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Mental Health Nursing · Chapter 14

Eye Level: What to Say to a Child or a Teenager

A child shows you in behaviour what they cannot yet say in sentences, and a teenager tells you almost nothing until the rules of the conversation are explained first. Choose the nurse response at six moments — all four options are then named for you, the technique or the exact trap. Then sort seven behaviours into expected for this stage and clinical concern, and see which signal tips each one over.

Six moments

Every line below is something a real nurse has said. Choose the one you would use, then read why the other three land the way they do.

What you have been practising

0
Moments
0
Therapeutic
0
Traps taken
Answer a moment and the technique you used — or the trap you walked into — is named here.
Assent is not the same as consent. The guardian consents; the child assents — their developmentally appropriate agreement to the blood draw, the admission, the medication. A child who is told is a child who can cooperate. A child who is surprised is a child who gets restrained.

Expected for the age, or a clinical concern?

The question is never simply “is this abnormal?” It is “is this expected for this developmental stage, and is it causing impairment?” Four signals tip the balance: intensity, duration, pervasiveness and impairment.
The first weeks are the tightest weeks. Antidepressants take about two to six weeks for full mood response, and energy and initiative often return before hopelessness lifts — which is exactly when a previously immobilised adolescent may act. Supervision is tightest in that window, not loosest, and new jitteriness, agitation, insomnia or disinhibition is activation: call the prescriber, do not wait it out.