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The Informed Parent

When You Receive Bad News

by Carolyn Warnemuende, M.S.
Published on Apr. 03, 2006

There are times in the lives of most parents when they receive unwanted news about their child. Bad news can run the continuum from, "Mr. and Mrs. Smith, your daughter is failing algebra," to "I'm sorry to tell you this, Mr. and Mrs. Jones. Your son has autism." It doesn't matter what the bad new is. It is disappointing at best, frightening and heart breaking at worst.

How parents respond to unpleasant news rests in part on how it is delivered by professionals. If a teacher or physician shows compassion and provides support, even the worst report can be taken more easily than if the deliverer seems cold and without feeling.

In this article we will look at what a family can expect from thoughtful professionals who deliver bad news. While no one likes to receive such information, no one likes to deliver it, either. It is not easy for professionals to discuss situations that are sad, frightening, or causing a life-changing impact on family structure with parents. Nonetheless, physicians, mental health workers, and teachers know this is part of their job. Many learn to do it in such a way that the family feels cared for and understood.

What parents can expect:

1. The Setting

You have the right to hear bad news in a private setting and with only immediate caregivers present. This may be a doctor's office, an empty classroom, or a consultation room. It should never be given in a public place like an IEP meeting or a hospital room where you have no privacy to experience and express your feelings.

Although not common, it is optimal if the setting has a family room with comfortable seating and visual appeal. Regardless of decor, tissues and water should be available and in an obvious place.

2. Adequate Time

When receiving news about your child that you would rather not hear, time is needed to process the information, to express one's feelings and concerns, and to generate initial questions. You should not feel hurried or dismissed.

3. Communication Style

Communication styles vary. Some professionals are more serious or brusque than you might like. Others have a warmer demeanor. Regardless of personal style, empathy is shown when they indicate that it is not easy for them to relay the information. They will deliver the news in clear language that can be understood. They will listen carefully and not minimize fears, sadness, and concerns. They will answer questions fully and sincerely, and provide you with hope. They will support your right to a second opinion.

4. Meeting Your Needs

You will be provided with a list of interventions and resources available in your community. Recommendations will be made about what steps to take and in what order they are best achieved. You will be given the accurate telephone numbers and contact persons of appropriate individuals in private practice and community agencies. Although professionals may not suggest that you use a specific individual or agency, if you ask, they will tell you of positive or negative experiences they have had with the provided resources.

5. Prognosis

A prognosis is the anticipated outcome of an illness, learning problem, or behavior/mental health disorder. You will be given a prognosis for the diagnosis, or name, of your child's problem. Professionals cannot predict the future. With their experience and knowledge, they can indicate what possibilities you might expect. All children are different. Some progress beyond expectations; others may not achieve what initially looked possible. A prognosis is a good guess based on current information. It is not written in stone.

6. Follow-up

At the end of the session, the professional will ask you to arrange a follow-up appointment, probably within seven-to-ten days. This gives you time to consider more fully the news you have received and to think about additional questions you may have. The time allotted for this appointment should not be so much time that your worry, sadness, and concern cause excessive stress in your life and that of your family. Even if you want a second opinion and have not had it, using the follow-up appointment is important. The more answers you have to questions and the more information you have about the diagnosis, the more prepared you can be for working with other professionals.

Many parents are aware that a problem exits before being given bad news. While they may not know the extent of the disorder, they are usually aware that their child or adolescent is different from others her age. They know that her health or development is not what they think it should be. Once the "knowing that something is not quite right" is labeled, parents have choices. While they may wish to ignore what they have been told, wise parents take the steps necessary for bringing their child to the greatest physical, mental, and emotional health possible.

If you are the recipient of bad news, you may attempt to deny it. You will feel loss. You may feel sadness, anger, fear, frustration, blame, or even shame. You will grieve. These feelings are to be expected. Talk to your significant other, the physician. or another professional. Attend available support groups. By giving yourself time to fully experience those feelings, and by sharing them with others in similar situations, you will begin to heal from the loss of what might have been. You will be able to see the possibilities for your child.

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