title: The role of the psychologist as a member of the cleft and craniofacial team in looking after patients and their families from the perspective of the literature and clinical experience.
abstract: The aim of the paper is to present the psychological situation of the family of a child with a craniofacial condition, as well as to describe the role of the psychologist in the therapeutic process. The perspective of the paper is based on both the author's clinical experience and a review of the literature. The paper adopted the parents' perspective and is therefore focused on their experiences concerning the diagnosis of the congenital craniofacial malformation. The author made an attempt to define what comprises a problem for parents and identify how their difficulties may influence the child's psychological development. Attention was devoted to challenges stemming from the unknown etiology of the malformation, difficulties in accepting and conducting the multistage treatment, changes in the look of the face, and the broadly considered imperfection. In the review of the literature, particular attention was drawn to identifying the risk factors for psychological development disorders associated with the cleft condition, as well as factors concerning the risk of the disorder influencing the parent-child relationship. It was concluded that the quality of that relationship may be influenced by the psychological state of the parents. Relying upon both the literature and own research results, it was established that the parents' psychological situation can be classified as atrauma. Its significance for the parent-child relationship was identified - especially in reference to parental sensitivity to the child's needs and their ability to support the child. The parent-child relationship may be meaningful for the child's psychological development - especially his or her emotions, self-esteem, and perception of the world. The basic idea was that the parents experience a period of mourning over the imagined "ideal" child, going through which is crucial for them to adapt to their role of parenting a disfigured one. Adjusting to the requirements of the situation, i.e. involvement in treatment, is also among the key challenges. Developing some coping strategies in the parents, as well as introducing certain therapeutic interventions, is of high importance in this process of adjustment. Some fields of psychological work - which are most useful for the parents' sense of competence are also pointed out in the article.
authors.affiliation: Instytut Matki i Dziecka, Kasprzaka 17a, 01-211 Warszawa, Poland, kinga.dutkiewicz@imid.med.pl.
authors.forename: Kinga
authors.initials: K
authors.lastname: Dutkiewicz-Częścik