How can the general practitioner support adolescent children of ill or substance-abusing parents? A qualitative study among adolescents

OBJECTIVES: To explore significant experiences of adolescents as next of kin that the general practitioner (GP) should identify and recognize. DESIGN: Qualitative study with focus-group interviews. SUBJECTS AND SETTING: Three focus-group interviews were conducted with a total of 15 Norwegian adolescents each with an ill or substance-abusing parent. The participants were recruited from existing support groups. RESULTS: The adolescents’ days were dominated by unpredictability in their family situation and their own exhausting efforts to keep up an ordinary youth life. Mostly, they consulted GPs for somatic complaints. In encounters with the GP, they wanted to be met both as a unique person and as a member of a family with burdens. Their expectations from the GP were partly negatively formed by their experiences. Some had experienced that both their own and their parent’s health problems were not addressed properly. Others reported that the GP did not act when he or she should have been concerned about their adverse life situation. The GP may contribute to better long-term psychosocial outcomes by ensuring that the adolescents receive information about the parent’s illness and have someone to talk to about their feelings and experiences. In addition, the GP may help by supporting their participation in relieving activities. CONCLUSION: KEY POINTS: Little is known about how a general practitioner can support adolescents with ill or substance-abusing parents. Adolescents experience unpredictability in life and strive to find balance between their own needs and the restrictions caused by parental illness. In encounters with adolescents having ill parents, the GP should take the initiative to talk about their family situation. The GP may help them by recognizing their experiences and struggles, give information, offer talks and support coping strategies.