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 normal developmental issues.

Body Image Issues

Adolescents are normally 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's comfort in becoming less dependent on parents. Parents of chronically ill adolescents often are more resistant to an adolescent's efforts to act independently. Some ways to address the conflict between normal development of independence, while still addressing healthcare needs of the chronic illness include the following:

• Involve adolescents in health-related discussions (i.e., current concerns about their illness, 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 interferes with time spent with peers or in the school setting, which is the adolescent'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, consider the following:

• Encourage spending time with friends as much as possible
• Discuss concerns about what to share with friends
• Help adolescents find ways to respond if teased by peers
• Encourage humor
• Encourage and assist friends in being supportive

When teens have a long-term illness, they start to learn more about it and want to manage it themselves. This often leads them to try making their own choices about their treatment.

Why Teens Change Their Treatment

It's common for them to try taking less medicine or even stopping it without talking to a doctor. While this is a normal part of growing up, it can sometimes cause health problems and require more doctor visits.

They might also feel angry or embarrassed about their illness. These strong feelings, or just poor judgment, can make it hard for them to follow their treatment plan. For example, a teen with diabetes might make bad food choices when they're with friends.

It's important for parents and doctors to help teens learn how to deal with their feelings in a healthy way. This helps them manage their illness better and live a healthier, happier life. Some ways to help adolescents deal with the complications which chronic illness often imposes on development may include the following:

• Encourage adolescents to share their ideas and concerns with health care professionals.
• When an adolescent's chronic illness reaches an unstable state due to non-compliance with 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 such as: "What do you think you would you do if ?" or "What do you think would happen if ?" Encourage adolescents to ask you the same kinds of questions.

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 the adolescent withdraws from or gives up interest in age-appropriate activities.

The need for an organ transplant is 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 the following:

• Be honest with your teen about the illness and health care 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 to cope with the process and life after transplant.
• Supportive communication is vital. Encourage your adolescent to ask questions and express fears and feelings about how this affects their life.
• Concerns about death and the possibility of dying are difficult to talk about. However, they are usually important to be addressed with adolescents in any life-threatening situation.
• Encourage hopefulness.
• 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 adolescent or for other family members.