Assessing and Enhancing Psychosocial Functioning

Social development occurs through ongoing interactions with family and peer groups and is influenced by larger systems such as community and culture. Positive social experiences are essential to health and wellbeing. The primary care provider’s office is an important social environment for an adolescent with special healthcare needs because physicians serve as both social agents and medical providers. Attaining the age of majority accelerates the transition to adult healthcare and occurs when social interactions are of paramount importance and are among the patients’ most salient preoccupations. The adult primary care provider (PCP) has a window into the social world of these patients. In light of evidence suggesting that young people with chronic conditions are at risk of problems with social competence and performance related to their illness, the PCP has an opportunity to detect and address problems in social functioning. Through strategic communication and appropriate use of external resources, the PCP can promote healthy social engagement and positive social behaviors. The following chapter will (1) review the most relevant aspects of social development during the young adult period; (2) discuss ways to identify barriers to optimal social functioning; and (3) provide assessment strategies for the PCP to facilitate this aspect of patient care.