Understanding doesn't make teens more responsible. Making them accountable for their behavior does. Most parents believe that if their teen understands the consequences of not taking care of his diabetes, he will act more responsibly.
But that's not true, says Joe Solowiejczyk, a family therapist and diabetes nurse who's been helping parents for more than twenty years develop in their children greater responsibility for managing their diabetes. "Don't get me wrong," says Solowiejczyk, "Kids are smart, very smart. But simply instilling understanding is not the way to get them to change poor behavior."
Treating your teen's irresponsible approach to diabetes management in the same way as any other irresponsible behavior and applying the same consequences, such as withholding videogames or other privileges, makes your teen more responsible managing his or her diabetes.
Parents want to do everything possible to protect their child or make allowances, says Solowiejczyk. Their child has already been punished enough just by having diabetes. "But parents in my workshop always nod their heads when I say, ‘If you're a worried parent now, you won't be able to stand it when your teen heads off to college and you don't trust that he can take care of himself. It's your job to apply consequences now to save your child from consequences later."
Clinicians agree that classes, support groups, and summer camps may help teenagers feel good about themselves. However, their attempts to use "understanding the consequences of poor diabetes care" as a motivational tactic rarely produce change in behavior. Last year at the American Association of Diabetes Educators conference, I sat in on a presentation about adolescent development and diabetes self-care.
I learned that adolescents are only beginning to master sophisticated thinking, such as seeing the links among their decisions, their actions, and the results. Indeed, it isn't until our early twenties that this type of cognitive thinking is fully developed.
Clinical psychologist Wendy Satin-Rapaport, who has worked with families for thirty years, says that "understanding" as a general theoretical concept doesn't motivate his behavior.
But parents understanding why their child makes certain choices (for instance, why your child doesn't correct a high blood sugar) can help you influence his behavior. If your child doesn't correct his blood sugar find out why: Is it because he fears he'll go too low?
This kind of understanding does change behavior. Satin-Rapaport also agrees on the use of consequences to improve teens' responsibility and recommends rewarding responsible behavior with privileges.
Positive reinforcement, such as letting your teen borrow the car, prompts desired behaviors and underscores how responsible behavior yields positive results. Like Solowiejczyk, who says he's the first to applaud teens when they're "doing the hard work," Satin - Rapaport says you can empower your teen when you point out what he is doing well.
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