HCML Specialist Rehabilitation Case Manager Louise Derrick provides insight into the children’s rehabilitation journey and how communication supports positive outcomes.
Why is it important to listen to what the child wants during their rehab journey?
Children communicate in many formats and so approaching the process in a child centred way helps ensure we listen to and understand the child’s voice. It’s important to capture the child’s likes or dislikes in all aspects of life, as this impacts the rehabilitation journey. This inclusivity is important for all children.
How does this impact their mental health and overall rehab?
Ensuring children are heard, understanding their fears and concerns, recognising and validating and effectively supporting their strengths and challenges, can make a significant difference to mental wellbeing and engagement and therefore progress.
How do case managers ensure the child’s voice is heard and acted on?
Being child centred ensures we build a clinical rapport, communicate clearly and enables us to plan rehabilitative goals with their input where possible or with advocation or other methods of communication. This ensures the focus remains on the child, their journey and needs, which can often get lost in the medical perspective of the process if not actively considered.
How does the case management process advocate for the child?
Paediatric case managers recognise and seek to include children in the process by adapting the Immediate Needs Assessment (INA), finding age-appropriate ways and methods of asking their feelings and thoughts about therapies; what they enjoy and dislike, what method they find easier e.g. face to face or virtual. These can vary between children and young people, dependent on any barriers, their age and preference, as well as modality which might be a centralised sports focus, or using technology to keep children motivated and access tuition. Or it could be about increasing motivation e.g. counting steps and being able to actively see progress and working closely with therapists for rehabilitation approaches to be fun and effective where possible.
How do case managers balance the wants/needs of the child with their parent’s wishes and the case manager’s own expert recommendations?
It can be difficult, but communicating clearly with children, families, schools, clinicians and collaborating effectively through reviews, Multidisciplinary Team meetings and preventing drift and disengagement where possible, as well as ensuring to be careful about not creating any false expectations and making goals SMART to show progress and participation benefits.
And how do they protect the child’s mental health?
You can’t stop children having difficult days, thoughts and feelings just like adults, but they may struggle to communicate, self-regulate or recognise what is wrong. So it’s important to ensure they are accessing the right support, that you advocate for them and help them access the recommended clinical services. Working closely with children, schools, their families and clinicians to review and validate the child’s rehabilitation and progress, keeping children motivated and recognising the benefits of early intervention and support can be effective in supporting the child’s mental health throughout the rehabilitation process.
What happens if a child’s wants are not in line with rehab goals – how do case managers work with the child and family to ensure this does not have a detrimental effect on the child’s mental health?
We have to find a way to engage in rehabilitation in a modality that will support that child and validate their wants and needs. This means working closely with schools and families and reviewing progress closely, ensuring we change to an alternative format if this doesn’t appear to be effective or having a positive impact. Communication is a key resource, building a clinical rapport and agreeing goals together.