From Drs. Murrell and Balentine (the Amy’s):
Coronavirus (COVID-19) can cause disruptions in physical health, but it also changes the everyday lives of children, teens, and parents. Youth’s school experiences and the routines they have with their parents are interrupted. Social distancing has affected their friendships. Some young people have lost even their basic securities, like food, shelter, and physical safety. All of these changes have a great impact on families. Children may seek more attention than usual. Teens may complain of boredom. Youth of all ages may act out, or they may become anxious, sad, or physically affected. Many are experiencing signs of trauma such as night terrors and intrusive thoughts. Parents, too, who are having to juggle brand new responsibilities are experiencing confusion, stress, guilt, and trauma. You are not alone.
Build on strengths
The good news is that we know how to promote resilience in times just like this one. Catching children in the moments when they are being good and giving them specific labeled praise makes them more likely to behave well in the future. This sounds like, “Morgan, I see you put your toys away. Great job. Thank you!” In addition, being at home more allows caregivers to use their children’s strengths to build upon. This is especially important for increasing social skills and empathy. For example, let’s say a child does an excellent job imitating their sibling. A caregiver could use that imitation as the first step in a perspective taking task in which the child now making the face and body postures that their sibling made can identify how that feels to them, and thus give it a label, and then state that their sibling was likely feeling consistent with that same feeling too.
Empower through education
During times of stress, providing developmentally appropriate information about current events is important. Teaching children the basic information about the virus (e.g., that you can give it to or catch it from other people or from things that other people have touched, coughed or sneezed on, and that it will affect the way you breathe if you catch it) and what they need to do to protect themselves and others (i.e., stay at least six feet away, wash their hands with soap and warm water for at least 20 seconds, cough and sneeze into their elbow, and wear a mask) is empowerment.
Healthy routines
Parents can emphasize routine healthy eating, sleeping, exercise, and school times. Having a schedule for these activities is critical, as is explaining to youth what happens to their bodies when they have a lack of sleep and proper nutrition (e.g., attention and memory fade, irritability increases). As some parts of the schedule prior to the pandemic may not be available to families in the same way, it becomes important to fold “new normal” activities in the schedule. As examples, a grocery drop-off may need to be scheduled around a teen’s use of the front yard to have a socially-distanced meeting with friends.
Relate to thoughts and emotions in a new way
Finally, allowing children to fully experience and express their feelings is important. Caregivers can provide meaningful connections and, with some extra patience, help youth understand that all feelings are acceptable. This can be done through encouraging children to identify their feelings without needing to change or deny them. They can be encouraged to express them nonverbally as well, such as through art. Families may also want to read books together that validate the range of feelings, such as “The Way I Feel” (Cain, Parenting Press). It is important for youth to know that circumstances like pandemic isolation conditions – and their thoughts and feelings about such circumstances – are not permanent.
One exercise that might help them become aware of this impermanence is to think of themselves as the sky and of COVID-19 as a storm. Scary thoughts about whether they or their loved ones may get ill, or even die, and anxieties about missing school and the like are dark clouds and lightning. These can be very attention-getting, but eventually they do pass. The sky, however, remains. It is bigger than the storm, and it is constant.
A picture book that reflects this same theme with a different metaphor is I See Me: More Than One Tree (Murrell, illustrated by Connally, 2018, Shawnee Scientific Press). This book also includes several therapeutic exercises on seeing yourself as capable and greater than your experiences. Encouraging children and teens to identify their upsetting thoughts and draw them as the storm or journal about them, along with the feelings that accompany them, can be a helpful way to feel less engulfed by - and fused with - their inner experiences and connect with the more expansive sense of self that increases their resilience.
Another important distinction to help children develop and improve resilience is between problems that we can and cannot control. There are several clever ways to do this. One is to draw a circle and write problems inside that we can control and to label the outside of the circle with problems outside of our control. COVID-19 causing physical distance from friends is outside of a child’s control but asking their parents to do a video chat with a friend is within their control, as an example. Problems we can mold like clay are in our control, whereas problems we cannot readily change are like rocks. A really nice book that might accompany this conversation for a picture-book aged child is “What Do You Do With a Problem” (Yamada, Compendium, Inc.). Our minds try to convince us that everything is a problem to be solved, but really not all things are. Parents don’t need our minds to shout out complex solutions about us loving our children. We don’t need our minds to chatter at us about figuring out how to appreciate a beautiful baby, or sunset. Sometimes, we just need our minds to be quiet.
Mindfulness
There are a multitude of ways to quiet down loud minds and the problems they cause. Progressive muscle relaxation, breathing exercises, and mindful eating and stretching are all activities that can help with coronavirus-related anxiety. There are also a number of books and workbooks that offer mindfulness activities for children, adolescents, and parents. Additionally, Ana Gomez has created a free self-published, downloadable book called, “ The Story of the Oyster and the Butterfly: The Coronavirus and Me,” which empowers children to address their upsetting feelings through mindfulness activities and other self-regulation strategies.
Consider the use of puppets and props like action figures, bubbles, books, and construction paper to assist the discussion with young children. Puppets can have conversations about worries and bubbles can represent feelings floating away and/or sticking to your children, as examples. The family should ideally learn and practice these self-regulation skills together, to encourage youth to use these skills. By practicing together, parents will better regulate themselves and have a greater capacity to support their children and connect with them.
Parenting from a place of resilience
Even during a very chaotic time such as the COVID-19 pandemic, setting clear expectations and consequences for breaking rules is important - as is doing fun activities with children and teens such as putting together puzzles and playing board games. Perhaps most importantly, this type of parenting signals to youth that they are safe in your presence even when the world is very scary. Being a calm and reassuring presence to your children is one of a caregiver’s most important tasks at this time. However, when parents get overwhelmed it is also valuable to model how to cope with difficult emotions. “The Joy of Parenting” (Coyne & Murrell, New Harbinger) has some great tips.
Meeting teens where they are
It is important to recognize that developmentally, teens need to be supported in their process of individuation, as well as the opportunity to return to parents as a secure base as needed. Having to stay home in quarantine thwarts this developmental task, leading to frustration on the part of the teen and often conflict in the home. Finding ways to give teens increased space, time alone, as well as independence and time to connect with peers is vitally important. Teens increasingly turn to peers for connection, intimate relationships, and social norms. Finding safe ways to allow teens to connect in meaningful ways with peers is key to their emotional well-being. For some, virtual opportunities feel fulfilling while others continue to crave in person meetings and are left feeling lonely and disconnected by virtual meetings. Teens who are connected to both their community at large as well as to meaningful peer relationships are more resilient.
Preparing to reengage socially
As quarantine restrictions lift, it will be important to assess whether a child or teen needs support in reconnecting to peers, especially in face-to-face interactions. Especially for children with anxiety, they may need support in addressing their anxiety and discomfort with engaging others in person after having little in person interaction for months. They may need social skill support in the form of role playing and psychoeducation. They may need some of the other skills addressed elsewhere in this article, including calming the mind through meditation and relating to thoughts differently.
Reach out for support
As we transition back to our school and work lives as they were pre-COVID, mental health professionals and teachers can help parents to recognize the importance of the need for consistency of safe presence and attunement with children’s emotions. They can also help parents develop self-compassion in this stressful time. Do not be afraid - at any point - to consider reaching out. We are here.