STAND: Support Through Art and Networking in Diabetes

1. STAND- Support Through Art and Networking in DiabetesA psychotherapeutic group for adolescent patients and their parents 14th June 2019 Helen O’Byrne

2. Background to the Service Paediatric Diabetes Team CHI at Tallaght Diagnosis of Type One Diabetes Approx. 350 patients (0-19) Full MDT- 2 Consultants, 2 Regs, 2 SHOs, 1 Intern, 1 ANP, 1 DNS, 2 s/n, MSW, Dietitian, Psychologist, Art Therapist Main medical clinic, Teen clinic, Transition clinic Annual Service Planning meetings- identified need re transition

3. Background to STAND 6 week group Psychology/Art Therapy led group- Teen group (16-19) MSW led group- Parents Focus on transition to independence within their Diabetes management

4. Purpose of the parent group provide a supportive space for the parents to meet others who have shared experiences provide a safe space for the parents to open up, confide and share advice. provide information & facilitate discussions regarding important & relevant topics associated with parenting a young person with Type 1 Diabetes, such as transitioning to independence, parent-child relationship & stress management.

5. Methodology Qualitative study- The parent’s expectations of the group, current struggles, improvement in Diabetes care or parent/child relationship post group? Pre and post- group questionnaires 12 participants of pre-group survey 3 drop outs, therefore 9 post-group surveys Social Constructivist Paradigm used for surveys- parents views of their world Interpretivist Paradigm used to evaluate the feedback

6. Findings Expectations of the group and what they learned: • Pre: • Meet others with similar challenges and worries for child • Tips and insights in relation to parenting • Post: • Suggestion of a longer or ongoing support group • Found topics useful. • Would have liked more discussion time • Group met their expectations

7. Findings Worries and challenges identified: • Pre: • Good Diabetes Management • Teens becoming more independent in their management • Couldn’t identify anything they were doing well in relation to Diabetes management • Post: • Feel more confident to support their child to become more independent in their Diabetes care

8. Findings Sources of support: • Pre: • 8 out of 12 respondents did not know anyone else with Type One Diabetes prior to the group • 9 out of the 12 could identify the Diabetes team or friends and family as sources of support. • 3 could not identify any sources of support. • Post: • Felt they weren’t alone • WhatsApp group was beneficial to support each other between groups

9. Findings Stress: • Pre: • Diabetes Management • General teen related issues • Work/family balance • MH/bereavement • Post: • 2 respondents implemented the stress management techniques learned in the group.

10. Conclusion • The group provided an informal support network that they did not previously have outside of the family • The parents decided to maintain contact post group • They participated in experiential learning which they reported was beneficial • They expressed feeling comfort in knowing other families have similar struggles • They noted that they had learned the importance of supporting the young person to safely transition to independent Diabetes management • From the feedback the group appears to have met the aims set out at the beginning • The parents felt they would benefit from a longer group (8-12 weeks)

11. Quotes “Some of the challenges are getting them to understand the importance of checking their sugars on a regular basis and taking control over their condition” “I talk more to my son about giving him more freedom and independence” “Probably extend the group to 8 weeks. The group was still at forming stage… so the extra 2 weeks would add more value. I would also like more in depth detail on how to transition to life in college and get students who have gone through it to come in and speak.” “I think most of the parents were very honest about their feelings and about how difficult it can be to be a diabetes parent because there was a relaxed and easy atmosphere” “I learned that as parents we all have the same worries, thoughts and concerns about our child with Diabetes. I am not alone.”

12. Outcomes 6 groups in total 7th in September Now meeting needs of teens transitioning to first year Parents group now has more elements of Art therapy in it while still offering psychoeducational sessions re parenting, stress, transition etc. Teen clinic has developed as a result Transition to adult services more efficient and safer Each group is audited- once as a Master thesis for UCC MSW student Findings continue to be positive- meeting others, exploring feelings and experiences. Plan to create a programme to be rolled out in the new children’s hospital

13. Acknowledgements:Dr Ciara McDonnell, Paediatric Consultant Endocrinologist, CHI at TallaghtProf Edna Roche, Paediatric Consultant Endocrinologist, CHI at TallaghtDr Claire Crowe, Senior Clinical Psychologist, CHI at TallaghtAimee O’Neill, Art Therapist, CHI at TallaghtBrenda Mehigan, Head of Medical Social Work, Tallaght University HospitalJean Roulston, Paediatric Social Work Team Leader, CHI at Tallaght

14. Questions? Social Work Department Children’s Health Ireland at Tallaght 01- 4142462 helen.obyrne@tuh.ie