An adolescent refuses to go to gym class after classmates jokingly called two freckles under his nipples extra breasts. Which intervention would be most therapeutic for this adolescent?
a. Reassure him that they are freckles not extra breasts, and send the student back to the gym to play basketball.
b. Acknowledge the student's self-consciousness while reflecting the reality that the statement was made as an insensitive joke.
c. Call the principal and explain the situation and the possibility that the school may be experiencing a bullying problem that focuses on anatomy jokes.
d. Inform his parents of their child's concerns, and suggest they have a discussion about hurtful joking and age appropriate anatomy to deal with the issue.
B
It is important to acknowledge the patient's concern while still focusing on reality. Inadequately addressing and minimizing the patient's concerns and sending the child back to the gym set up a situation that may create a regressive struggle. Calling the principal is an overreaction at this point. Informing the parents and suggesting a follow-up discussion would be premature and could overwhelm an already traumatized and sensitive adolescent.
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