Supporting teenage parenting after brain injury: A case manager’s perspective

By Alison Billingham, ILS Case Management

With a professional background in children’s social work, which included providing parenting guidance and co-delivery of a parenting course, I’ve seen how parenting evolves through each stage of a child’s life.

Parenting for any parent is an ongoing journey often filled with difficulties.

As children grow, each stage brings new demands, and the teenage years, in particular, are a time when parents need to be flexible and adaptable whilst providing emotional support and guidance to their young adult.

For any parent, this can be challenging, but for those navigating the effects of an acquired brain injury, the demands of parenting a teenager can seem amplified and, at times, overwhelming.

Teenagers are also navigating their own emotional development, hormonal changes and growing independence.

Parents are expected to set boundaries around time spent outside the home, manage online safety, and offer guidance around safe relationships – all while maintaining emotional availability and consistency.

These responsibilities can be arduous for any parent, but when the sometimes ‘invisible’ effects of an acquired brain injury such as cognitive, behavioural and emotional difficulties are present these challenges become amplified and even more difficult for the parent to manage and can unintentionally impact on the teenager meaning that the parent and teenager may ‘clash’ and both feel isolated in the family home.

How brain injury can affect parenting

Irritability and lack of tolerance

An acquired brain injury can reduce a parent’s patience and increase irritability.

This can lead to conflict with the teenager who may be managing their own hormonal changes such as an increase in oestrogen and testosterone which impacts their emotional development and can cause mood swings, as well as developments in the brain, which heighten emotional responses and risk-taking while decision-making skills are still maturing.

As a result, tensions and communication in the home can become more challenging for both parties especially when the parent is unable to provide a calm, consistent approach and manner with the young person.

Social and communication difficulties

An already self-conscious teenager may feel embarrassed by their parent’s behaviour, particularly if they perceive them as ‘different.’

This can lead to a disengagement in family activities and a reluctance to invite peers to the family home.

For the parent, the effects of a brain injury can make socialisation difficult and as such social isolation can become a frequent problem.

A ‘simple’ act such as the teenager bringing peers to the home may be problematic for the parent who manages daily life in a quiet predictable environment and a change such as a noisy house can prove overwhelming for the parent to adjust to even for short periods.

This difficulty can isolate the teenager, making them and their peers feel unwelcome, and lead them to spend more time out of the family home, leaving the parent unaware of their whereabouts or friendship groups.

Fatigue

The fatigue, physical pain and limited mobility that can accompany a brain injury can make it difficult for the parent to support or engage in physical activities with their teenager, especially if the young person has a keen interest in sports.

The fatigue can also make it difficult for the parent to keep up with the emotional demands of a teenager. Issues such as a ‘fall out’ with a peer can become overwhelming for the parent to manage.

Impaired judgement and impulsivity

It can be difficult for the parent to make safe and appropriate decisions and manage conflicts in a calm manner.

Online safety can be a concern if the parent is vulnerable themselves, especially when social and family isolation is a factor.

Alison Billingham

The cognitive and emotional impairments associated with brain injury, and reduced executive functioning, can make the person susceptible to manipulation.

This in turn can make it difficult for the parent to monitor, guide and ensure online safety for their young adult effectively.

Memory

The parent may forget commitments, details of the teenager’s life or conversations which can lead the teenager to feel unimportant or unheard by their parent.

This can damage the trust in the relationship and lead to conclusions that the parent is not actively involved in their child’s life.

This perception can also be concluded by professionals such as school staff if they are unaware of the family circumstances.

Case study: Supporting a sole parent and teenager

My client was experiencing many of the difficulties outlined above and was parenting her teenage daughter alone.

She was isolated socially and had limited family support due to an ongoing fractured relationship with relatives.

As her case manager, it was important for me to understand her family dynamics, explore any potential wider support, and connect with the professional networks already in place.

I welcomed the opportunity to support my client, drawing on my previous experience in social work to inform my approach.

However, supporting a parent with a brain injury through the teenage years brought a very different set of demands, shaped by the ongoing complexities of the injury.

An approachable, non-judgemental, and supportive manner was essential to help her build trust and feel able to turn to me for support and guidance when needed.

Regular communication – such as a weekly call or text message to ‘check in’ helped ensure she didn’t feel alone in her parenting role.

It was important that at the start of my work I clarified how often I would make contact, as I did not want her to feel overwhelmed by my calls or under pressure.

I recognised that being responsive to changing situations and demands of a teenager could be overwhelming for the parent, this meant, at times, I would receive daily communication for advice.

With the client’s agreement, I contacted the dedicated safeguarding lead at her daughter’s school to update them on the client’s injury and potential home scenarios that were impacting on her.

I supported my client in navigating the school’s online communication portal and liaising with them around GCSE option choices.

I also advocated for inclusive communication for the parent and requested that the school share important information with my client via phone rather than rely on the online portal which was difficult for her to navigate.

I provided practical support such as a visual board which was sited by the door and showed times for her daughter to return home.

This provided a reminder for both the client and the young person of the rule they had agreed.

I also made sure that the client knew who to call in the event of her daughter not returning home.

I spoke directly with the young person and, with her agreement, made a referral for counselling.

This was successful and provided her with a safe space to communicate any difficulties she was having. She engaged in the counselling and was provided with coping strategies to use when required.

Again, with her consent, I also corresponded with the school to ensure that there was a dedicated teacher she felt comfortable to go to if support was needed.

Understanding how fatigue affected my client, I encouraged her to prioritise rest and self-care wherever possible.

Reflections and learning

Working with my client has demonstrated how the vulnerabilities, and the physical and emotional difficulties sustained during a brain injury, can impact on a parenting role especially during the teenage years.

A case manager can often be the ‘eyes and ears’ in a home, especially when a client is isolated from friends and family.

We also hold a safeguarding responsibility both for the client and young person in the home.

In my previous role, I would have referred the parent to an in-person or online parenting course, another alternative would have been to commission individual parenting work to take place in the family home.

However, these services would not have accounted for the difficulties faced by my client due to their brain injury and would not have been suitable for her to access.

I spent time researching appropriate resources and exploring options that could meet her needs.

Organisations such as Headway offered helpful and practical guidance, which I was able to adapt and share in a way that felt manageable and relevant.

Through this tailored support and ongoing involvement, I was able to help both the client and her daughter feel more supported and better equipped to manage the complexities of their situation.

Learn more about ILS Case Management at indliv.co.uk