Personal agency and adolescent health

Dr Asha Pemberton

teenhealth.tt@gmail.com

Over the past week, while International Adolescent Health Week was celebrated, several forums were held to discuss ways in which, as a global community we can work together to support and enhance adolescent health care outcomes. Many negative teen experiences are derived from the consequences of poor decisions and unsupervised behaviours. It thus stands to reason that supporting healthy decision making in teens can mitigate these risks.

A critical aspect of healthy adolescent development involves the personal agency. The term 'agency' concerns an individual's ability to take responsibility for their own life. This includes the capacity to critically reflect on values, intentionally make choices, and act on her choices authentically. When a young person has personal agency they believe that they have the power to complete goals. They feel a sense of control over their environment and importantly understand that their actions have consequences, both positive and negative. Scientists consider teenage years to be a sensitive period in the formation of personal agency. It is the period of coming into being such personal characteristics as self-identity, volitional powers, a sense of maturity, and personal autonomy.

Young people who do not develop a sense of agency struggle with the need for control which can manifest in self-harming behaviours, manipulation, acting out or mental distress. In addition they are vulnerable to being influenced by people around them, making them more readily victimised. Perhaps the most concerning aspect of poor personal agency is the inability to connect action with outcome. When young people feel like they have no control or decision making ability, they tend to disconnect themselves from their actions and assume the role of the victim.

When supporting agency in teenagers there needs to be an appropriate balance between allowing them to have a voice in things that affect them and parental authority. This balance changes gradually as they mature and learn good values and decision-making skills. Nevertheless each young person is different, as is the trajectory of their growth. Some will require more latitude to make decisions as it can be supportive of a more fragile self-esteem while others require closer monitoring due to more defiant or irrational thinking. There is simply no one rule that fits all.

Emotional intelligence is closely linked to personal agency as it facilitates the understanding of feelings and the connection between thoughts and emotions. For parents, it is important to consistently and regularly check in with your teens and teach them to reflect. Use open ended questions and allow young people to answer themselves. Often in the haste and anxiety to get things done, parents step in and almost tell young people what they are thinking or feelings. Give them the space to understand what they are feeling, process it and then arrive at good next steps. In times of decision making, ask them to analyse their value systems and use them as a foundation for making decisions. Make time daily, to ask them about their day at school or activities. This seemingly simple step allows them to practice recall of situations, consider how they felt, reflect upon their role in ongoing peer or other dynamics and then arrive at the best next step confidently. Young people navigate social and emotional dramas literally on a daily basis. Without these steps of quiet analysis, opportunities toward emotional intelligence and personal agency are lost.

Finally, is important to recognise that our digitally connected generation have the ability to now create virtual worlds of their making, in which they can occupy any role that they choose. While the fantasy and entertainment aspect of gaming is easy to understand at the surface level, for some young people who have a more tenuous sense of personal agency, it is easier to slip deeply and lose a sense of reality. In these situations when they do not feel empowered to make decisions or have any control in their lives, they create worlds in which they are more powerful or assertive. As they age, this can be complicated and challenging and indeed more and more young people remain so embedded in fantasy gaming, they are less interested in the real world. Another reason why parents should consider personal agency as important as all other aspects of adolescent health.