Table 1

Provider recommendations on how to initiate screening of pornography use

All routine visits should include52
  • Discussion about sex and sexuality.

  • Screening for high-risk sexual behaviour.

  • Allowing space for teens to ask questions and gather accurate and safe resources.

If screening is positive for pornography use7History of pornography use
  • Define the specific behaviour

  • Assess duration (ie, when did it start), intensity (ie, violent, soft porn) and frequency (ie, how often used)

  • Identify symptoms of current behaviour and how it is interfering in day-to-day functioning.

  • Which specific areas of functioning are impacted by pornography (ie, intrapersonal, interpersonal, sleep, academic performance, mood lability and physical health (neck or genital pain).

The function of the behaviour
  • Help patient identify the function of the behaviour

  • Some examples would be: avoidance, boredom, negative affect management, emotion regulation and socialisation.

Past mental health/physical health history
  • Review all former and current symptoms, diagnoses and treatments

  • Research shows that there are higher rates of mental health diagnoses and family challenges with teens engaging in pornography.

Review/assess social and developmental history
  • Developmental milestones

  • Academic History (learning disorders, 504 Plans).

  • Social history (ie, friends, acquaintances, significant others, social anxiety, social isolation, bullying).

  • Family history (med and psych hx, involvement, substance abuse, abuse, neglect).

How PCP’s can foster parent–child communication about pornography51
  • Encourage early parental education at home about: sexuality contraception and pornography.

  • Discuss strategies for promoting healthy and safe use of pornography.

  • Make sure that education and discussion is consistent with ‘family’s attitudes, values, beliefs and circumstances’.

  • Discuss strategies for promoting healthy and safe use of pornography.

  • Help families use reputable sources of information.

  • PCP, primary care provider.