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Teens and Coping with Chronic Illness

Teens and Coping with Chronic Illness

Programs related to this topic

	Children's Hospital Neighborhood Partnerships		Integrative Therapies Team
	Outpatient Psychiatry Service		Medical Acupuncture Service
	Medical Coping Team		Pediatric Psychiatry Inpatient Consultation Service
	Richmond Psychiatry Inpatient Service		Group Therapy Team
	Office of Clinician Support		Adolescent/Young Adult Medical Practice
	Psychopharmacology Program		Psychosocial Treatment Program
	Emergency Psychiatry Program		Social Work Training Program

Adolescence, alone, is a stressful developmental process even for physically healthy teens. Chronic illness during adolescence further complicates life for teenagers.

The chronic disorder, treatments, hospitalizations, and surgery (when necessary) all intensify concerns about physical appearance, interfere with the process of gaining independence, and disrupt evolving relationships with parents and friends. Also, adolescent developmental issues can complicate a teen's transition toward taking responsibility for managing their illness and learning to comply with recommended treatment.

Developmental complications of chronic illness

Adolescents who are faced with acute or chronic illness are more likely to experience increased concerns and fears when their illness or healthcare needs conflict with the following normal developmental issues:

Body image issues - Adolescents normally are focused on the physical changes occurring in their bodies. Chronic illness intensifies these concerns with fears or distortions related to their illness (such as fearing a surgical scar will interfere with physical attractiveness or the ability to wear certain clothes).

Encourage adolescents to share their concerns related to their body and how it may be affected by their illness or treatment.

Inform adolescents about anticipated physical effects of medications and treatment. Encourage discussion about ways to reduce or cope with the effects.

Developing independence - Chronic illness frequently interferes with an adolescent becoming less dependent on his or her parents. Parents of chronically ill adolescents often are more resistant to their child's efforts to act independently. Some ways to address this conflict, while still addressing healthcare needs of the chronic illness, include the following:

Involve adolescents in health-related discussions (such as concerns about their illness or treatment choices).

Teach adolescents self-care skills related to their illness.

Encourage adolescents to monitor and manage their own treatment needs as much as possible.

Encourage the development of coping skills to address problems or concerns that might arise related to their illness.

Relationships with peers - Chronic illness and treatment often interfere with time spent with peers or at school, which is a teenager's primary social environment. Self-esteem issues related to acceptance of one's self and concerns about acceptance by others are intensified by chronic illness and related treatment needs. To address these concerns:

Encourage spending time with friends as much as possible.

Discuss concerns about what and what not to share with friends.

Help find ways to respond if teased by peers.

Encourage humor.

Encourage and assist friends in being supportive.

Non-compliance with medical treatment and teens:

As adolescents with chronic illness learn more about their illness and are encouraged to take responsibility for its management, attempts to make their own decisions about management are common. Trials of decreasing their medication or not taking it without consulting a physician often occur.

For example, adolescent diabetics are more likely to use poor judgment in making food choices when they are with their friends. It is important for parents and healthcare professionals to help the adolescent develop emotionally healthy ways of living with their chronic illness and its management requirements.

Some ways to help adolescents deal with the complications chronic illness often imposes on development may include the following:

Encourage adolescents to share their ideas and concerns with healthcare professionals.
When an adolescent's chronic illness reaches an unstable state due to non-compliance of treatment recommendations, encourage discussion of what happened rather than reprimand non-compliance.
Teach and encourage use of problem-solving skills related to their illness. Ask questions and encourage them to do so too.
Seek mental health services when:

an adolescent seems overwhelmed with emotional issues related to living with a chronic illness.

a pattern of non-compliance continues.

an adolescent's development regresses, overly dependent behavior continues, and/or the adolescent withdraws from or gives up interest in age-appropriate activities.

Teens and transplant-related issues

The need for an organ transplant can be difficult to understand, accept and cope with for anyone. The emotional and psychological stress impacts all family members. For adolescents who are developing the ability to think in new ways and explore new thoughts, the idea of facing transplantation stimulates thoughts, concerns and questions about their bodies, their relationships, and their lives.

Important factors in helping adolescents cope effectively with a transplantation experience include:

Be honest with your teen about his/her illness and his/her healthcare needs.
Include your adolescent in discussions and decision-making related to the need for transplantation, the benefits, and the risks involved. This is very important to helping him/her cope with the process and life after transplant.
Supportive communication is vital. Encourage your adolescent to ask questions and express his/her fears and feelings about how this affects his/her life.
Concerns about death and the possibility of dying are difficult to talk about. However, it is important to address this topic with adolescents in any life-threatening situation.
Encourage hopefulness.
Encourage humor, as it helps to reduce stress.
Encourage friends to visit your teen in the hospital, when possible.
Enlist the help of mental health professionals in addressing fears, feelings, and behaviors that are problematic for your teenager or for other family members.


					Children's Hospital Boston is the primary pediatric teaching hospital of Harvard Medical School

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