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Parenting Success... Initial Stages of Diagnosis and Beyond
structure and parenting with type 1 diabetes
This is part of the series Parenting Success: Seven Steps to Navigating the Initial Stages of Diabetes and Beyond (by Michael Watts, Assistant Professor at Mount Royal University and former Medical Social Worker at the Alberta Children's Hospital).
If you have not done so already, we suggest reading the following as background information:
Introduction to the Seven Steps of Parenting Success
Step 1: Respect

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 arranged or put together by the parents and members of the family.

When working with families, I routinely assess the structure, or family environment. Is the environment warm, supportive and caring? Warm, supportive and caring are all protective factors for consistent and proper diabetes management. Is the environment cold, harsh, accusatory and divided?  The diabetes literature speaks of the myriad risks associated with cold, harsh, accusatory and divided environments (Schafer, McCaul & Glasgow, 1986), and the risks include complications related to poor glycemic control, mental and emotional health issues and unhealthy family relationships.  

I understand and am sensitive to the multiple reasons why some families have cold, harsh, accusatory and divided environments.  My daily work includes validating, normalizing and empowering families (subject to these environments) to improve their environments with the hopes of maximizing the family’s sense of togetherness. I encourage such families to think of ways to use the diagnosis as an opportunity to evaluate and improve the family environment.  Steps towards improving the environment can be as simple as everyone identifying one realistic thing he or she can commit to in order to improve the environment.  Having weekly family meetings to evaluate family member’s progress towards improving the environment provides family ownership over the positive direction the family is aiming for.  
It is important for the leaders of the family (usually the parents or other care givers) to create a structure which provides opportunities for the child or adolescent to feel safe and supported as he navigates the initial stages of adjustment and beyond.  A great way to build a healthy structure within the home is to meet as a family and identify what you do well collectively as a group, and what you could work on collectively as a group to improve the environment. For parents who feel they have lost a sense of purpose as a parent caring for a child with diabetes, I remind them that part of their purpose (as parents) is to continue to strive towards creating the most optimal familial structure so that their child can thrive mentally, emotionally and physically.   


Next...  Step 3: Expectations

Any questions? Comments? Feel free to Contact Us.

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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