Interview with Belén Tarrat, psychologist

Belén Tarrat
Belén Tarrat (© Private)

We know that in your daily work with children with congenital heart disease, you give a lot of importance to education. Why is education so important?

School is one of the most important places for children, because during their childhood it is the place where they spend a long time, more than they do at home. That is why the school has to be prepared when a special situation arises with some children, a situation making them different from the other pupils, for example when a child has congenital heart disease.

Can you describe in more detail the difficulties for children with congenital heart disease?

The main problem for children with congenital heart disease is school absence because of long-term admission to hospital. Absenteeism is a difficult situation for parents and teachers, which needs to be handled carefully to minimise the harmful effect on the child. When children are admitted to hospital, many parents push the school into the background. They are worried about the surgery, hoping that everything goes well and for their child’s recovery. Nobody tells them that, as part of the recovery process, the child needs to be connected to daily life. If we think about the case of adults that have to face a serious illness, most decide to work during the long treatments because it keeps them occupied and helps them to continue fighting. Why do we not see it in a similar way for children? Sometimes a parent might say: “No problem if my child loses 1 school year, he will make it up in the future”. However, when a child loses a year of school, he also leaves behind his friends. This situation can cause him a slower school development and can affect his mood. To deal with this situation, the child needs support from the school and from the hospital-based school.

Do you think that schools are prepared to face this situation?

Many schools are not prepared. Many details have to be considered: first, the family; second, the curricula adaptation, the class training, the communication with the child’s colleagues, the coordination with hospital school, etc.  In many cases, the parents are afraid of rejection and they avoid providing information to the school. As a psychologist, I act as an intermediary between parents and school, so that the communication will be more fluid.

Besides school absence, what other problems are frequent in the school environment for children with congenital heart disease and what are the repercussions?

The other important problem in children with this disorder is discrimination, which is generated mainly in specific activities, such as sport activities. Some teachers put excessive restrictions on children with congenital heart disease when they practise physical activities because of fear or ignorance, which has an effect on the self-esteem of the child and on the relationship with his or her classmates. In this case, the parents should talk with the physical-education teacher so that the child can develop physical activity while under supervision, but without feeling different from the other children, because difference can create an added problem of social integration.

Have you detected other school problems in children and teenagers with congenital heart disease who you have treated?

In the first school years, the main problems, in addition to school absence, are the conflicts caused by hyperactivity and lack of attention, and problems related to behaviour. For teenagers, the main difficulties at school are caused by lack of motivation and challenging behaviour. Problems of social integration and school failure can also occur in children and teenagers with congenital heart disease.

Are these problems more frequent in children and teenagers with congenital heart disease than in healthy children?

Although we cannot confirm that these problems are more frequent in children and teenagers affected by congenital heart disease than in others, we do know that school absence and discrimination have a direct effect in the appearance of these problems, mainly in difficulties that are related to the lack of motivation and social integration.

How can these problems affect the child’s future educational and employment prospects?

School problems in children and teenagers with congenital heart disease can be resolved. Thus, everybody who is involved (family, school teachers, classmates and hospital-based teachers) should work to prevent these problems, to detect them and to treat them in an appropriate and effective way, so that the children can lead a normal life and have no difficulties in their employment prospects.

What message would you send to the people involved in the school success of a child with congenital heart disease?

Parents, doctors and teachers have to be conscious that, although the child is not at school, he has to study and pass the course, since his psychological health will depend on how well his education proceeds. Importantly, parents and teachers should not overprotect the child. Many times, education is conditioned by the critical medical situations that the child has faced, which affects the attitude of the parents. The parents are sometimes more permissive with some things, such as school duties, than they are with others that they are more afraid of. For example, parents are more frightened and worried when their teenage child goes out to the disco than when they have bad results in school. I believe that the success of school development in children with congenital heart disease depends on parents’ attitude. It is important to analyse how parents inform the school representatives about the child’s illness, the self-confidence that they transmit to the teachers, the school duties that they demand to their children and the amount of protection that they give to them.

About Belén Tarrat

Belén Tarrat has studied Psychology in the Complutense University of Madrid (Spain) and has completed a Masters degree in Psycho-Oncology at the same centre. Additionally, she has done several courses related to interventions for children and patients with serious diseases. Her involvement as a volunteer and professional in non-lucrative organisations has been constant. She has worked in different hospitals in the service of paediatric hemato-oncology and with children at risk with the Tomillo Foundation. Since April 2007, Belén Tarrat has been working as psychologist in Menudos Corazones Foundation, where she makes psychological interventions for children with congenital heart disease and their family. She also gives courses and talks as a professional psychologist.

Author(s): Montse Mireles
Last updated: 2008-09-22

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