Steps Toward Adult Responsibility: The S.T.A.R. Program for Adolescents with Chronic Illness at CHaD, the Children's Hospital at Dartmouth at the Dartmouth-Hitchcock Medical Center

The S.T.A.R. Program began in September 1997. The program is located at the Hood Center for Family Support and is tied to both the Departments of Pediatrics and Psychiatry at the Dartmouth-Hitchcock Medical Center. The program is designed to help teens with chronic illness develop healthy coping and adjustment skills as they transition through adolescence to adulthood.

The program is directed by Mark Detzer, Ph.D., a clinical psychologist and assistant professor of psychiatry and pediatrics at the Dartmouth Medical School. Dr. Detzer works directly with teens with chronic illness and their families in inpatient and outpatient settings . He also consults with health care providers and schools to help them most effectively address the needs of teens with chronic illness. His methods include individual, family and group counseling sessions which address common concerns held by teens with chronic illness, such as coping with symptoms, sibling, parent, peer and dating relationships and the impact of illness on the school experience. S.T.A.R. has also benefitted from the leadership of Dartmouth undergraduate Kate Creskoff, of the ArtCare program, who devoted her spring 1998 academic term to S.T.A.R. and will continue as the student leader.

The S.T.A.R. program was made possible by a local benefactor, Phyllis Wilson, Ed.D., who pledged to fund S.T.A.R. over a five-year period in memory of her daughter, Phyllis Ruth Wilson. Phyllis Ruth contracted polio at a very young age and died accidentally at the young age of 38. As a result of her polio-induced physical restriction, which was a great source of estrangement from her peers, she battled with great adversity throughout her young adult years.

Although polio is no longer a problem in most areas of the world, the adversity and coping difficulties faced by young adults with chronic medical conditions are just as prevalent today. The S.T.A.R. program targets teens with a diverse group of chronic illnesses, including (but not limited to) diabetes, asthma, juvenile rheumatoid arthritis, cystic fibrosis, spina bifida, Crohn's disease/colitis, seizure disorders and cerebral palsy. It recognizes that the difficult challenges in emotional development caused by a chronic illness are often even harder for adolescents in rural areas like Northern New England, because it is unlikely that they will live near others who are in a similar situation.

Accordingly, a main focus of the S.T.A.R. program is the development of social support. During the spring of 1998, Dr. Detzer and the S.T.A.R. Program joined forces with Kate Creskoff, a rising senior at Dartmouth College, and the Koop Institute to develop some support programs for teens in the program and to create an opportunity for them to share their stories. A result of this collaboration has been the birth of a mentoring program for teens with chronic illness with Dartmouth students, which has gotten off to a successful start and will continue to grow in the next few years. Later that year, teens involved in a focus group run by the STAR Program had written their stories about living with chronic physical illness. One of the group attendees described the experience of sitting in a room and connecting with teens of various conditions "a blast!" These stories were eventually published and can now be viewed in the Resources section of the Koop Institute's website. For further information about the STAR Program, please visit their homepage at www.starprogram.net.