Support systems are critical for young adults in fostering healthy post-transplant adjustment. Support people may include parents/caregivers, extended family, friends, school and church communities, and even pets! Different types of support can be helpful for adolescents and young adults, including emotional, logistical, social/peer support, vocational, and financial. People or resources within these domains of support can help in different ways. For example, a patient’s teacher might extend a deadline for the student after an unexpected hospital admission or a friend might lend their ear to talk about a patient’s feelings of isolation when they’re struggling with their transplant health. Patients may lean on these supports during transition to help navigate the changes they are experiencing in their healthcare environment, along with the many other stressors that arise in daily life.
Providers should think of patients as falling into tiers of risk for adverse psychosocial outcomes according to the Pediatric Psychosocial Preventative Health Model (Kazak, 2003), below. Within this model, all patients benefit from psychoeducation regarding support systems, mental health, and signs of distress and should be screened for concerns (Universal Tier). A smaller population of patients may exhibit risk factors for psychosocial concerns and may benefit from interventions and ongoing monitoring (Targeted Tier). The smallest population falls into the Clinical/Treatment tier, where patients have persistent distress and risk factors and require behavioral health treatment.
Kazak A, et al. Families and other systems in pediatric psychology. In: Roberts M, ed. Handbook of Pediatric Psychology, 3rd ed. New York, NY: Guilford Press; 2003:159-175.
Similarly, providers can use the visual below to think through and talk about various aspects of positive post-transplant outcomes in terms of physical and emotional health, and how each of these domains are important components. Support systems should exist within each of these domains as well. Again, normalizing conversations about these domains as part of transplant medical care is important.
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