Having ‘The Big Talk': Mothers' strategies for communicating with their adolescents about sex

Background: Most studies of parent-adolescent communication about sex rely on parent or adolescent recall to describe the communication process. Almost no studies have examined parents' styles for communicating about sex in real-time. Objective: To characterize the communication strategies mothers use when talking with their adolescents about sex. Methods: Mothers came to our research office to participate in a semi-structured conversation with their adolescent son or daughter aged 10 to 14 years. Dyads discussed every day issues (e.g., hobbies), abstinence, condoms and birth control. Dyad interviews were audio-recorded, transcribed, and coded using a grounded theory approach to content analysis to identify mothers' communication strategies. Results: Between June 2011 and December 2012, we conducted 21 dyadic interviews: 6 with mother-son dyads and 15 with mother-daughter dyads. Seven communication strategies emerged reflecting: (1) the amount of information mothers provide before inviting comment from their adolescent; (2) how emotionally evocative (e.g., fear, anger) discussions were for mothers; (3) responsiveness to adolescent inquiries (positive, negative, or dismissive); (4) use of personal disclosures to facilitate discussion; (5) motivations for discussions (e.g., to handle this better than my parents did; to force specific adolescent behaviors); (6) articulation of family values and behavioral expectations, and (7) nurturance of adolescent autonomy and sexual decision-making capacity. Conclusions: Mothers use a variety of strategies when communicating with their adolescents about sex. Whether and how mothers' use of these strategies changes as adolescents get older and the relationship between mothers' use of these strategies and adolescent sexual behaviors requires further inquiry.