http://www.hivcareforyouth.org/adol?page=md-module&mod=03-02-05

Making Transitioning a Process

Developmental, Transitioning, and Adolescent Models of Care

Developmental Models
Pediatric ModelAdult Model
Family CenteredPatient Centered
Health MaintenanceDisease Management
Developmental FocusProgressive Decline Focus
Prescriptive (responsible for)Collaborative (responsible to)
Source: Patricia White
Transitioning Models
Disease SpecificGenericPrimary CareSingle Site
Patient transitions from a pediatric specialist to a pediatric/adult specialist to an adult providerPatient moves from pediatrics (birth-14) to an adolescent program (15-24) to an adult program (>24 years)The family general practitioner is the patient's care coordinator, and specialist(s) serves as consultantPatient moves from pediatric care to adolescent care to adult care within the same environment, where clinical services remain constant

As bridges between pediatric and adult models of care, adolescent programs strive to:

  • Shift health care responsibility from the parent and provider to the youth
  • Promote growth, self-expression, and personal decision-making
  • Provide planned, purposeful transition interventions
  • Move clients with chronic illnesses from child-centered to adult-centered health care systems

Adolescents are members of their families as well as their peer systems; they are also vital participants within the health care, community, and education systems. Negotiating these systems requires skills that may become impaired as a result of the effects of stress, illness, and other psychosocial factors factors such as parental lack of familiarity with the health care system due to recent migration or linguistic sensitivity from clinicians. Success or failure in transitioning to adult health care when youth approach age 21 or 24 hinges on mastering or failing to master central life skills. These life skills include the ability to access and negotiate medical and case management systems, develop a knowledge of self-care, and acquire the resources for pursuing additional education.