The Journal of Primary Prevention

, Volume 40, Issue 6, pp 631–642 | Cite as

Stresses, Strengths and Resilience in Adolescents: A Qualitative Study

  • Susan P. PhillipsEmail author
  • Kristen Reipas
  • Barb Zelek
Original Paper


Resilience, or positive adaptation in the face of adversity, mitigates the negative effects of stress and promotes lifelong physical and mental wellbeing. Identifying adolescents who are struggling with stress could provide opportunities for individual clinical preventive interventions. However, resilience assessments are rarely performed in clinical settings and no clear, evidence-based protocols or language for such exploration exist. The aim of this qualitative study was to identify both clinically feasible methods for assessment, and actual findings, regarding stress, supports, attributes, and strategies youth consider most useful for building resilience. We recruited 59 urban and rural dwelling 13–16 year olds from two Canadian primary care practices. Interviewers asked five open-ended questions about sources of stress and resilience and wrote summaries of answers provided. These were then coded. Researchers independently identified conceptual themes, then reached consensus on these. Stress arose from schoolwork and conflicts with friends or family, rather than from socioeconomic adversities. A majority of participants felt able to manage stresses well, finding strength through (1) social connection with family or friends; (2) self-reliant activities including exercise, music or drawing; and (3) personal attributes such as optimism, calmness and competence. They used a variety of approaches to work through stress, many of which align with key domains of resilience, as well as the novel technique of distraction. Ruminating on stress-provoking events made youth feel they were coping poorly. Most participants experienced stress and drew strength from psychosocial and emotional assets, as well as external resources that fostered resilience. Direct, open conversation was particularly effective for building rapport, augmenting strengths by discussing them, and identifying those who were struggling. Similar questions asked in clinical practice may open doors to deep and, perhaps, transformative conversations and evidence-based preventive interventions.


Adverse experiences of childhood Resilience Adolescence Optimism Self-confidence Self-control 



We thank Sonya Swift for the initial literature review and her help conceptualizing the study. Funding for this project was provided by Queen’s University’s Centre for Studies in Primary Care and the Mach-Gaensslen Foundation of Canada Studentship.


This study was funded by an Initiation Grant from the Centre for Studies in Primary Care, Queen’s University (FMED-328-13). KR received a summer studentship award from the Mach-Gaensslen Foundation of Canada to support her participation.

Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethics Approval

Ethics approval was received from the Queen’s Health Sciences Review of Ethics Board (file #6010513 FMED-328-13) and Lakehead University’s Research Ethics Board (file # 1464574).

Human and Animal Rights

The study involved interviews with human subjects, age 13–16. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Parent(s) gave verbal or written informed consent for their adolescent to participate. Participants, themselves, also provided verbal informed consent when they contacted researchers to schedule an interview and arrived for that interview. At the start of the interview confidentiality, the purpose of the interview, and the option to not answer questions or stop the interview at any point were reviewed.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of MedicineQueen’s UniversityKingstonCanada
  2. 2.Northern Ontario School of MedicineMarathon Family Health TeamMarathonCanada

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