Adolescent Resilience Assessment in Person-centered Medical Care
Keywords:adolescence, child, resilience, primary care, assessment, mental health, adversity, indigenous health, self-control, optimism, physician's role
AbstractBackground. Acquiring resilience and psychological strength is central to adolescents' development and evolution from dependent child to autonomous adult, but is rarely addressed by physicians. Nevertheless, resilience, that is, positive adaptation to stress, predicts adult health and wellness. Objectives. We examined how to assess resilience in youth in a person-centered manner of merit to participants themselves. Our aim was to identify characteristics of resilience such as self-control and optimism, and foster these strengths at the same time. Method. Fifty-nine13-16 year-old adolescents from a small Canadian city, a remote town and one northern Ontario First Nations Reserve answered the 28-item Resilience Scale for Adolescents (READ) privately. Then they were asked semi-structured questions about their responses, family and social stresses, and strengths. Medical histories provided information about childhood adversities like poverty, abuse and family disruption. Results. We found READ scores to be statistically valid, comparable across gender, but lower among on-reserve indigenous youth. Results aligned loosely with subsequent interview information. However, the real merit of the resilience scale was as a door-opener to deeper, person-centered discussions. Only via interviews did we learn that youth had often adapted positively to the adversities identified in standard social/medical histories and named these as sources of strength and resilience rather than stress. Participants welcomed engaging as individuals rather than offspring of parents, and talked at length and with insight and enthusiasm. Conclusions. The positive response to and contextual understanding gained during interviews suggests that use of the READ followed by a qualitative discussion is a valuable and feasible clinical component of adolescent-centered medical care.
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