There are a number of ways to help an adolescent prepare for a difficult medical test or procedure.

First, provide detailed information and explain reasons for the procedure. You can use videos in which other adolescents do the teaching to demonstrate the procedure
and provide information, if available. Let your child participate and make as many decisions as possible.

Depending on his or her age and independence, your child may or may not wish you to be present during the procedure, and his or her wishes should be respected. During adolescence privacy is important and should be protected.

PRE-PROCEDURE PREPARATION:

Explain the procedure in correct medical terminology, and provide the reason for
the test (ask your health care provider about the specific reason for the test if you are not sure). An increased understanding of the need for the procedure may reduce your child's resistance and anxiety about it.

To the best of your ability, describe how the test will feel. Allow your child to practice different positions or movements that will be required for the particular test or procedure, such as the fetal position for a lumbar puncture.

Be honest about discomfort that may be felt, but don't dwell on the topic. It may help to stress the benefits of the procedure and anything that the child may find pleasurable afterwards, such as feeling better, knowing what may or may not be needed next, or going home. Rewards afterwards may be helpful, if the child is up to them (shopping trips or movies).

To the best of your ability, describe the operation of equipment that will be
involved in concrete, literal terms.

Suggest ways for to help the child maintain control:

• Counting
• Deep breathing
• Relaxation (thinking of pleasant thoughts)
• Squeezing the hand of the parent (or someone else) during the procedure

Include your child in the decision-making process, such as the time of day or the procedure is performed. When possible, let your child make some decisions. The more control a person feels over a procedure, the less painful and anxiety producing it is likely to be.

Allow your child to participate in simple tasks. Encourage participation during
the procedure, such as holding an instrument, if allowed. If your child wishes to hold your hand or that of someone else in the room for comfort, this should be encouraged as it can actually help reduce pain by reducing anxiety and providing distraction.

Discuss potential risks. Adolescents commonly have elevated concerns about
risks, particularly about any effects on appearance, mental function, and sexuality. Address these fears honestly and openly if at all possible. Provide information about any appearance changes or other possibly disturbing side effects that may result from the procedure or test.

Older children may better benefit from videos that demonstrate peer modeling
(peers explaining, demonstrating and undergoing the same procedure). Ask your
health care provider if such films are available for your child's viewing.

DURING THE PROCEDURE:
If the procedure is performed at the hospital or your health care provider's office, you will most likely be given the opportunity to be present. Your child may or may not desire your presence, and it is best to honor his or her wishes.

If you are not asked by the health care provider to be by your child's side and would like to be, ask if this is possible and ask your child if he or she would mind your presence. Out of respect for your child's growing need for privacy, do not allow peers or siblings to view the procedure unless he or she wants them to be present.

Other considerations:

• Ask your health care provider to limit the number of strangers entering and
  leaving the room during the procedure, since this can raise anxiety.
• Ask that the care provider who has spent the most time with your child be
  present during the procedure.
• Ask that anesthetics be used where appropriate to reduce the level of
  discomfort for your child.
• Your adolescent may have difficulty with a new authority figure entering his
  or her life (the health care provider). This complication can be minimized if a
  familiar health care provider performs the test. Otherwise, your child may offer some resistance to the procedures. Prepare the teen in advance for the possibility that the test will be performed by someone unfamiliar if this is likely to happen.