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Parenting Success... Initial Stages of Diagnosis and Beyond

Michael Watts, MSW, RSWParenting Success with type 1 diabetes
Medical Social Worker: (formerly, Diabetes and Endocrine Clinics, Alberta Children's Hospital)
Assistant Professor: Mount Royal University

Please note: The term child will be used throughout this article to reference children and adolescents of all ages.
It is well documented in diabetes literature that the initial adjustment period of caring for a child with type 1 diabetes is challenging (Kovacs, Goldston, Obrosky, et al. 1997). The challenges for parents include navigating the day-to-day practical, mental and emotional issues related to caring for a child with diabetes.

My experiences in the Diabetes Clinic at the Alberta Children’s Hospital include working with parents who, in addition to their own adjustment process, periodically find themselves ‘owning’ the unpleasant emotions their child presents with when the child is experiencing moments in which he is struggling with living with diabetes.

For example, a parent may be having a wonderful day however as soon as the child (who has had a diabetes-related frustrating day at school) returns home he presents as frustrated, anxious, agitated, confused and closed-ended.  The parent makes several attempts to try and figure out what the child’s issues are, however each attempt is futile.

The parent’s earlier experience of having a wonderful day is now interrupted with a personal level of frustration, anxiety, agitation and confusion. The process plays itself out over and over, until similar types of episodes become a regular part of the family’s week.  As time goes on the pattern is not addressed, and family members become susceptible to creating unpleasant communication and emotional climates within the home, as they relate to diabetes management and care.

The aforementioned scenario is a process the communication literature refers to as Emotional Contagion.  Emotional contagion is the process by which emotions, either positive or negative, are transferred from one person to another (Alder, Proctor III, Towne & Rolls, 2008).

I work with parents of the newly-diagnosed who often experience (negative) emotional contagion influenced by their child or adolescent.  The dynamic creates an ongoing atmosphere in which general diabetes-related expectations (e.g. communication about, actual management) are both perceived and experienced as unpleasant events for everyone involved.

In my experience, when diabetes tasks become perpetually unpleasant for all involved, families are at risk of not consistently applying best self-care practices which have previously assisted them with managing the condition on a day to day basis. Furthermore, relationships are jeopardized, parents’ patience runs low and parents are at risk of losing a sense of purpose as a parent caring for a child with a chronic illness.  

To assist parents who feel the relationship with their child is periodically overshadowed by conflict related to diabetes management, who feel as though their patience is running low, or who often feel a loss of purpose as a parent caring for a child with diabetes, I have come up with seven steps which I believe help to preserve relationships, patience and purpose during the initial stages of diagnosis and beyond.

Seven Steps to Navigating the Initial Stages of Diabetes and Beyond

Step 1: Respect

Every child must be respected! In my experiences, a child will typically respect his parents to the degree the... (Read more)

Step 2: Structure

Structure is generally defined as the way things are arranged, or put together.  In the context of family, structure includes the type of environment... (Read more)

Step 3: Expectations

During a recent trip to the United States, an Immigration Officer asked me what it was I did for a living, and I replied that I’m a therapist and a professor.  The officer then asked me “what do you profess?” and I said, “I profess the expectation that every child...” (Read more)

Step 4: Boundaries

Many of the families I work with struggle with boundaries – especially families with teenagers. In my experiences, the primary reason for this struggle is... (Read more)

Step 5: Discipline

Discipline is synonymous with teaching.  When a child displays a pattern of making unwise decisions, it is the job of the parent to... (Read more)

Step 6: Follow-Through &

Step 7: Consistency

I often use the metaphor that a family is like a successful sports team. In the history of sport, the perennial championship teams have one thing in common... (Read more)


Adler, R.B., Proctor III, R.F., Towne, N., & Rolls, J.A. (2008). Looking out, looking in. 3rd Ed. Canada: Thomson/Nelson    

Kovacs, M., Goldston, D., Obrosky, D.S., et al. (1997). Psychiatric disorders in youth with IDDM: Rates and risk factors. Diabetes Care, 20, 36-44

Schafer, L.C., McCaul, K.D., & Glasgow, R.E. (1986). Supportive and non-supportive family behaviors: Relationships to adherence and metabolic control in persons with type 1 diabetes. Diabetes Care, 9, 179-185

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The above information was written by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.

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