Developmental Perspective

Adolescence (13–18 years)

Adolescents undergo an amazing transformation. Most obvious is the change in a teenager’s body, but the invisible changes are just as significant. It is a time of important identity development and aspiring independence. A teen often has an easier time rejecting parental values or criticizing the behaviors or ideas of adolescents in other cliques, than knowing exactly who he is or what he believes in. During this time, the norms of dress, behavior, and activities of the teen’s peer group become the key yardstick, and parental viewpoints are frequently seen as out of date. Teens might, if permitted, spend all their time with friends and no time with family. Moodiness is common. Sexuality is in the air, and intimate relationships are being explored.

Beneath the surface

When parents discuss their illness or treatment with their teenagers, it is common for the teens to seem to understand it as well as any adult. However, the ability to discuss a parent’s medical situation rarely translates into a teenager demonstrating consistent, appropriate behavior in light of the demands that the illness places on the family. That disconnect between understanding something in what seems like a mature fashion and behaving without the same maturity is a normal part of adolescent development. This can be one of the greatest challenges of parenting a teenager while living with an illness. Sometimes the “perfect” teen who has put her life on hold to support the parent is the child who one needs to worry about the most.

Communication challenges

With or without an ill parent, this is a phase of development that leaves many parents worrying. The same child who may have been open to discussing anything with a parent when younger may now prefer privacy and declare important discussion topics off limits. Honest dialogues, especially about the topics that worry parents most and carry serious risk to a teen’s well-being and future—such as drugs, alcohol, sexual activity, driving or riding in a car, and depression or anxiety—may be hard conversations to engage in. Some teens may not want to abide by the safety rules that parents impose and others may not want to share information that might worry an already stressed parent.

Parenting tips

Be mindful of the settings and situations in which good conversations most often happen. Try to make your availability in these settings a priority. Sometimes the best talks happen in the car on the way home from the mall, school event, or practice. Even though these pickups would be easy to delegate, if you can sometimes be the chauffeur you may facilitate these precious openings for a meaningful conversation.
Listen more than you talk. Teen culture is always changing. Convey to your child that you want to hear how things are for her and that you want to learn about her experience and perspective.
Don’t be afraid to enforce unpopular rules to help your teen stay safe. When an adolescent believes your rules come from loving concern rather than disregard for their happiness, that love is felt in spite of the irritation that you are too protective. Let your child know you will compare your rules with other parents you respect to see if indeed your rules are out of synch with others’.
It is normal for teens to have important relationships with adults other than their parents. Keep those quality adults in the loop with information about your illness and changes that may affect your teen. These are often adults with whom your teenager will discuss their worries and the situations that make them uncomfortable. When that person is someone you feel is a good role model, you and your child both benefit.
Find a balance between including your teen in family time and supporting their independent relationships and activities outside of your home. Some families will designate two or three evenings a week as family dinner nights, when a teenager is expected to be included in family time unless there are special events or circumstances. It is important for a teen to have solid relationships with both peers and parents.
If a teen is engaging in risky behavior or shows signs of depression or serious anxiety, seek professional assessment. Start with your pediatrician or a counselor at school to assist you in finding appropriate professional supports in your community.