Learning to manage treatment and therapies is important to adolescents and young adults (AYA) with childhood onset RMD and core to self-management training and transitional care. Adherence is often considered in the context of medication, but it is also relevant to self-management activities like blood test monitoring, hospital appointments, therapy exercises and healthy lifestyle advice. Adherence may also vary according to the task and is associated with better health outcomes, but it is a challenging area for the AYA, family and professional alike. This chapter will explore the terminology of adherence, the particular challenges facing young people with rheumatic disease, provide examples of how to assess adherence in the clinical situation and present useful strategies to try with AYA to help them optimise adherence.