Articles & Resources

Society for Health Psychology

Considerations in Working with Young Adults (Ages 30-39)

Adolescent/Young Adult

By Danielle Schwartz Miller, MS, Marie Barnett, PhD, & Karly M. Murphy, PhD

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Background/Developmental Milestones

The unique needs, issues related to life transition, and healthcare concerns of young adults (YAs) ages 30-39, exclusively, remain understudied. For many, entering one’s 30s is a significant turning point marked by reflection of life and their intended direction for adulthood [1]. In other words, young adulthood as a 30-something involves a reassessment and potential pivot of one’s priorities [2]. YAs also embark on creating new meaning for themselves as established adults with a deeper sense of responsibility compared to their 20s [2]. One critical developmental consideration among YAs is childrearing and raising a family – caring for children is a salient experience for a large number of YAs and requires adequate energy, time, resources, affection, and understanding of one’s role as a caregiver [3]. However, not all women in this agegroup find it easy to become pregnant and bear children. Years of research on women in their 30s demonstrate elevated rates of fertility concerns and higher risk for pregnancy-related complications compared to younger women [4]. Depression and anxiety may arise among individuals who experience complications related to fertility [5], and quality of life is often negatively impacted [6]. Moreover, infertility takes an emotional toll not only on the women who experience it, but also their partner [6]. Conversely, individuals who successfully bear children may find themselves feeling co-occurring joy and exhaustion in their new roles as parents. This can be particularly true among YAs who are a “sandwich generation,” caring for both their children and elderly parents [7]. Finally, many YAs have settled in their routines regarding careers, raising families, maintaining a social network, and strengthening their romantic relationships. This adherence to routine may mark a positive transition to stability for some YAs; however, others may feel increasingly stagnated in their routines after finding the newfound independence and novelty of one’s 20s exciting. Although many YAs maintain these established structures and routines, others may experience difficulty doing so. For instance, a divorce, substantial careerchange, or diagnosis of a physical illness may occur. Such monumental changes can result in significant psychological stress [8]. In summary, there are a variety of developmental considerations and milestones that make this time a unique decade of life experiences, and more research is necessary to better understand the needs and concerns of individuals in this age-range.

Clinical Implications and Needs

The National Institute of Mental Health has determined that one out every five adults in the U.S. has a diagnosable mental health disorder [9]. Current research lacks focus on addressing the clinical needs of YAs in their 30s. This particular decade of life includes experiences that are unique to one’s 30s such as starting a family, finding a long-term partner, and getting established in one’s career; thus, researchers and clinicians ought to consider these distinctions and provide tailored and culturally informed care. Although 30-somethings are considered YAs [10], they may have more health concerns than adolescents or 20-somethings have. Specifically, rates of obesity, diabetes, and cancer rise during this decade [11]. Furthermore, one’s busy schedule of maintaining a full-time job and caring for their family can result in less dedicated time toward physical wellness. YAs often find themselves providing for both older and younger loved ones – those with aging parents and children feel accountable for ensuring the health and wellbeing of a wider sphere of family members than younger adults tend to [7]. Constant focus on others’ needs and other domains of one’s life can naturally lead to less time dedicated for one’s own wellbeing. It is important to encourage YAs for whom this is true to metaphorically put on their own oxygen masks before assisting others in doing so. Awareness of and sensitivity to the experiences one might encounter in their 30s is critical to properly addressing the needs of YAs. Clinicians are encouraged to develop competence in implementing interventions that target the grief of adults who have lost a parent [12] or child [13] and adults going through divorce [14]. Lastly, research suggests low healthcare utilization [15] and high barriers to mental healthcare among adolescents [16], but very little is known about this among adults in their 30s.

Evidence-based Interventions and Assessment

YAs are often included in intervention trials of adults (e.g. ages 18+, ages 18-65). While this means that a number of existing intervention studies have included this population (e.g. cognitive-behavioral therapy [17], problem-solving therapy [18], acceptance and commitment therapy [19]), often they have not been adapted to address the unique needs and concerns of the individuals in this age-range. Clinicians must be mindful of tailoring evidence-based interventions to ensure that concerns relevant to this age-range are addressed. Such concerns can be identified via thorough assessment. A non-exhaustive list of common concerns by domain and measures to assess them is provided below.

Mental Health & Functioning
Physical Health & Functioning
Social Health & Functioning

Cultural Factors to Consider

Assessment and awareness of broader socio-cultural considerations when working with this age group is crucial. While culture and diversity is multifaceted, two components of diversity and culture are particularly relevant to YAs: race/ethnicity and sexual and gender identity. With regard to race/ethnicity, being part of a minoritized group has been associated with poorer physical and mental health outcomes among adults. For example, a 2017 review found that individuals from minoritized and historically underserved racial/ethnic groups with severe mental illness have poorer outcomes than their white counterparts [20]. Similarly, sexual and gender minority adults (e.g. lesbian, gay, bisexual, transgender, intersex, queer) face a disproportionate burden of physical and mental health difficulties. Indeed, a recent study with a large, nationally representative sample indicated that sexual minority individuals have an increased risk of developing many physical health conditions [21].

More recently, research has focused on the intersectionality of minority group identification; in this emerging area of research, it has been demonstrated that individuals who are part of more than one minority group experience an even higher likelihood of experiencing physical and mental health disparities [22,23]. Age may also be an important factor that intersects with minority group identification; for example, YAs with cancer have been identified as a medically underserved population [24]. Thus a YA who is diagnosed with cancer and identifies as a racial/ethnic and/or sexual minority has an elevated likelihood of experiencing poorer physical and mental health outcomes [25,26]. The reasons for such disparities are apparent at multiple levels of analysis, from federal policy, to community or organization level factors such as access to resources or education, to individual experiences of discrimination that result in stress [27]. As such, interventions that target multiple levels are needed to reduce health disparities, and health psychologists can play a critical role in the development and implementation of such interventions [28]. When providing individual-level interventions, it is imperative that providers seek to understand the socio-cultural challenges these YA individuals face, and maintain cultural competence in these areas through review of relevant literature, training, and consultation [29].

Resources

References:

  1. Rönkä, A., Oravala, S., & Pulkkinen, L. (2003). Turning points in adults’ lives: The effects of gender and the amount of choice. Journal of Adult Development, 10(3), 203-215.
  2. Rutter, M. (1996). Transitions and turning points in developmental psychopathology: As applied to the age span between childhood and mid-adulthood. International Journal of Behavioral Development, 19(3), 603-626.
  3. Caffarella, R. S., & Olson, S. K. (1993). Psychosocial development of women: A critical review of the literature. Adult Education Quarterly, 43(3), 125151.
  4. Crawford, N. M., & Steiner, A. Z. (2015). Age-related infertility. Obstetrics and Gynecology Clinics, 42(1), 15-25.
  5. Covington, S. N. (2015). Fertility counseling: Clinical guide and Case studies. Cambridge University Press.
  6. Chachamovich, J. R., Chachamovich, E., Ezer, H., Fleck, M. P., Knauth, D., & Passos, E. P. (2010). Investigating quality of life and health-related quality of life in infertility: a systematic review. Journal of Psychosomatic Obstetrics & Gynecology, 31(2), 101-110.
  7. Flinn, B. (2018). Millennials: The emerging generation of family caregivers. Innovation in Aging, 2(Suppl 1), 240.
  8. Amato, P. R. (2000). The consequences of divorce for adults and children. Journal of marriage and family, 62(4), 1269-1287.
  9. National Institute of Mental Health (2022). Mental Illness. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimh.nih.gov/health/statistics/mental-illness
  10. National Cancer Institute (2020). Adolescents and Young Adults with Cancer. U.S. Department of Health and Human Services, National Institutes of Health. https://www.cancer.gov/types/aya#1
  11. LeBauer HealthCare (2022). 4 Health Risks to Watch in Your 30s. https://www.lebauer.com/2017/01/23/4-health-risks-watch-30s/
  12. Hayslip Jr, B., Pruett, J. H., & Caballero, D. M. (2015). The “how” and “when” of parental loss in adulthood: Effects on grief and adjustment. OMEGAjournal of Death and Dying, 71(1), 3-18.
  13. Meij, L. W. d., Stroebe, M., Schut, H., Stroebe, W., Van Den Bout, J., Heijden, P. G., & Dijkstra, I. (2008). Parents grieving the loss of their child: Interdependence in coping. British journal of clinical psychology, 47(1), 31-42.
  14. Bogolub, E. B. (1991). Women and mid-life divorce: Some practice issues. Social Work, 36(5), 428-433.
  15. Adams, S. H., Park, M. J., & Irwin Jr, C. E. (2015). Adolescent and young adult preventive care: Comparing national survey rates. American Journal of Preventive Medicine, 49(2), 238-247.
  16. Cadigan, J. M., Lee, C. M., & Larimer, M. E. (2019). Young adult mental health: A prospective examination of service utilization, perceived unmet service needs, attitudes, and barriers to service use. Prevention Science, 20(3), 366-376.
  17. Beck, J. S. (2020). Cognitive behavior therapy: Basics and beyond. Guilford Publications.
  18. Nezu, A. M., Nezu, C. M., & D’Zurilla, T. (2012). Problem-solving therapy: A treatment manual. springer publishing company.
  19. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change. Guilford press.
  20. Maura, J., & Weisman de Mamani, A. (2017). Mental health disparities, treatment engagement, and attrition among racial/ethnic minorities with severe mental illness: A review. Journal of clinical psychology in medical settings, 24(3), 187-210.
  21. Streed Jr, C. G., Hall, J. P., Boyd, B. A., Batza, K., & Kurth, N. K. (2021). Comparative Health Status and Characteristics of Respondents of the 2019-2020 National Survey on Health and Disability by Sexual and Gender Minority Status. LGBT health, 8(8), 563-568.
  22. Trygg, N. F., Gustafsson, P. E., & Månsdotter, A. (2019). Languishing in the crossroad? A scoping review of intersectional inequalities in mental health. International journal for equity in health, 18(1), 1-13.
  23. Dyar, C., Taggart, T. C., Rodriguez-Seijas, C., Thompson, R. G., Elliott, J. C., Hasin, D. S., & Eaton, N. R. (2019). Physical health disparities across dimensions of sexual orientation, race/ethnicity, and sex: Evidence for increased risk among bisexual adults. Archives of sexual behavior, 48(1), 225242.
  24. Smith, A. W., Seibel, N. L., Lewis, D. R., Albritton, K. H., Blair, D. F., Blanke, C. D., Bleyer, W. A., Freyer, D. R., Geiger, A. M., Hayes-Lattin, B., Tricoli, J. V., Wagner, L. I., & Zebrack, B. J. (2016, Apr 1). Next steps for adolescent and young adult oncology workshop: An update on progress and recommendations for the future. Cancer, 122(7), 988-999.
  25. Munoz, A., Kaiser, K., Victorson, D., Yanez, B., Garcia, S., Synder, M., & Salsman, J. (2014, Feb). Comparing Self-Reports of Health-Related Quality of Life Among Racial and Ethnic Minority Survivors of Young Adult Cancer: A Mixed Methods Approach. Psycho-Oncology, 23, 82-82.
  26. Desai, M. J., Gold, R. S., Jones, C. K., Din, H., Dietz, A. C., Shliakhtsitsava, K., Martinez, M. E., Vaida, F., & Su, H.-C. I. (2021). Mental health outcomes in adolescent and young adult female cancer survivors of a sexual minority. Journal of Adolescent and Young Adult Oncology, 10(2), 148-155.
  27. Carter, R. T., Lau, M. Y., Johnson, V., & Kirkinis, K. (2017). Racial discrimination and health outcomes among racial/ethnic minorities: A meta‐analytic review. Journal of Multicultural Counseling and Development, 45(4), 232-259.
  28. Gorin, S. S., Badr, H., Krebs, P., & Das, I. P. (2012). Multilevel interventions and racial/ethnic health disparities. Journal of the National Cancer Institute Monographs, 2012(44), 100-111.
  29. Yali, A. M., & Revenson, T. A. (2004). How changes in population demographics will impact health psychology: incorporating a broader notion of cultural competence into the field. Health Psychology, 23(2), 147.
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