Talking with providers
depression, anxiety
TRANSITION
The phase 1 results indicated that youth were more confident in talking to providers than any other subscale, with a median score of 5.00 (the maximum possible score for a subscale). As such, there were some unexpected findings arising from the qualitative interviews which counter this level of confidence in communicating with providers.Some youth in phase 2 expressed feeling very comfortable talking with clinicians, asking questions and describing their symptoms (see Figure Joint Display of TRAQ talking with providers' subscale results. IQR, interquartile range; TRAQ, Transition Readiness Assessment Questionnaire.An unexpected finding arising during the integration of data sources specific to this domain related to the ways in which mental health comorbidities made communicating with providers more challenging. In fact, several youths interviewed expressed a lack of confidence in communicating with their care teams, primarily in relation to their mental health. For some youth, a hesitancy to express their true feelings, particularly related to depression, for fear of disappointing providers contributed to this lack of confidence.For others, the symptoms of generalized and/or social anxiety made talking with clinicians without caregivers present for the first time stressful. Some youth described the incapacitating effects of anxiety on communicating with care providers. Fears about not having the ‘correct’ answers, not sharing enough information or not asking the right questions during appointments with new adult care providers were exacerbated by pre‐existing anxiety for many youths. They explained the pressure they felt to perform in adult care and how, at times, this pressure led to them shutting down and ‘going completely silent’ so as not to say the wrong thing.Given the incongruence between the phase 1 and 2 results in this domain, it is possible the two TRAQ questions focused on communication are not sufficiently capturing this phenomenon for youth with co‐occurring diagnoses. While phase 1 participants expressed confidence via their TRAQ subscale scores, youths' experiences indicate the importance of exploring whether youth feel their opinions are valued by providers and their comfort in advocating for their needs and asking questions above and beyond the TRAQ subscale questions.