Transactional processes matter: experiences between parents of children with acquired brain injury and health and education providers.

Purpose: Little is known about how parents' transactions with health and educational professionals shape their experience of these systems, and impact on capacities to support their child with acquired brain injury (ABI). We explored experiences of specific transactions and perceptions of impact. Methods: A focus group and individual interviews were conducted with seven parents of children in the chronic phase of recovery following ABI. Thematic analysis was used to interpret the data. Results: Four superordinate themes were identified: "These Encounters Matter," "A Person not a Number—Interpersonal Skills that Count," "The Blind Leading the Blind," and "Becoming the Backbone." Findings highlighted that these transactions mattered to parents, promoting either distress or empowerment. Positive outcomes were characterized by transactions related to communication, empathy, trust, collaboration, and connection. However, there was a perception of the "blind leading the blind" and that ultimately parents needed to enter such transactions armed with knowledge and their own therapeutic goals. Conclusions: Our findings unpack contextual and transactional elements of parents' experiences with health and education professionals which empower or distress. Understanding and improving these processes is important, given the central role families play in child outcomes following ABI. Implications for clinical practice are discussed. IMPLICATIONS FOR REHABILITATION: Findings suggest encounters with health and education professionals impact parent functioning and enable, or undermine, them in supporting their child with acquired brain injury. Transactional processes between parents and professionals that led to empowering and positive, or disempowering and negative, outcomes were elucidated and professionals are invited to consider these. Training for health and education professionals related to knowledge of childhood acquired brain injury, but also attunement and interpersonal processes for consultations with parents, are highlighted as important. Findings suggest that helping parents develop effective advocacy skills for their child may also be indicated. [ABSTRACT FROM AUTHOR]