The changing family

Rapid family change is occurring throughout the world, though trends differ greatly between subregions and countries. Families are generally becoming smaller, as fertility declines and nuclearization of family structure are more common. The transition to adulthood is being delayed. Delayed marriage, increasing cohabitation, and higher levels of partnership dissolution characterize many parts of the world. Fewer children are growing to adulthood living with the same two parents. Ageing of populations is a worldwide trend, and although the proportions of elderly living with a child or grandchild are much higher in Asia than in the West, in Asia as well they are tending to decline. One of the key issues for the future is the relative roles of family, community, and state in supporting the dependant elderly.

How does a narrative understanding of change in families post brain injury help us to humanise our professional practice?

In this paper, we critically explore the discourse of change post brain injury and challenge the dominant discourse of negative change, which alone leaves little room for other perspectives to exist. These negative changes pose a considerable risk to the well-being of families who may benefit from engaging in richer accounts making room for a more coherent and connected sense of self and family post-injury. We explore how narrative approaches provide opportunities for all practitioners to expand their professional scripts and support families to move towards a future which is not dominated by a discourse of loss. While loss and negative change is an important and very real consequence, of brain injury, focusing purely on stories of loss is life limiting for family members and can cause psychological distress. The life thread model is offered as a visible tool for all practitioners to engage with and use while working with families, providing a concrete focus for reflection and discussion of narratives relating to change which otherwise can feel quite abstract in everyday practice. We argue that one way we can humanise our professional practice is to support all practitioners to engage in a narrative understanding of family change following ABI.