Exploring the Experiences of Fathers of Children with a Visible Facial Difference

Abstract

This study examined the experiences of fathers of children with a congenital visible facial difference (CVFD), focussing on cleft lip with/without palate (CLP). The face plays a central role in self-concept and social existence for humans and holds vast cultural significance. However, research has been slow to go beyond individual and address the significant wider impacts on the family. Fathers have been particularly neglected. This is surprising given the wealth of evidence regarding the important direct and indirect influences fathers have on child development. This study aimed to explore how men experience fatherhood in relation to having a child with CLP, their perceived roles within the family and their experiences of support. The study employed a qualitative methodology. Participants were recruited via a national charity and via Twitter. Individual, semi-structured interviews were conducted with eight fathers of children (under the age of ten) with CLP. The data were analysed using Interpretative Phenomenological Analysis, generating three super-ordinate themes: ‘Loss of the perfect child’; ‘The power of ‘normality’; and ‘The expectations and roles of fathers’. Participants faced challenges in managing intense and conflicting emotions, with societal and personal conceptualisations of difference having a significant influence. They emphasised their roles as protector and supporter, highlighting the implications of successfully fulfilling these or not. Feeling excluded, insignificant and undersupported were prevalent issues. Support was derived from partners, and selfmanagement strategies (e.g. avoidance, focussing on practicalities) were identified. Unexpected (mainly positive) outcomes of CLP were also acknowledged. The findings are discussed in relation to the literature on the lived experiences of fathers of children with CLP, other CVFDs and other conditions where relevant. Implications for future research and clinical practice are considered, e.g. taking an actively inclusive approach with fathers, and offering opportunities to speak with a psychologist away from the multidisciplinary team spotlight

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