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G4 THE STRUCTURED MEDICAL HISTORY: OBTAINING THE MOST AVAILABLE FORM OF EVIDENCE IS CHILD SEXUAL ABUSE THE SPOKEN WORD
Presenters: Martin A. Finkel Abstract Category: Medical Instruction Level: Intermediate Presentation: Click Here
Description: Medical history in child sexual abuse; engaging in a therapeutic dialogue to obtain the most available evidence; the spoken word.
Abstract: The medical history is one of the most challenging aspects of evaluating children and adolescents in suspected cases of child sexual abuse. Although there has been great interest in interpreting physical examination findings little attention has been given to the how to's of obtaining detailed medical histories from children that reflect the chronology of events when sexual abuse is suspected. This workshop will offer insight into how to obtain a medical history from children of varying ages that seeks age appropriate idiosyncratic details of sexual victimization, identify signs and symptoms associated with the alleged sexual interaction, address discrepancies between a child’s perception of their experience and the physical examination findings and address body image concerns. Examples of introductory statements and specific questions will be provided to assist the clinician in engaging children in a dialogue that creates a therapeutic relationship with the child enhancing the probability of them sharing the details of their experiences.
In addition the presenter will discuss how to create a medical record that enhances the potential for admissibility of out of court statements (medical history) obtained by the health care professional under the diagnosing and treating physicians’ exception to hearsay. A structured medical history will be offered as well as examples of a format for creating a medical consultative report with an emphasis on formulating a diagnostic assessment. This workshop will also be of value to law enforcement and social work professionals as it will increase their understanding of how the medical history can clarify a child’s experience and be the first step in the therapeutic process.
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