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Susan Rabinovitz

Teen Clinic Head Urges Listening to--not Demonizing--Adolescents

April 22, 2001|MOLLY SELVIN | Molly Selvin is a Times editorial writer

It's at least an hour before the school day ends, yet the waiting room in the teen walk-in clinic, part of Childrens Hospital Los Angeles, is busy. A handful of girls, waiting for counseling or medical care, idly twist strands of hair or play with their jewelry. Each seems lost in private thoughts or fears. A boy stares at the floor.

This is a place where the hazy adolescent nostalgias of Sweet Sixteens and beach parties yield to the hard reality of condoms, HIV testing and runaway hotlines, a place where Working Mother magazine shares space with back issues of HIV Plus.

Susan Rabinovitz is the quiet, unprepossessing presence overseeing the clinic at Sunset and Normandie, along with several other clinics and teen services around the city. Rabinovitz, associate director of the Division of Adolescent Medicine at Childrens Hospital, is a self-described "child of the '60s"

Bent on "making change," she left the Midwest, where she grew up, for California in 1972. Nursing school at Los Angeles Community College followed, and Rabinovitz, 51, eventually found her calling with adolescents after a stint as an elementary-school nurse in Boyle Heights. There she saw, firsthand, how a bad fall from the monkey bars could plunge a family without insurance or much income into financial crisis. "It showed me that unless you have access, you don't get the care you need." At Childrens Hospital since 1983 and the division's associate director for the last eight years, she has helped to bring medical and counseling services to the places where kids are.

Childrens Hospital now serves some 10,000 teens annually in a wide range of settings. The hospital operates clinics in three Los Angeles high schools and homeless shelters, along with services tailored to pregnant and parenting teens, gay and bisexual youth, teens who have experienced abuse and neglect, and those dealing with substance abuse and HIV.

Soft-spoken and quick to laugh, it's easy to see how Rabinovitz builds trust with teens. Her experience parenting an adolescent behind her--she has a 26-year-old son--Rabinovitz now shares her Silver Lake home with her physician husband. She lists hiking, reading and going to the theater among her hobbies.

Rabinovitz was interviewed in her office near downtown.


Question: Is it harder to be a teenager today?

Answer: About 80% of adolescents navigate their adolescence pretty easily. . . . One of the jobs of an adolescent is to develop a sense of identity and separate from their parents and . . . that's why kids get involved in risk-taking behavior. What's of concern nowadays is that risk-taking behavior can be so much more extreme--HIV, substance use and violence.

Q: Recent school shootings, including at Santana High School near San Diego, may have resulted from bullying. Kids have always been mean toward one another, starting at an early age. Is there something different happening now that kids pick up a gun when they feel they've been bullied?

A: One of the things that's different [is] the availability of guns and [the fact that] guns are used in ways they weren't used in the past. With bullying, with fights in the past, kids would use their fists. . . . But the use of weapons in interpersonal violence is a newer phenomenon and has increased.

Q: Why the resort to guns?

A: We have helped to make those guns available to young people and have created a society in which weapons are used against one another. It's really not the fault of young people who [turn to guns.] It's the failure of our society to keep [guns] out of the hands of children who shouldn't be using [them].

Q: Is it just guns or are there more pressures on kids that are causing them to explode?

A: Adolescence is very different than it was 100 years ago. The whole idea of adolescence is very new. A hundred years ago . . . teenage childbearing used to be normative behavior because people's life expectancy was so much shorter. . . . You got married early. You had children early. You had many children. . . . Now we have a whole prolonged adolescent period, where the age of menarche is even younger, 10 years old, when it was 12 1/2, 13 in the past. . . . We also have a very complex society in which it's hard to be successful. There's lots of uncertainty about the future. A sense of how are they going to make a contribution. It's particularly true for young people of color and young people who are impoverished and disenfranchised. We have 30% of children in L.A. in poverty. That's tied to all kinds of other serious negative outcomes. . . . Young people talk a lot about wanting to be heard and acknowledged, [yet] a part of our culture really demonizes young people. That's one of the concerns about school shootings and that kind of school violence.

Q: We hear a lot about teen rage these days. How should we respond to that?

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