The process of identity change following ABI from the perspectives of adolescents and their mothers: A relational grounded theory approach.

This study explored the process of identity adjustment following adolescent brain injury, within the systemic context of the parent-adolescent dyad. Six young people with an ABI (mean age 16.5 years, range 15-18 years; TBI: n = 3) were individually interviewed, and six respective mothers (mean age 45 years, range 37-50 years). A novel relational qualitative grounded theory approach was used, with analyses of dyads linked in an attempt to capture the shared process of adaptation post-injury for young people and their parents. Shared themes emerged for adolescents and mothers regarding "continuity and change" and "acknowledging or rejecting" experiences of change post injury. Adolescents experienced change as an, at times, distressing sense of being "not normal". While mothers turned towards their child, working hard to try to "fix everything", adolescents sought continuity of identity in the context of peer relationships, withdrawing socially to avoid feeling abnormal, reframing or finding new relationships. Some mothers sought to fill social losses through family or disability-specific activity. This study provides a relational understanding of the process of identity adjustment post adolescent BI. Future research and clinical practice should recognize the significant work of mothers, and significance of social relationships to adolescents' emerging post-injury identity.

Evaluation of the EssenCES in a neurodevelopmental inpatient service for adolescents.

Ward climate is a key element within psychiatric settings, associated with positive clinical outcomes. The Essen Climate Evaluation Schema (EssenCES) is a ward climate measure, which is validated for use within UK forensic settings. It has been studied within neurodevelopmental psychiatric inpatient settings with mixed findings on its appropriateness, and there is a dearth of EssenCES research which has been conducted within an adolescent psychiatric inpatient setting. The present study piloted the EssenCES within an inpatient psychiatric neurodevelopmental setting for adolescents in the East of England, in order to explore its usefulness within this setting and to provide preliminary normative data for a child and adolescent mental health services inpatient learning disability population. Staff and service users from a locked ward ( N = 28) and low secure ward ( N = 31) participated in the pilot. Results are discussed in relation to the body of the literature on ward climate, including consideration of discrepancies in the results between wards and discrepancies between staff and service.