Written by: Ilene M. Vinikoor, DCSW, LMFT
After reading a recent and ongoing “conversation” on our PEP Squad Facebook page about non-compliant teens, I felt it was important to respond with some ideas.
As a type 1 diabetic since 1968, and an individual, couples and family therapist, practicing for 37 years, I fully understand the emotional aspects of T1D. Coping with the fears, frustrations and everyday concerns of living with T1D can be overwhelming. For parents of children who have diabetes, a sense of helplessness is sometimes unavoidable.
The big question is: How can I encourage my child to be a responsible person—not only about diabetes, but in every way?
As you know, rebelliousness is most common during your child’s adolescent years—it’s part of the growing-up process. Your teenager’s irresponsible behavior must be addressed and have consequences. Consequences are necessary in order to teach your teen the lesson that any wrong-doing will not be overlooked. If s/he skipped school, didn’t do homework, lied, broke curfew or any other irresponsible behavior, you would give a consequence. Not testing and not taking insulin—and other non-compliant behaviors—must have consequences. It is irresponsible behavior, with the added concern that it can be life-threatening or lead to serious complications.
When I am treating families living with a T1D teenager, I often help them to write a contract. The contract lists the rules the family requires.
1. I will test at least four times a day.
2. I will bolus prior to each meal and count carbs.
3. I will spend no more than one hour a day on my computer playing games.
4. I will report my whereabouts at all times.
5. I will respect my curfew.
6. I will complete my homework assignments by 9:00 PM.
If you decide to not comply with the above rules, the consequence will be one of the following:
1. You will be grounded for one week, or
2. You will not be permitted to drive, or
3. You will not have use of your computer to play games for one week.
It may also be helpful to add rewards for responsible, compliant behavior. For example: you may extend existing privileges, curfew times or allow more time for computer games. Behavior modification theory means providing rewards for acceptable behavior and consequences to extinguish unacceptable behaviors.
Each parent and the teen, after discussing the contract and feeling it is understood, will sign it.
I wish there was a magic formula to have our teens living with T1D to be compliant and responsible. However, if the irresponsible behavior is not managed after you feel you have done everything in your power to extinguish it, please consider seeking professional help from a family therapist.
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