In recognition of the theme ‘Let’s Connect’ for this year’s Children’s Mental Health Week, the third article in our insight series that looks at the ways in which communication, understanding and relationships impact mental health following traumatic injury in children, we investigate the influence of family.
A change in family dynamics
The influence of family relationships is incredibly important in the rehabilitation of children and young people. Traumatic injury often affects the whole family, particularly the dynamics. Parents who worked may now find themselves unable to as they need to be the primary caregiver for the child. Siblings who are used to having a certain relationship with their brother or sister may find that they are unable to play or communicate or do the same things they used to be able to do with them, and they may even have to assume more responsibility as their sibling needs more care than before.
Dynamics can have a big impact on mental health. The shift in family roles and responsibilities may lead parents and siblings to struggle with their own mental health, which may have an impact on the injured child’s mental health.
That’s why Rehabilitation Case Managers will develop relationships with the wider family to ensure they have the right help they need to be able to support the child.
For some families it might mean counselling. For others it may be helping them to access the services their child is entitled to. In other cases it might mean working with siblings to help them re-establish relationships with their brother or sister post-injury.
How family can support effective communication
Cognitive impairments as a result of injury may make it difficult for the family to communicate effectively with each other. Where the child has difficulties expressing themselves and/or understanding what is being communicated to them, their mental health may understandably suffer.
Families may need to work on different ways of communicating with the child, and allow the child to express themselves in different ways. Some key tips in helping the child to communicate include:
- Reducing distractions, so that the child can concentrate on what they want to communicate.
- Giving the child time to respond. They may find it difficult to find the right words or lose their train of thought. Interrupting can be incredibly frustrating for the child as well as unhelpful. Families must be patient and give the child the time they need.
- Being aware of when the child has had enough. Fatigue has a huge impact on cognition and being able to communicate effectively, particularly in children. It can exacerbate unhelpful emotions such as frustration, anxiety and feeling sad, so it’s important to understand when the child is beginning to tire.
Being mindful of development stages
Following childhood traumatic injury, the developmental stages of growth may be very different for the child. For traumatic brain injury this is particularly evident, as the brain continues to develop, and it can be difficult to understand how the injury will impact this. Some children may be very delayed in reaching certain developmental milestones, while others might start showing different symptoms of the brain injury, which only become apparent once the child has reached that milestone. The case management process should prepare parents and in some cases, the wider family, on what they might expect and provide reassurance in being able to offer support throughout the rehabilitation process.
Adjusting to behavioural and cognitive changes in addition to expected developmental growth stages can affect mental health. Ongoing monitoring of the child’s development is vital to ensure they receive the relevant support they need at specific developmental stages, and family can help spot signs of change and work with Rehabilitation Case Managers and other clinical specialists to get the right support in place.
If you’d like to find out more, please get in touch with the Children and Young People’s Services Team.