Helping Parents of a Teen with TBI Move Forward
Dr. Mariann Young talks about working with families who have a teen with brain injury and the many layers of change and acceptance — and love — that come during the journey to recovery.
See more video clips with Dr. Mariann Young.
[Dr. Mariann Young] In working with parents of children or adolescents that have been injured, it's extremely important to get the family in for family sessions. When a child—when anyone is injured—the injury doesn't happen to the person; it happens to the whole family. So you not only have to get the parents in. You have to get the siblings in. You have to work through the grief and loss. That's the first part of the counseling. That's the first part of the work—to address with the parents the child that they lost and to work in small steps, to work with them to accept and appreciate the child that they have now. This is difficult. It's like parents will come to us, and they'll work with us, and they'll listen, and eventually they'll want a time limit. Eventually they'll want, "Well when is this going to be different? When will I have my child back?" And you have to assist the whole family in understanding that the changes are gradual, no one will understand how far the child, the adolescent will come in treatment, and we don't know— we do know that the child won't be the same, the adolescent won't be the same, but we don't know how much recovery. And to hold on and to praise and to enjoy the glimpses or the time, the reactions, the behaviors, the attitudes you have that are the same, and then gradually learn to accept that there are some things that may be different. It's extremely difficult when there are behavioral changes—when the child may become verbally aggressive or physically aggressive to a parent, and this child or teen had not displayed that behavior prior to the injury. Medication may be involved. And if you're a parent that has issues with medication and never used it, there's a lot of education that has to come. But it in fact may be helpful to controlling the behaviors, to controlling some of the mood swings that you do see after an injury with adolescents. There's a lot of training. You may work with a behavioral specialist within the home. You're changing your family constellation because you have people involved that have never been involved, and you didn't think nor did your child think. So you have a kid who normally would go and say, "I'm going out with friends. Is this okay?" and ask Mom or ask Dad, and it would be okay. Now you have a kid that you can't necessarily just ask Mom or Dad—sometimes you have to ask the behavior analyst, or sometimes there's a psychiatrist, or sometimes there's a physical med and rehab doc, or sometimes there's a case manager, or if you have OT/PT speech and the constellation of therapists that may be working with them. So a decision that may have been simple at one time, all of a sudden involves a constellation of people that were not a part of— and probably should never have and hopefully never should have been a part of—but are there to assist. In school it may be special education services, whether through a 504 Plan, whether through an IEP. But even more people involved in that teen's life. Nothing is simple and even for parents, it's appreciating the smaller steps and something they never thought they would have to do.
Posted on BrainLine May 1, 2014.
Mariann Young, PhD, CBIS, is a licensed clinical psychologist who has worked with children, adolescents and young adults with TBIs for over 20 years initially at Children’s Hospital of Michigan and currently at Rainbow Rehabilitation Centers, Inc.
Produced by Victoria Tilney McDonough and Justin Rhodes, BrainLine.