand against the use of violence within families. Both undergraduate and continuing medical education should involve training in communication skills in general and problem-solving techniques in particular. Pediatricians need more time during their training to learn about child behavior and family dynamics.
Wissow
L S
LS
Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
Roter
D
D
D002648:Child; D002668:Child Rearing; D003142:Communication; D003376:Counseling / Q000379:methods*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D008297:Male; D009819:Office Visits; D010290:Parents / Q000193:education* / Q000523:psychology; D010358:Patient Participation; D010372:Pediatrics / Q000193:education / Q000379:methods*; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D011320:Primary Health Care / Q000379:methods*; D011340:Problem Solving; D011678:Punishment / Q000523:psychology*; D014481:United States; D014754:Violence / Q000517:prevention & control