(CONSULTATION) The process of thinking during a consultation, and subsequently describing what happened to a group of colleagues, soon leads to an awareness of many unspoken communications from the patient. Mode of dress, the presence or absence of eye contact, feelings of anger, despair or withdrawal coming from the patient are reported by the doctor. [...]

Training to improve skills in this work should be sought by anyone who is encountering many patients with sexual difficulties. Information about training is available from the Institute of Psychosexual Medicine. Perhaps those who work in family planning and are not seeing patients with sexual problems should examine their consultation skills (see Chapter 13) to [...]

In some instances the patient is reluctant to stop a method because of the noncontraceptive advantages it provides. If the woman finds the messiness of sex unpleasant she may prefer her partner to continue to use the sheath. It can be difficult to persuade some women to stop the Pill, especially if they have the [...]

Unplanned pregnancies, particularly if there are several in quick succession, can give a sense of being out of control that can border on panic. For the woman with several small children, the fatigue and despair may lead her to put great pressure on the doctor for a sterilization which she feels would at least give [...]

Legally it is usual to work with the parent or carer if the patient is under age. As they are normally the people requesting help, this is not a problem. It is unlikely that a person under 16 would be seen without such involvement, for the Department of Health Guidelines on working with the under-16s [...]