Patterns of Change in Families Following Severe Head Injuries in Children

After severe head injuries, children can display behavioural problems for many years. Factors related to the individual have been discussed in other articles, and authors have also suggested that resulting behaviour problems may affect the family. This paper assesses the direct effect of the injury and events around it on the family. The reaction of the family may contribute to the persistence of the behavioural change, rather than just be a result of it. This paper describes the effect of the accident on family relationships and discusses the behaviour of the identified victim in terms of the stage of the family life cycle. The family as a whole, and not just the child, is a victim of the event, and therefore the use of family therapy is an important and appropriate part of treatment. A comparison of family and individual therapy is made, and the problem of assessing whether behavioural changes are related to organic brain injury is addressed.