Re-Developing Family Roles after a Traumatic Brain Injury

Brain Injury Blog 

Re-Developing Family Roles after a Traumatic Brain Injury

by Jessica Felix Jager, MSW/CBIS

According to Boeing, M., Barton, B., Zinsmeister, P., Brouwers, L. Trudel, T., Elias, E., and Weider, K. in their article Lifelong Living After TBI, the impact of a  Traumatic Brain Injury (TBI) can change every aspect of family roles across the life continuum (2010). Change like the seasons is inevitable. Change either becomes an opportunity or a threat to how life is lived and how circumstances are experienced (Boeing, M., et. Al, 2010).

Each family member plays an important role in the adjustment process after a loved one falls victim to a TBI. Rather than focusing on the loss of who the loved one was prior to the traumatic event, each member can help by discovering new interests and abilities that their loved one now attains. This will help the TBI survivor rebuild their self-image as they also learn who it is they now are.

Once a TBI survivor is released from intensive care, the family becomes the primary support system and often takes on many different roles to properly care for their loved one. Family members have found themselves as:




Case managers



Along with other roles as deemed necessary. In the family system when one member is sick another member typically picks up the slack to keep the family unit functioning as a whole. For example, if the mother of the family received a TBI and prior was the nurturer and provided the emotional needs of the family, after a TBI the oldest daughter may step up and take on that role until the mother can once again function in her role to that capacity.

Re-Developing roles within the family structure occurs many times without the family members defining it as so. Simply put, it just happens. More often than not, the family realizes it happened in hindsight. It is very important for a family to understand that re-developing roles will occur, and to be mindful of it so that each family member may maintain healthy boundaries throughout the transition.

The Social Work Dictionary has identified key terms used to define situations where healthy roles were not maintained. These terms are known as: Role Overload and Role Reversal. According to the Social Work Dictionary, Role Overload is defined as: a situation in which a person is expected to behave in many different, often conflicting, ways so that it is difficult to fulfill any of the expectations satisfactorily (Baker, 2003). Many caregivers struggle with role overload. Wives of Veterans that have come back from war with a TBI have reported feeling overloaded in their new roles as wife and caregiver.

According to the Social Work Dictionary, Role Reversal is defined as: a situation in which one person changes behaviors and begins to act in a way that is expected  of another person. For example, a father might begin to act childishly around his son, who in turn acts with more maturity around his father (Baker, 2003). Role reversal is more distinctly noted if the loved one that acquired a TBI is the mother or father of the family. Role reversal is not as common if a child of the family acquired the TBI.

To avoid role overload, role reversal or confusion among family roles, family members can take the time to intentionally re-develop roles within healthy boundaries. Roles will become re-defined one way or the other, but taking action prior will ensure a more positive outcome. Below are steps a family can take to re-develop health roles:

Re-Developing Healthy Roles 

◊ Define Clear Roles

Each family member must know and own their roles and responsibilities that go along with that role.

Types of Role Responsibilities:

  • Provider- Providers resources, money, food, shelter, necessities etc.
  • Nurturer/Supporter – Nurtures and supports other family members through comfort, encouragement, and being there for the member when most needed.
  • Life Skills Developer – Teaches necessary life skills on emotional, educational, physical and social development levels. Guides, instructs and advices in life issues such as choosing a career path, etc.
  • Family Decision Maker – Handles big family decisions, family finances, takes the leadership role.
  • Team Players – Often times in a healthy setting, the children need to just be the team players and go in the direction that the family is heading while they grow into adulthood. They can help take on everyday responsibilities such as helping with transporting each other around or cooking dinner occasionally or helping with chores and so on. However, the main key roles should still be predominately met by the parental roles of the family.

◊ Allow Room for Flexibility

Roles may change in times of crisis, so there needs to be room for flexibility so that the role that is  “out of commission” can be filled by another member. Depending on the situation it is sometimes necessary for other family members to take on additional roles.  

◊ Assign Roles Fairly

Every member should be responsible for fulfilling his or her specific role. Problems may arise if a family member is forced into a role they do not want to be in, so it is important that roles are distributed fairly and that each person understands and accepts their role. 

Take Responsibility in Fulfilling your Family Role

Families where each member takes his or her role seriously tend to be healthier. An example of a member not taking responsibility in her role is of a mother who does not provide adequate emotional support, which then causes the children to seek out and get that need met elsewhere among friends or peers.

It is clear that when a TBI happens to a loved one, it happens to the entire family. A strong family that becomes a united front to help their loved one reach optimal recovery produces greater results. Re-developing healthy roles after a TBI will help keep the family strong and will produce the level of support the TBI survivor needs to thrive.


Barker, R.L. (2003). The Social Work Dictionary (5th ed). Baltimore, MD: Port City Press.

Boeing, M., Barton, B., Zinsmeister, P., Brouwers, L. Trudel, T., Elias, E., and Weider,

  1. (2010). Lifelong living after TBI. Retrieved November, 14, 2011 from


November 23, 2011

3 responses to “Re-Developing Family Roles after a Traumatic Brain Injury”

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