This module discusses the difficulties presented by the complex transition between pediatric and adult care for adolescents with Sickle Cell Disease.

This module typically takes around 90 minutes to complete. A more detailed module structure can be found in the SCD Facilitator’s Guide.


  • Health system challenges, including lack of continuity
  • Challenges in transition from pediatric to adult care models
  • Adolescent empowerment

Learning Objectives

  • Identify common challenges for adolescents living with SCD as they transition to adult care
  • Explore the relationship of stress, grief and uncertainty on the transition process
  • Discuss ways to support adolescents in the transition from pediatric to adult care

Introduction and Debrief Plenary

Art Activity and Transition Plenary

  • (If applicable) What stood out for you regarding the Art Activity?
  • What stood out for you regarding the Transition plenary?

Film: Transitions

Reflections and Discussions

Individual Reflection

  • What are your initial responses to this film? What surprised you?
  • What did you notice about your thoughts, feelings, body sensations? What do these tell you about yourself?

Group Discussion

  • What are your responses to the transition we saw in the film?
    • Is it realistic? Sustainable?
  • What were the emotional responses of patients in the film when they need to transition?
  • What are the emotional responses of patients when they need to transition at your institution?
  • What are the emotional responses of family members?
  • What does your institute do to transition patients from pediatric to adult care?
    • At what age are they transferred?
    • Do you transfer all patients at that age or only certain patients?
  • What are the differences between your pediatric and adult care clinics?
  • As a clinician, what is your perspective on transitions?
    • Letting go, grieving loses, like “losing a family member” (Jeff)
    • Attachment to children “Just like being a parent” (Kim)
  • Are your feelings positive or do you have reservations? (Prompts:
  • Do you think your attitude towards transition affects patient perspectives of transition?
  • What is the relationship of stress, grief and uncertainty on the transition process for patients, families and clinicians?
  • What are some ways these issues could be addressed more effectively?

Consider drawing the following (or similar) on flip-chart to help guide discussion:

  • How can we change from making transition seem impossible, to making it seem normal and demystify it?
    • What about anticipatory guidance for the process?
    • When to begin making the transition?
  • What system issues contribute to the challenges experienced by adolescents transitioning from pediatric to adult care?
  • How do we change the way the system is viewed while also acknowledging the systems (e.g. billing, lack of adult clinicians) gets in the way?
  • What role can palliative care play in transitioning child to adult care?

Application to Self and Home Institution

  • Regarding what we have discussed during this group, what change would you like to see/make at your home institution?
  • Discuss how perceptions of how transition could go better at your institution (in terms of changing the structure of care, etc.) and how you can facilitate adolescents make a successful transition.