Dr. Michael Jellinek
So how much time do your patients spend online every day? Does it interfere with getting their homework done? Have they withdrawn from prior hobbies? Would they rather text their friends or hang out with them? Do they have their own phone? Have they ever seen a sext? Have they felt pressure to send one? Do they turn their phone off at night? Have they ever been involved in texts that felt cruel?
These questions are similar to ones that arose when day to day life was face to face; they flow from expected adolescent development, but are now worth considering for both the real and the virtual world. And if, as a pediatrician, you can ask these questions of your patients directly and warmly, you will likely get honest answers. Most young people, although nimble with these technologies, are happy to have your interest in this area and even your advice about their use of these technologies.
It can be equally powerful to speak with parents about this to find out what their concerns are, whether they understand the role of this technology as part of adolescent development, and whether they know the answers to questions about their child’s use of technology. It can help to ask whether they find themselves on their smartphones when they are with their children and are supposed to be watching them play soccer or are eating dinner together.
Parents need to be mindful of what they are modeling if they hope to help their children better control their use of technology. It can be powerful for parents to hear that it is reasonable for them to set firm, clear rules around technology use, and enforce those rules. Parents can explain warmly and clearly that phones and computers go off at a certain time or are taken away, that they don’t belong at the dinner table, and that their children should imagine that every text they send or photo they post could be seen by their parents, teachers, or college admissions committee before they hit send.
As technology changes and the teenager matures, sharing some of the dilemmas or challenges of current technology and negotiating expectations and enforcing rules, in the context of ongoing, honest communication, is likely the best path. When the teenager’s use of the technology reflects poor judgment, rigid overuse, or serious risk taking, mental health referral is indicated.
Dr. Swick is an attending psychiatrist in the division of child psychiatry at Massachusetts General Hospital, Boston, and director of the Parenting at a Challenging Time (PACT) Program at the Vernon Cancer Center at Newton Wellesley Hospital, also in Boston. Dr. Jellinek is professor of psychiatry and of pediatrics at Harvard Medical School, Boston. E-mail them at pdnews@frontlinemedcom.com.