Why Children With Chronic Conditions Must Learn to Be Independent Before Becoming Interdependent

Your child with a chronic condition may have a head start understanding the advantages and the necessity of mutual support. They likely grasp that the unwavering presence of their family has enabled them to remain healthy and to live as normal a life as possible. Critically, they understand that none of us get through life all on our own. 

These lessons last a lifetime and may mean that your family is strengthened precisely because the challenges you have navigated together will forge an enduring bond.  

Independence is a Developmental Milestone

Your teen may have a chronic condition, but they are a teen first. Their condition does not – and must not – define them. They need to meet the same developmental milestones as all other young people. For all adolescents, these years serve as a bridge between the dependent years of childhood and adulthood. Adulthood is where we should be prepared to navigate the world on our own.  

Independence is earned one step at a time. Your baby had to crawl before they could stand.  As a toddler, they had to balance on wobbly legs before they could securely walk. Remember: Their wobbly legs failed them at first, and they fell down before your encouragement gave them the confidence to get back up. The details change during adolescence, but the basic steps in the journey towards independence stay the same. Skills are gained one at a time. Every new skill is achieved after trial and error. Temporary failures set the stage for recovery and improvement. 

Although independence is a crucial milestone of adolescence, there is never actually a singular moment when a young person can declare they’ve achieved independence. There are so many things to learn! Based on their strengths and limitations, exposures and experiences, and the guidance they receive, people gain skills in different areas of their lives, each at its own pace. 

Parents should expect to (occasionally) be pushed away as their children gain independence. This is not rejection, even if it feels that way sometimes. Just as your 2-year-old said, “Me!” if you tried to put on their shirt for them, your adolescent needs to prove to themselves they can do (some, maybe most) things on their own. 

Independence is a Critical Step Towards Interdependence

Having the capacity to be independent doesn’t mean that we should choose to go it alone. Humans thrive best when they are mutually reliant on one another.  

Our goal is for our children to choose to be interdependent with others. We give them roots and wings so they stay a connected part of the family while going off to explore the world. What gives them the confidence to make that choice? Knowing that they could handle their lives on their own. In other words, the ability to be independent is an essential step in the journey towards healthy interdependence.

Make an Intentional Effort to Support Independence

Young people with chronic conditions have learned the vital lesson that sometimes relying on others is a necessity. But we cannot forget that they still must gain confidence in their ability to make wise decisions and navigate life’s complexities. In fact, precisely because their condition may require ongoing support from others, their drive for independence may be heightened. They must learn to stretch into new territory in every area unrelated to their health. They need to discover their likes and dislikes, strengths and challenges. That is partly how they chart their path in the world.  

Because their health condition may limit some choices, parents must be intentional about letting them earn growing independence and decision-making in all other areas of their lives. Let them make mistakes and grow. Encourage them to learn life’s lessons by stretching into new territories in school, with their peers, on the fields, in programs and activities that engage their interests, and in service to their community. 

Chronic conditions can present serious challenges to growing independence. However, learning to manage chronic conditions can also present a concrete opportunity to increase independence – a step at a time. Learning that something that feels overwhelming at first can be mastered with resolve and commitment is a vital lesson in building resilience. When we break big problems into small, manageable pieces, we can handle things we hadn’t imagined we could control. 

Managing a chronic condition requires the team of health clinicians, the family, and the young patient to arrive at the optimal treatment plan. Ultimately, your teen will need to manage their health condition on their own in partnership with a trusted health clinician. Preparing them to maintain their health is a vital developmental milestone your child must achieve. So, we should include our teens in discussions about their health. They must be increasingly involved in decision-making alongside their clinician. They should learn to describe their symptoms, experiences, and what works for them. This allows them to build their communication skills and reinforces that their voice is essential in crafting any health care plan. This will help them transform into becoming their own healthcare advocate and ultimately take ownership of their condition.

Your Role in This Journey

You want your child to have the skills to independently navigate the world while having a deep sense of security that allows them to choose to be interdependent with others. This allows them to thrive! How you support this journey may make a difference to your teen’s growing confidence and their desire to remain mutually reliant with you far into the future.  Here are some tips to achieve long-term healthy interdependence with your adult child. 

• Help your teen earn control over their life by building new skills, including decision-making skills involving their health condition.
• Maintain a watchful eye over your teen to ensure they remain safe as they stretch into new territories. When we protect our children this way, they learn that they deserve to be safe.
• Be a guide for your child. Young people reject overcontrolling or overprotective parents because they receive the message that their parents don’t think they can learn to manage their own lives. In the drive towards independence, they may push their parents further away. On the other hand, when we serve as a guide through active listening and being a sounding board while offering advice (when asked and needed!), young people cherish our presence. Now and far into the future.
• Be a person who seeks support from others. Demonstrate that your strength is built when choosing not to go it alone. You seek advice. You seek connection with others to enjoy life. You turn to others in your vulnerable moments.
• Model lifelong learning. Your teen may be in a rush for independence. In truth, however, they likely worry that they won’t learn it all in time. There is no precise time in which we are declared “independent.” We all learn. We continue to grow. We stumble and get back up. Be the kind of human who models a commitment to continued growth. 

Ensure Your Child’s Independence and Confidence

Doing all of this during the adolescent years ensures your child safely earns independence while still under your watchful eyes. Once your child senses an increased amount of control over their own condition, not only will they likely become physically healthier, they will become more emotionally secure. Their condition will feel like less of a burden. They will gain confidence in the management of their condition – and perhaps in other areas of their life. Their health condition will feel less like a limitation and more like something that has shaped them into a robust, resilient human who knows how to master their journey. Equipped with this confidence, they will more likely become people who choose to gain guidance from others and who know it is a privilege to lend their support to family, friends, and community. That is healthy interdependence.

Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number R01NR020005. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.