Rehabilitating families with burned children.

A critical factor in the successful or unsuccessful life adjustment of the badly burned patient is his family's reaction to this chronic problem, its ability to support him, and to help him pursue the long course of treatment and its many associated problems, and to also help him navigate the social world into which he must go. The high incidence of emotional disturbance in families sustaining burn injuries makes it vital to deal effectively and in a sustained manner to assess the types of emotional disturbances which exist in these families and to see how they influence the responses to the injuries and to the long and arduous treatments that follow. Different patterns of adaptation occur, some much related to economic class and special types of psychiatric disorder in the family. Some reactions of chronic grief and intermittent helplessness and hopelessness may transcent all groups, but the ability to follow through in later care varies enormously, and is correlated with the overt depression of the mother. Several types of reaction are epitomized in the cases presented, along with directives for their management, and the interplay of social, somatic, and psychological factors which lead to these patterns will be delineated.