Friday, April 19, 2013

MGH expert: How to talk to kids in wake of attacks

Gene Beresin, MD, director of Child and Adolescent Psychiatry Residency Training at the MGH and director of the MGH Center for Mental Health and Media, shares advice on how to talk to children after the Boston Marathon explosion incident.

For children of all ages:
Children need to have answers to three fundamental questions:

• Am I safe?
• Are you, the people who take care of me, safe?
• How will these events affect my daily life?

It’s important to provide answers to these questions, even if your children don’t put them into words. You should expect to answer these questions several times over the next few days and perhaps longer. Keeping as normal a schedule as possible will help reassure your children as well.

Children will be very upset at the images of mourning friends and family members. Often this will make them concerned about the safety of their own family and other loved ones. It’s important to reassure children that you’re doing everything you can to stay safe so that you can take care of them. Share your feelings with your children. Let them know that it’s OK to be frightened or sad or angry – that’s part of being human.

While you should try to answer your children’s questions at a level they can understand, remember that you don’t have to have an immediate answer for everything. Some questions don’t have any good answers. Right now we do not know why this happened or who did it. No one has these answers.

Infants, toddlers and preschoolers:
Very young children are more disturbed by their parents’ and caregivers’ distress than by the actual events. That is why they are comforted more by your actions than your words.

Expect young children to regress emotionally a bit. They may become clinging or whiny, and have difficulty sleeping. The more patient and reassuring you are, the more quickly this will pass. Much of their reactions will be in response to seeing that you are upset.

Spend extra time hugging and cuddling with your child. This will reassure both of you. Your child may want to sleep in your bed. That’s OK, especially at times like this.

School-age children:
Encourage your school-age children to share their feelings and concerns with you. Reports of people being taken to the hospitals may frighten them, even though they may be afraid or embarrassed to admit it. Let them know that it is all right for them to be upset, and that you’ll do everything you can to protect them from harm.

Remember that children often work through emotional issues with play instead of words. Don’t be surprised if your children use toys to replay the images of destruction that they’ve seen or imagined. This is healthy. It can also give you insights into their fears and misunderstandings.

If your children’s play seems “stuck” in one scenario – they repeat the same event over and over – offer some suggestions for change. Even something as simple as, “Maybe the rescue workers can use shovels to help the people escape,” can allow children to come to terms with their fears.

If your children are watching or listening to news reports of the aftermath, be in the room so that you can answer questions and clarify things. Let younger children know that even though they’ve seen TV images of explosions dozens of times over many days, they each happened only once and on one day. The marathon was only run once and it is over.

Expect your children to ask the same questions several times. Be patient. Remember that by asking the questions, they’re telling you that they trust you.

Remind your children that there are many, many more good people in the world than there are bad people, and that the good people will try to take care of them and protect them.

Many adolescents are scared. They may know others who went to the marathon and some even planned to be at the finish line. They wonder what this means for the safety of others, including parents who work, go to school and live in Boston. They’re also struggling with questions about justice, power, and control – issues that have been in the news since the Sandy Hook shooting, and even more in the recent debates about gun control.

Let your teenagers listen in as you discuss both events and feelings with other adults. If they join in, welcome their participation even if you disagree with what they’re saying. Simply talking will help them to put their concerns into perspective.

Be with them when they watch TV news reports of the aftermath. Comment on what you’re seeing and listen openly to their comments as well.

Sometimes it’s easier for teens to talk about disturbing things if they don’t have to look you in the face. That’s why some of the best discussions take place while you’re doing something else, such as playing a game, driving in the car, or doing household chores. Share your feelings with them. This gives adolescents permission to do the same with you.

Most children will cope with the support and understanding of their parents, teachers, coaches, friends and clergy. Some who may be vulnerable because of previous personal experiences may need special attention from a school counselor or family pediatrician.

Read more articles from the 04/19/13 Hotline issue.

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