Case Study

Promoting Protective Factors and Resilience in Children and Adolescents

“It is never too late to build resilience.”
Center on the Developing Child, Harvard University (2018)

Adam’s brother left home last year, putting the 12-year-old “in charge” of two younger siblings every weekend while their mother pulls double shifts at work. Their father is in the military and stationed overseas.

Adam confides during the private segment of his Texas Health Steps preventive medical checkup that he’s tired of preparing meals, cleaning up, and keeping “the little kids” occupied. He feels ignored and underappreciated by his mother and resents not having a smartphone like his friends. His attitude about school, friends, and family is suffering. “I’m stuck at home while everyone else is having fun. What’s the point?”

Resilience can help Adam navigate this stressful situation and prepare him for the future.

“Life will certainly provide the ‘opportunities’ to walk through stressful circumstances, but parents and other support systems – including pediatricians – must ensure that the child has the protective factors in place to prevent long-term negative outcomes. These protective factors include parental resilience, social connections, concrete/tangible help in times of need, parent knowledge of child development, and social and emotional competence of the child”
American Academy of Pediatrics (2018).

Patient: Adam
Sex: Male
Age: 12 years

Click below to explore four best practices that promote resilience.

Educate the family.

Resilient children have a stable and supportive relationship with at least one parent or caregiver. These relationships provide personal attention and guidance about emotional regulation, which is key to learning how to adapt to adversity and stress. Emphasize to Adam’s mother the importance of paying attention to her son and finding ways to talk regularly about how things are going and planning ahead. Encourage the family to set up a regular time for Adam to communicate with his father via phone, email, or old-fashioned letter writing.

Emphasize self-efficacy and perceived control.

Adam’s child-care responsibilities are overwhelming, leaving him—a child himself—without a sense of control or accomplishment. Adam is making a lasting contribution to his family, and it is important that his work be recognized. You are in a position to support both Adam and his mother, who may feel guilty that her job requires long hours away from home. With empathy and understanding, discuss ways that Adam and his mother can improve their situation by defining and streamlining Adam’s family duties. Be sure to cover what Adam should do in emergencies and how to allow him more time for schoolwork and friendships. Explain how supportive social connections are vital to Adam’s ability to build resiliency.

Offer support and expertise.

As Adam’s primary care provider, you are a caring adult in his life. Reassure him and his mother that you can provide support and resources as they work to build resiliency for Adam. Promote the importance of praising Adam’s strengths. Suggest that Adam’s mother explore with her son’s teacher possibilities for Adam to be part of a team project or connect with a community youth group that can help Adam develop his interests and talents.

Consider case management or care coordination.

Case managers, also known as care coordinators, may be available to help families access community resources and empower them to be active participants in their own health care. Case management providers also serve as patient advocates by communicating with community agencies, schools, or other entities on the patient’s behalf.

Why It Matters

Resilience, the ability to overcome hardship, helps children and adolescents reach their full potential and lead healthy and productive lives. You can help youths and their families build resilience by talking about what to do, working together to solve problems, emphasizing a family’s strengths, and reminding them to stay hopeful in difficult times. Learn more by enrolling in the related courses listed below.

About Texas Health Steps

Texas Health Steps’ award-winning online program offers FREE CE courses for primary care providers and other health professionals. These courses offer updated clinical, regulatory, and best practice guidelines for a range of preventive health, oral health, mental health, and case management topics.