Motivating children and adolescents to improve adherence.

Pediatricians and their colleagues often have considerable difficulty in understanding and managing poor adherence. It is hard to comprehend why children with life-threatening illnesses do not adhere to their treatment regimens and even more difficult to comprehend why their parents do not provide optimal care. Yet, clinical experience indicates that in chronic illness such as cystic fibrosis (CF), epilepsy, asthma, or diabetes, poor adherence is the norm. The general response of clinicians and parents to poor adherence is to coerce. This tends to have the opposite effect to that intended. The focus of this paper is on motivational enhancement therapy in children and adolescents with chronic illness to improve adherence to treatment.