Emotional and psychological support

Students returning to school after a spinal cord injury will need support in all elements of education – learning, social, extracurricular, career planning and more. For a child or young person to be appropriately and fully included, as is their right, schools should recognise and offer this multi-faceted need for support. This section covers emotional, psychological, relationship and sexuality support.

“The school could have been more understanding of the emotional impact that it had on our son. He went off the rails a bit as he lost confidence in the system and was frustrated. It was a bit of knock for him and his anxiety could have been recognised by the school better, even though it was a few months after the operation they could have been more supportive.”

Janet, mum of son aged 17

When developing relevant and appropriate support for a child or young person with spinal cord injury, consider the same aims and outcomes you would use for any child or young person. Think about the bigger aims related to learning – both academically and socially – but recognise that you may need to make extra adjustments to achieve the outcomes. It is important that any plan be age appropriate and developed with the particular child or young person at its centre.

Children or young people with a spinal cord injury will inevitably experience psychological and emotional adjustment alongside changes in their body. These adjustments may be short-lived or recurring and will change as they interact with the significant development processes that occur naturally at these ages.
If you are a child and young person and want to find out where you can get support for coping with your emotions, visit our section 4 d

“As [children and young people with an SCI] are growing and developing, they are going through normal developmental patterns and on top of that they’ve got to negotiate their injury. From a psychological point of view, new issues might arise at different stages. There is a need to review both physical and emotional issues along the way as individuals go through different developmental stages.”

Zoe Chevalier, Clinical Psychologist, National Spinal Injuries Centre, Stoke Mandeville Hospital

However, despite facing significant trauma, research shows that people with a spinal cord injury are resilient and go on to have positive outcomes.

“None of this has been easy for our son. That said positive messages, examples and support all contribute to making the life of a young man far more manageable. He does not think of the problem that he faces, but is driven with an ambition to do things, get about, run his own affairs and to carry on as normal. These aspirations are supported by Back Up and assist us in reinforcing the positive in his mind, and also the minds of those with whom he comes into contact. I believe that Back Up’ schools and families inclusion service is extremely important for those youths who suffer injury early in their lives, as it reminds us all that life goes on, and that spinally injured individuals continue to have ambition and desires in life, and that they should not be treated differently from others.”

Parent of son aged 17

While in hospital, children or young people with a spinal cord injury will have access to a Clinical Psychologist who will meet with them and their families to see how they are coping. They may be referred to a mental health specialist in the community if there is seen to be a clinical need, but this is relatively rare.

“At Stoke Mandeville, we have a strong research and clinical background, and from that are able to say that most people adjust and cope really well in the long term and do go on to do really well and get back to school and education and create relationships. This is a really important message to get across. It’s not the norm that people with spinal cord injuries have long term psychological trauma and difficulty. It’s more normal to cope and make adjustments.”

Zoe Chevalier, Clinical Psychologist, National Spinal Injuries Centre, Stoke Mandeville Hospital

Children and young people who have a spinal cord injury may feel reluctant to return to school or engage with anything that reminds them of their impairment. Offering emotional or psychological support, as well as being sensitive to their situation, are some strategies to address this.

Research has shown that re-connection to their communities and social networks are linked to more positive outcomes and adjustments for children and young people with a spinal cord injury. Recognising the critical importance of peer support and of maintaining friendships is key.

“In terms of friendships, that has been the most difficult area, trying hard to encourage situations where her friends can take on role of helping A. eat. We want to leave her to her friends when she can socialise. I want the 6th form to really be the time when she spends more time with friends away from adults, and becomes a more independent learner.”

SENCO, Gloucestershire

Assistance that schools can provide in this area will be beneficial, especially during the teenage years.

“One of the main messages we want to give is that we know from research that people with spinal cord injuries who do better in the longer term are people who are able to participate in social and community activities, like being included in school, hobbies, or sports. If children or young people are able to be connected and participate in their communities, go back to studies, have support regarding their career options, and go out with friends, they will do better in the longer term.”

Zoe Chevalier, Clinical Psychologist, National Spinal Injuries Centre, Stoke Mandeville Hospital

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