It’s been a rough couple of months living through a pandemic, with little indication regarding if and when life will ever go back to “normal.” Explaining what “normal” looks like to children is difficult when there are no real answers. Anxiety in children is fueled by fear of the unknown which causes worry, stress and irritability.  

Even as the state continues to reopen and loosen restrictions, there are still so many questions about what’s next that we don’t have the answers to. 

Unfortunately, anxious children live in the world of “what–ifs.” What if school is different? What if I must wear a mask? What if I forget my mask? What if I won’t know anyone? What if I can’t go to Girl Scouts, or basketball or to summer camp? What if my parents get sick? What if I don’t want to go outside, to the beach or swimming? What will I do this summer if we can’t go anywhere? 

As parents, what can you do? 

Do Your Best to Answer Questions 

Answer the “what if” questions as best you can, using simple language and being honest about what you don’t know. Anxiety is typically about anticipating that something bad will happen. Children with anxiety need reassurance more than most other children. They are looking for an answer to quell the fear that keeps them up at night. If you don’t know the answer, it is OK to say that you don’t know, but that you and the important people in the child’s life are doing everything you can to make sure that they are safe wherever they are.  

Prepare Ahead of Time 

Children with anxiety like to be prepared. They want to anticipate every scenario. It may feel frustrating to you that they want to know for the sixth time if the school is safe, if desks are spaced apart, if teachers will wear masks, etc. Taking the time to have these conversations will go a long way toward reducing the fears that could potentially result in school refusal, tantrums, anxiety attacks or physical symptoms later.  

Brainstorm Answers to “What if” Questions 

Give them concrete examples of how they can respond to their “what if’s” on their own. For example, “what could you do if you have to wear a mask and you forget it at home?” Have them brainstorm ahead of time about what they would do in this situation; keep an extra mask in their backpack, tell their teacher, go to the nurse, etc. This is a way to turn a “worry thought” into a “positive thought” by creating a plan of action. 

Avoid Avoidance

Children who are anxious want to avoid situations that are scary or triggering for them. Allowing them to avoid these situations reinforces that the way to deal with their anxiety is to hide from it. You can help soothe their fears by taking small steps toward the feared situation, instead of running from it. 

Build a Coping Kit 

Help your child build a “coping kit” of tools that will work for them when they feel anxious. Some children like having a stress ball or fidget toy handy. Others like to practice deep breathing and yoga or put on headphones and listen to distracting music under a weighted blanket. Still others prefer to work with their hands – to draw, make a bracelet, knit, or build something. You and your child know best the tools that will help to calm them, and it is important that your child have access to those tools before their anxiety takes over. 

Debrief 

After your child has tried different coping tools, ask them what worked, and why, or alternatively, what didn’t work, and why not? Ongoing practice and reinforcement of these tools will allow them to access these coping skills when needed. Sometimes a skill works for a specific fear, but not for something else, so adjusting and problem solving is the best way to create lasting change. As with any skill, managing anxiety takes practice. 

Finally, do your best to manage your own anxiety around your children. You may be dealing with your own job changes, financial issues, childcare concerns, etc., but ideally it is best to keep those concerns among the adults. 

Mobile apps can also be a way to help quell anxiety, especially for preteens and teens who are rarely without their phones. 

For young children: 

• Breathe, Think Do, by Sesame Street 
• Stop Breathe and Think 
• Breathing Bubbles 
• Positive Penguins
  

For older youth: 

• Calm 
• Dreamy Kid 
• Smiling Mind 
• Take a Chill 

If you need immediate help – If you or your child need to see a counselor, contact the Behavioral Health Partners of MetroWest at (844) 528-6800. Telehealth services can be set up until in-person services resume. 

Lauren Barry, Ph.D., is a counseling psychologist who has provided treatment to children and adolescents at Wayside for over 20 years.

The post Parenting Children With Anxiety During COVID-19 appeared first on Wayside Youth & Family Support Network.

When most people think of Post-Traumatic Stress Disorder (PTSD) they likely picture an adult who has been in combat, a serious accident or experienced violence. Children can also have PTSD either from experiencing trauma directly or witnessing it. Childhood trauma can be from a specific event like a car accident or dog bite, but it can also include witnessing domestic violence or enduring neglect or abuse.

Children diagnosed with PTSD are more likely to react strongly to change in their life, to have more trouble managing their emotions and to have less ability to tolerate the disruption and unpredictability. On top of that, these children are significantly affected by the loss of their routine and social connections.

As you might imagine, COVID-19 is not helping.

Research has shown that traumatic experiences impact the developing brain. New fears can develop and old triggers for children can reappear or be exacerbated by the current pandemic.

Children who have been diagnosed with PTSD typically exhibit symptoms that fall into four main categories:

• Body – headaches, stomach aches, sleep problems
• Brain – thinking, concentrating, memory problems
• Emotions – feeling unsafe, having trust and attachment issues, always on edge, having trouble expressing feelings, low self esteem
• Behavior – overly reactive, irritable, aggression, difficulty with impulse control

What can you do as a parent to lessen trauma when it feels as though it’s all around us?

Five Things You Can Do:

1. Respond calmly. Parents who are calm reduce the tendency for children with PTSD to overreact with emotions or behavior. It is important to remember that your child is not a “bad kid,” but that bad things happened to them.
2. Help your child stay in the present which will make it easier for them to concentrate and manage their everyday life. There’s a popular and effective method we use at Wayside, where PTSD is the third most common reason families seek mental health treatment for their children, called the 5, 4, 3, 2, 1 Five Senses Grounding Technique. The technique is designed to help children calm themselves when their fears start to take over. It begins by your child taking a deep breath and looking for five things around them (saying them out loud), four things they can touch or feel, three things they can hear, two things they can smell and one thing they can taste. They then take another deep breath to finish the exercise. This can calm their body’s physiological fear responses as well as distract them from their anxious thoughts.
3. Talk to your child about what triggers their PTSD and plan ways they can calm themselves when they become anxious. Children with PTSD react with a “fight or flight” response, even when that is no longer helpful or necessary. Being aware of the specific triggers – sounds, smells and emotions can help minimize PTSD symptoms. Write down your child’s triggers on one side of a paper and specific solutions or distractions on the other side. For a child who was bitten by a dog for example, the trigger might be the sound of a dog barking or seeing a dog outside. They might need to know that you are close by, need to see the size of the dog or to be distracted by music or a movie. Reading stories about dogs or looking at puppy videos might help them feel less fearful of dogs.
4. Keep your child occupied with hobbies or things that will keep their mind busy. Try having them write in a journal or use breathing techniques until the feelings of panic pass. Some children want to talk things through, while others just need a quiet place to read a book or watch a movie. When they find a coping strategy that works for them, encourage them to use it again. If it didn’t work, come up with a different strategy so they feel more in control over their fears.
5. Try using mobile apps. There are family-friendly apps designed specifically for managing symptoms of PTSD including:

If your child is not currently in treatment but is exhibiting symptoms of PTSD and needs professional help, you can contact the Behavioral Health Partners of MetroWest at (844) 528-6800.

Lauren Barry, Ph.D. is a Counseling Psychologist who has provided treatment to children and adolescents at Wayside for over 20 years.

The post Parenting Children With PTSD During COVID-19 appeared first on Wayside Youth & Family Support Network.

For children who struggle with mental health issues, being at home during COVID-19 normalizes many of the behaviors that are generally warning signs for depression – staying in bed all day, not showering or getting dressed and lack of interest in activities. It’s understandable given the current circumstances that your child may want to wear pajamas and stay in their room all day, but children with depression can quickly slip into a black hole if this behavior continues for days or weeks.

Children with mood disorders like depression have a harder time being quarantined, especially teens who rely heavily on social interaction and peer support. It’s important that your child continues to take prescribed medications and schedules “visits” with their provider via Telehealth or by phone.

To help your child stay mentally healthy, you can work with them on coping strategies that will help improve their mood. One technique, called “behavioral activation,” decreases isolation by increasing positive activities. Parents can work with children by identifying small, daily goals and rewarding their child when goals are achieved.

Let your child decide what goals they want to set and activities to do at home. Depending on the level of depression, it may be as simple as taking the dog for a walk, baking cookies or playing a video game with a sibling. Ideally, you want to work with your child each day, to plan activities that will include basic hygiene, movement, using their brain (ideally by participating in remote learning) and some type of social connection.

If your child is not currently in treatment but seems to be exhibiting the symptoms of depression including sadness, irritability, lack of motivation, sleeping problems, appetite changes, concentration issues or feelings of hopelessness, check in with them about how they’re feeling. Focus on listening.  You can’t fix the situation, but you can be compassionate and listen to their perspective.  If it seems that they need professional help, you can contact the Behavioral Health Partners of MetroWest at (844) 528-6800.

If you are concerned that your child is experiencing thoughts of suicide (they are exhibiting the symptoms above and are also talking about wanting to die, they are giving away possessions, they are writing or drawing images of death, they are withdrawing from you and from contact with friends, their personality changes drastically, they are agitated and feel out of control), contact the Mobile Crisis Intervention program in your area by calling 877 382-1609 or on-line at www.masspartnership.com/member/esp

At Wayside, a large percentage of the children and adolescents we work with are diagnosed with some type of mood disorder. Our counselors work with the youth and their families through outpatient and/or in-home therapy to improve their mood and return them to their typical level of functioning.

There are also some great apps that can help boost your child’s mood. Here are a few:

• Daylio – A mood tracker that involves tracking and journaling.
• Happify – games designed to improve mood.
• Pacifica – a mindfulness program for teens.
• Virtual Hope Box – ways to focus on hopefulness.
• What’s Up – A mental health app that designed to practice coping skills. Ages 4+
• Calm Harm – an app for teens to help manage thoughts of self-harm.
• A Part of Me – A game that helps children cope with the loss of a of a parent, loved one or someone close to them. Ages 11+
• My gratitude journal – A journal that encourages users to list five things they’re grateful for using text, photos and emojis. Ages 10+

Lauren Barry, Ph.D., is a counseling psychologist who has provided treatment to children and adolescents at Wayside for over 20 years.

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