Adherence in adolescence

Abstract

An understanding of adolescence and adolescent development is critical for clinicians who wish to be able to help their patients with adherence and illness control. Many teens seem perfectly capable of managing a chronic illness, yet to the surprise of many clinicians, adherence is often at its worst in adolescence, as is chronic illness control. In this chapter we explore the reasons why adherence in adolescence is so challenging and frustrating for patients, parents, and providers alike. We argue that some degree of nonadherence is actually likely to be normative due to the developmental, neurodevelopmental, and cognitive changes of this period, which are almost antithetical to maintaining consistent adherence behaviors. Continued parent involvement will therefore turn out to be a key component of successful illness management in the teenage years. Of course, this involvement is not without its own challenges and costs. We conclude that encouraging a focus on supporting patient autonomy (i.e., volitional behavior) without pushing youth independence (i.e., acting alone) can foster youth development without necessitating a withdrawal of needed parental assistance with illness management.