Raising Teens with Cystic Fibrosis: Making Good Life Choices
by Foster W. Cline, MD and Lisa C. Greene
There is a common myth that teens rebel and are hard to parent. The fact is: teens and parents can be great friends. Love and respect grow when teens start thinking like adults. Of course, this does not make the nightly news! The press does not cover healthy, happy stories the way it covers problems. Many think it is the norm for teens to rebel and cause strife and pain. It does not have to be that way!
That said, the journey can be hard. In this article, we discuss how to respond to your teen during those rare (we hope) rough times. The way parents respond to their teens can have a big impact on how well things go both during the conflict and later.
The Main Reasons for Teen/Parent Conflict
1) Parents and teens may not spend enough time together having fun. Even though teens might not seem like they want to spend time with the family, experts stress finding activities the whole family can enjoy. Having fun outdoors is especially good for bonding. Try things like hiking, rafting, camping, biking, and other sports. Gardening, hanging out at the beach, swimming, and exploring new places are other less "rugged" ideas. Of course learning how to play your teen's favorite video game is a good idea, too! When people spend time with each other, love and friendship grow.
2) Research shows the teenage body is perfectly made for hard work and extreme sports. However, parents often view this as the path to certain death! Research also shows that teens are still learning cause and effect thinking so may not always have good judgment. Thus, what some say is a danger to teen bodies, teens often view as quite safe!
3) Teens search for their identity. They have new energy, sexual urges, and priorities. These may not match their parent’s values, customs, and beliefs. At this stage, teens may question and reject family ideas, practices, and values.
4) Teens want more space and privacy. This can lead to secrets and sneaking, which causes tension. Teens may feel that what they are doing is just fine. But they may also feel that if their parents knew what they were up to, they would freak out, be disappointed, or not understand. Teens may hide things because they love their parents and do not want to hurt them or because they do not want to cause conflict or be punished.
Conflict can Increase with Health Issues
In any home, the four issues above can stress the way parents and teens relate. It can be even tougher when teens have a serious or chronic illness. These teens are more likely to make poor, harmful choices including skipping medications. Parents are even more apt to freak out, be disappointed, or not understand!
As a result, parents may “crack down” and set firmer limits. This pushes teens to rebel even more. They may rebel by making poor choices about their illness. Teens angry with parents who love them may think they can get back at their parents and upset them by not taking their medicines. This becomes a vicious cycle: Teens make poor health choices. Parents get concerned and try to control by setting stronger limits. Teens rebel still more.
We must note, at this point, that most ill teens adhere to medical routines like adults do. Adherence is often poor no matter what the age! Research shows that people adhere to only about 50% of their medical routines. What may look to some as a teen being a rebel may really be a teen being a human!
Health issues can cause teens to rebel and battle for control. How should parents respond to a teen’s poor, harmful choices?
How NOT to Respond to Your Teen’s Poor Choices
When kids behave in a harmful way, parents may respond by getting…
…mad at…
…frustrated with…
…hurt because…
…worried about…
…fearful that…
…sad for…
It is normal for parents to feel these six things, but showing the first four will often make things worse. The last two may not help but may, at least, not increase the chance of rebellion.
Making Poor Choices Easy
Parents often finance their teens’ poor choices. When over-protective parents do too much for their kids, they raise kids who “can’t stand on their own” and “bite the hand that feeds them.” This is called hostile-dependency. This common situation is detailed in the book "Parenting Children with Health Issues" by Cline and Greene on pages 203-208. We also wrote about it on our www.pcwhi.com website under Articles.
How TO Respond to Your Teen’s Poor Choices – What Often Works
When teens make poor choices, parents often seek professional help. Ask yourself, “How would a therapist respond?” Therapists will not show the first four emotions. Therapists will not say, “I feel so hurt when I have a client like you,” “I am so mad at you,” “A client like you frustrates me so much,” or “I am so worried about you that I can’t sleep at night.”
Therapists may show sorrow, empathy, or concern for their clients, but will not be wringing their hands. Most often, therapists work to tone down the emotions. They listen, are curious, explore options, use problem-solving skills, wonder about the results of choices, and help clients respond in helpful (rather than unhelpful) ways.
Consultant Parents
Love and Logic® is a parenting program taught throughout the United States in schools and communities. It teaches parents how to be Consultants rather than Helicopters or Drill-Sergeants. We discuss this idea fully in the Living with CF pamphlet on the Elementary School Years as well as on our website at www.PCWHI.com. Briefly, Consultant Parents…
• share ideas and give advice but let kids make decisions and affordable mistakes.
• set an example by taking good care of themselves.
• offer choices and options, not orders.
• set firm limits, not demands.
• use meaningful actions with empathy when things go wrong.
Consultant Parents send this message: “You are in charge of the quality of your life. You can do this. I believe in you!”
One of the main tools a Consultant Parent has is to be curious and show interest by asking loving questions. Questions imply choices and offer teens healthy options and control. To listen and ask questions improves almost all relationships. When relationships work well, life works well! If your teen is making poor choices, ask questions like…
• What are your choices here?
• What ideas/thoughts/feelings do you have about …?
• How does this fit with your plans for your life?
• If you keep doing this, how worried are you about your future?
• What do you think is the best option?
• What is your plan for…?
• What can I do that will help you to…?
• How could you make the situation better?
• How can I help you with…?
When asking questions, do not put your child on the witness stand. The idea is to be gently curious and move your teen into thinking and problem solving.
Consequences
When teens continue to make poor choices even after problem-solving, parents may need to impose consequences. Consequences should:
• Be carried out calmly, in a matter-of-fact manner with empathy.
• Make sense and be related to the “crime.”
• Mimic what might happen in the real world as much as possible.
• Not be carried out with the intent to make the child feel bad or guilty.
When teens continue to make bad choices, counseling is advised. A counselor can help improve communication, focus on problem solving, enhance relationships, and end the cycle of teen rebellion. Counseling can stop concerned, loving parents from imposing punishments that do not work.
Parents as Models
Kids learn far more from the examples set than from the words and lectures parents give. Parents can be good role models by taking good care of themselves. Eating right, exercising, getting enough rest, and taking medications properly are all a part of setting a good example.
Caring for your own physical and mental health also means being sure you are not making it easy for your kids to make poor choices. There is such a thing as parents spending too much time, energy, and resources to “save” their kids from the results of their own poor choices. This is often seen with drug addiction. It can be applied to teens with CF making poor choices with no desire to change. When all else fails, parents must give this message:
• It is not healthy for me to watch you make choices that may kill you.
• I feel used when I see my money wasted.
• If you feel you must…(name the harmful behavior), you will have to do it elsewhere.
A Contract With Your Child
At some point, parents may have to require contracts and/or send their child to a safe place away from home. Good contracts include clear, and fair, expectations. Most starting by giving teens a choice:
If you expect to live here…
…you can expect these things from us…
…we can expect these things from you…
…you agree to these consequences if you break this contract…
In Summary
A child’s poor choices are perhaps a parent’s toughest problem.
Wise parents grow a relationship with their teen based on love and respect for each other. Both parents and teens give time and energy, respect privacy, show concern, and respect choices of friends and clothes.
Wise parents attempt to avoid direct confrontation about their teen’s self-destructive behavior. Instead, they show interest, ask careful questions, and wonder about their future while not allowing their teen to control the parent’s emotional environment.
Many parents find counseling helpful.
If questions, choices, and problem solving do not work, study the art of consequences and use it with your teen.
Using consequences may involve a clear, thoughtful behavior contract, which outlines the results of breaking the contract.
Parents must always model taking good care of themselves. They must not help their child make poor choices.
This is the outline of what a Consultant Parent looks like. These are the basics of a happy, healthy, loving, life-long relationship with your teen.
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Foster W. Cline, MD, is a well-known child psychiatrist and co-founder of Love and Logic®. Lisa Greene is the mother of two children with cystic fibrosis and a parenting educator. They have written the award-winning book “Parenting Children with Health Issues.” For free audio, video, articles, and other resources, visit www.PCWHI.com. Also visit www.TipsForCFParents.com.
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