Criteria for Psychological Assessment of Parents’ Position in The Process of Rehabilitation of Children Who Have Suffered Severe Trauma

Psychological support of the family whose child is in rehabilitation after severe injury is one of the important areas of medical psychologist activities. The psychologist is to involve parents into the rehabilitation process as active participants. Thus, at the initial stage of support, the psychologist’s task is to identify unproductive parental patterns and correct them in a timely manner.

The aim of the study is to develop psychological criteria for assessing the parental position in the situation of rehabilitation of children with severe trauma.

MATERIAL AND METHODS The trial setting was the Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russia. 40 parents of children with severe trauma were included in the study. Research instruments were as follows: overt observation of parent-child interaction based on selected evaluation criteria, clinical interviews as well as analysis of homework assignments with the child. To assess parental position in the rehabilitation process, a number of criteria were formed: involvement in the rehabilitation process, attitude towards their child and child’s trauma, attitude towards their child’s independence, attitude towards their parental role as well as the attitude towards the outcome of rehabilitation.

RESULTS Types of parental position in the process of the child’s rehabilitation were clarified and updated; its subtypes were defined and characterized. So, according to the criterion “Involvement in the rehabilitation process”, the following distribution by sample was observed: passive (10% of parents), formal (20% of parents), controlling (25% of parents) and productive (45% of parents). According to the criterion “Attitude towards their child” — rejecting (7% of parents), condoning (18% of parents), dominant (35% of parents), accepting (40% of parents). According to the criterion “Attitude towards their child’s trauma” — superficial (10% of parents), defective-directed (32% of parents), positively-directed (18% of parents), adequate (40% of parents). According to the criterion “Attitude towards their child’s independence” — directive (22% of parents), hyper-protective (25% of parents), permissive (18% of parents), democratic (35% of parents). According to the criterion “Attitude towards their parental role” — unformed (17% of parents), dependent (25% of parents), rigid (30% of parents), reflexive (28% of parents). According to the criterion “Attitude towards the outcome of rehabilitation” — amorphous (15% of parents), anxious (15% of parents), categorical (35% of parents), and flexible (35% of parents).

CONCLUSIONS The performed psychological assessment of parental position in the process of their child’ rehabilitation after severe injury has revealed important intra-group differences, indicating that a significant part of parents need psychological help, since they cannot independently come to productive forms of interaction with their child in the process of his rehabilitation.

1. Hanna K, Rodger S. Towards family-centred practice in paediatric occupational therapy: a review of the literature on parent-therapist collaboration. Austral Occup Ther J. 2002;49:14–24. https://doi.org/10.1046/j.0045-0766.2001.00273.x

2. Kemp P, Turnbull AP. Coaching with parents in early intervention. Infants and Young Children. 2014;27(4):305–324. https://doi.org/10.1097/IYC.0000000000000018

3. King G, Chiarello LA, Ideishi R, Ziviani J, Phoenix M, McLarnon, et al. The complexities and synergies of engagement: An ethnographic study of engagement in outpatient pediatric rehabilitation sessions. Disabil Rehabil. 2021;43(16):2353–2365. PMID: 31847621 https://doi.org/10.1080/09638288.2019.1700562

4. Osher TW, Osher DM. The paradigm shift to true collaboration with families. J Child Fam Stud. 2002;11(1):47–60. https://doi.org/10.1023/ A:1014715527823

5. Rober, M, Leblanc L, Boyer T. When satisfaction is not directly related to the support services received: Understanding parents’ varied experiences with specialised services for children with developmental disabilities. Br J Learn Disabil. 2015;43(3):168–177. https://doi.org/10.1111/bld.12092

6. Rosenbaum P, King S, Law M, King G, Evans J. Family-centred service. Phys Occup Ther Pediatr. 1998;18:1–20. https://doi.org/10.1080/J006v18n01_01

7. Sukkar H, Dunst CJ, Kirkby J. Early childhood intervention working with families of young children with special needs. New York, NY: Routledge; 2017.

8. Schmidt B, Khoziev VB. Theoretical and Empirical Models of Parenthood in Childhood Autism (ASD). Pt. I. E-Journal of the Dubna State University. A series of “Science of man and society. 2022;(1):37–50. (In Russ.)

9. Schmidt B, Khoziev VB. Theoretical and Empirical Models of Parenthood in Childhood Autism (ASD). Pt. II. E-Journal of the Dubna State University. A series of “Science of man and society“. 2022;(1):51–64. (In Russ.)

10. Bikova VI, Lukjanov VI, Fufaeva EV, Semenova ZhB, Valiullina SA. Peculiarities of Characterologic Features, Anxiety and Coping-Behaviour in Parents of Children With Severe Traumatic Brain Injury. Child and adolescent rehabilitation. 2013;2(21):46–52. (In Russ.)

11. Samoylyuk LA, Logunova KG, Solomennikova AA. The Involvement of Parents in the Speech Therapy Process as a Condition for Its Effectiveness (on the Example of a Rehabilitation Center). Pedagogical IMAGE. 2022;16(2): 229–242. (In Russ.). https://doi.org/10.32343/2409-5052-2022-16-2-229-242

12. Suroegina AYu., Kholmogorova AB. The Parents’ Adaptation to Chronic Disease of Child by the Example of the Spinale Cord Injury and the Cerebral Palsy of Teens and Young People. Counseling Psychology and Psychotherapy. 2015;1(84):177–195. (In Russ.)

13. Kholmogorova АВ, Sergienko AI, Gerasimova AA. Attitude to Support the Child’s Subjective Position and Posttraumatic Growth in Parents of Children with Disabilities. Cultural-Historical Psychology. 2020;16(1)13–24. https://doi.org/10.17759/chp.2020160102

14. D’Arrigo R, Ziviani J, Poulsen AA, Copley J, King G. Child and parent engagement in therapy: What is the key? Aust Occup Ther J. 2017;64(4):340–343. PMID: 26831473 https://doi.org/10.1111/1440-1630.12279

15. Hoover-Dempsey KV, Sandler HM. Why do parents become involved in their children’s education? Rev Educ Res. 1997;67(1):3–42. https://doi.org/10.3102/00346543067001003

16. King G, Currie M, Petersen P. Child and parent engagement in the mental health intervention process: A motivational framework. Child Adolesc Ment Health. 2014;19(1):2–8. PMID: 32878365 https://doi.org/10.1111/camh.12015

17. Walker JMT, Wilkins AS, Dallaire JR, Sandler HM, Dempsey KVH, Wilkins AS, et al. Parental involvement: Model revision through scale development. Elem Sch J. 2005;106(2):85–104. https://doi.org/10.1086/499193

18. Karabanova OA. Psikhologiya semeynykh otnosheniy i osnovy semeynogo konsul’tirovaniya. Moscow: Gardariki Publ.; 2005. (In Russ.)

19. Stolin VV. Samosoznanie lichnosti. Moscow: Izd-vo Moskovskogo Universiteta Publ.; 1983. (In Russ.)

20. Spivakovskaya AS. Psikhoterapiya: igra, detstvo, sem’ya. Moscow: Aprel’ Press, Izd-vo EKSMO Publ.; 2000. (In Russ.)

21. Ovcharova RV. Roditel’stvo kak psikhologicheskiy fenomen. Moscow: Moskovskiy psikhologo-sotsial’nyy institute Publ.; 2006. (In Russ.)

22. Galasyuk I. Parental Position in a Family, Bringing Up a Mentally Disabled Child. Bulletin of the Moscow Region State University. Series: Psychology. 2014;(3):52–64. (In Russ.)

23. Posysoev NN. The Parental Position as a System of Relationships. Yaroslavl Pedagogical Bulletin. 2017;(6):248–251. (In Russ.)