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Dear Christine,

My daughter has a chronic health problem that we’ve been dealing with since she was almost three years old. Until very recently, I managed everything about her illness for her: appointments, medications, decision making around treatment, etc. She’s always been interested in learning more about her disease, and she’s been a compliant patient.

But now that she is a teenager, she needs to be more in charge of herself, and more involved in making decisions about her treatments. In some ways, she’s doing this well; for example, she gives herself a weekly injection. 

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I’m frustrated, though, because it seems like I can’t give her important information about her illness without eye-rolling and resistance. She needs more information than she currently has to make good decisions for herself. Right now, she wants to take herself off of a medication that makes her nauseous, and her doctor and I are worried that this is going to lead to more severe long-term health problems.

How can I influence my teenager? What used to work doesn’t seem to work anymore.

Loving Mom Trying to Let Go

Dear Trying to Let Go,

I feel your pain. I find it really frustrating that I can’t just give my teenagers lots of (important!) information and expect that new information to translate to positive behavior. Even kids who don’t have a chronic disease don’t usually know what they don’t know about lots of things that will affect their health over the long run. It’d be much easier if we could just download information to them—say about sex and drugs, or about their health and wellness—and know that they were going to use that information well.

But, alas, as you and I know from experience, giving teenagers a lot of information doesn’t seem to be the key to influencing them. In fact, we know from some interesting research on this topic that what is somewhat effective for elementary school children—giving them information about their health that they can act on—tends to be mostly ineffective for teenagers.

This is because adolescents are much more sensitive to whether or not they are being treated with respect. The hormonal changes that come with puberty conspire with adolescent social dynamics to make teenagers much more attuned to social status. More specifically, they become super touchy about whether or not they are being treated as though they are high status.

In the teenage brain, the part of your daughter that is an autonomous young adult is high status. The part of her that is still a kid who needs your support is low status. Our teenagers might be half–independent young adult, half–little kid—but they are hugely motivated to become 100 percent autonomous. (Even if they do know, on some level, that they still need our support and guidance.)

So, when we give our adolescents a lot of information about an (important!) topic, especially when it is information that they don’t really want or that they think they already have, it can feel infantilizing to them. Even if we deliver the information as we would to another adult, the mere fact of our instruction can feel disrespectful to teenagers.

What is a smart parent (with loads of important information!) like yourself to do? I’ve gleaned three ideas from a related study by some of the smartest thinkers about teenagers: Ron Dahl, Carol Dweck, and David Yaeger.

1. Accord them high status from the get-go. Bring up the topic as you would to someone with the highest possible social status, someone you really, really respect. (I have to literally imagine that person in my head, and then imagine both the tone and the words I would use with that person.) Remember, if they feel disrespected, nagged, spoken down to, pressed upon, or infantilized at all, all bets are off.

The goal: Give them enough information that they can make their own informed decision, hopefully one that benefits their health and well-being in the long term, but do it in a way that allows them to feel respected and high status in the short term. They’ll need to feel competent, so it can help to point out all the ways that you see them as already very competent in this arena. What do you admire about them?

One way to convey your respect is to really listen well. Let this be a two-way conversation, not a lecture. Show your daughter that you are listening to her by reflecting back to her what she is saying (not what you wish she were saying).

Another way to convey respect is to demonstrate her value to a group of other teenagers. Are there other kids with the same chronic health issue that your daughter could help? Could you have her write a letter to someone else struggling with the same decision, outlining her situation and all that she knows about the decision she needs to make? This would help her engage in what researchers call “self-persuasion,” and it would make palpable the wisdom that she has to share and the way that she can help others.

2. Keep it short. You may have a mountain of information to impart, but research shows that less is more. Do not do what I often find myself doing in these situations: repeating myself. This can sound like nagging, and research shows that parental nagging activates anger-related regions in teenager’s brains, and it reduces activity in regions related to planning and behavior change.

I definitely talk too much. I learned this the hard way. I was trying to make an important point to one of my kids, and she didn’t seem to be getting it. I plowed on, with more examples. “Are you hearing me?” I finally asked. She looked up, eyes glazed over. “Yes,” she said. “I hear your words. So. Many. Words.”

So, use as few words as possible to make your point, and then shut up and watch for a response. Awkward silences are okay; often teens will want to fill the silence and in so doing will actually contribute to the conversation.

3. Let them be in control of both the conversation and the actions they take following the conversation. Do not, under pain of death, tell teenagers what to do. When it comes to conversations about their own health, invite them to discover what the information means for their lives.

So instead of sitting your daughter down for a Big Talk using a tone that suggests you are going to decide the course of her treatment, wade in sloooowly. Raise the issue you’d like to discuss from a couple of very different angles. For example: “Do you want to talk about what it is like when you feel nauseous at school?” or “Do you want to talk about what the risks and benefits are of going off of your medication?” Ron Dahl recommends that we always also throw in a super-open-ended question like, “Or maybe there is something else you would rather discuss? What do you think?”

If they say they don’t want to talk, let it go temporarily. Force never works, but persistence does.

As parents I think we often forget that teenagers are motivated by totally different things than we are. We want them to do the things that are best for their health and well-being; they want to do the things that bestow on them the highest social status. But we are most influential when we are able to take advantage of teens’ existing motivations, rather than trying to get them to feel motivated by our goals.

Fortunately, our motivations tend to turn out to be aligned already: Our adolescents want to feel like competent, well-respected, autonomous adults. And, in the end, we want our children to be competent, autonomous adults who make choices we respect and admire. Decisions like the one your daughter has ahead of her are a bridge between how she wants to feel and the young woman she is becoming. Though she may not see it right now, she is so lucky to have you walking across that bridge beside—or perhaps a touch behind—her.


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