Impact of medical trauma on the family:
When a child is ill or injured, the whole family can feel upset. Kids, teens and parents may feel stressed about different parts of the experience.
- Young children may feel scared about being alone in a hospital with strange sounds, smells, and people.
- Teens may feel upset about looking different or being separated from their friends and family.
- Parents may feel helpless when seeing their child in pain or may be scared that their child might die.
Traumatic stress symptoms in the aftermath of trauma are common and often temporary. They can include:
- Being easily upset, irritable, or uncooperative
- Feeling anxious or jumpy
- Feeling upset at trauma reminders
- Thinking constantly about the trauma (or trying not to think about it at all)
- Trouble concentrating or sleeping
- Being on the lookout for danger constantly
- Showing less interest in normal activities
Most children and families are able to cope with these stress reactions with information, support, and talking about their experience.
Read more about the signs and symptoms of traumatic stress or traumatic stress reactions by age group to find out how children and teens react.
AT THE HOSPITAL
How can I help my child at the hospital?
At the hospital, it is important to help your child feel safe. Try to stay calm and in control. Remember that your child looks to you to know what to feel and how to act. When you are unsure of what to tell your child, ask questions or advice of the doctors and nurses. In addition, here are some suggestions for helping your child:
Be ready to listen.Explain what is happening in an honest and simple way and encourage your child to ask questions. You can say:- "A lot has happened. Is there anything you're worried or confused about?"
- "It's ok to feel upset. When I feel upset, talking about it helps me feel better."
Be a coach for your child.Give lots of hugs and praise. Remind your child that lots of people are doing their best to help.
- Remember ways that your child has coped before with tough or scary times, and help them to use those coping skills
- Teach your child how to take deep breaths while counting
- Help your child tell an imaginary story
- Distract your child with books, puzzles, games, or music
Be patient. Changes in your child's behavior are common and most likely temporary. Your child may be struggling to cope with being ill or injured and the changes taking place. Try to be patient with small changes in behavior, like whining and clinging. In addition, you can:
- Suggest better ways to show feelings like talking, telling stories, or drawing
- Try to do some things at the same time each day (getting up; meals, TV, etc.) so that things are more predictable.
- Set limits on extreme behavior, as you would at home.
For more tips for parents, read:
General (English / Spanish):
- At the Hospital: Helping My Child Cope (General)
- En el hospital: Cómo ayudar a mi hijo a sobrellevar la situación
- At the Hospital: Helping My Teen Cope (General)
- En el hospital: Cómo ayudar a mi adolescente a sobrellevar la situación
Illness:
- At the Hospital: Helping My Child Cope with Illness
- At the Hospital: Helping My Teen Cope with Illness
Especially for kids after the hospital (English / Spanish):
Read more about working with your child's healthcare team at AftertheInjury.org.AT HOME
How can I help my child back at home?
Getting back to a normal routine will make things predictable again, which can help your child feel safe. Help your child go back to school, play or re-connect with friends and family, as much as the illness or injury allows. Let your child know that you are still ready to listen if they to talk. In addition, you can:
Give it time. Each family member will react in a different way. Allow everyone time to re-adjust.- Remember that brothers and sisters can feel upset or jealous
- Remind everyone that it may take additional time for things to return to normal
Keep a routine. Make sure your child knows what to expect each day.
- Keep the same family rules
- Let your child have control over some daily decisions.
- Avoid big changes in your child's life if you can
Help your child have fun, as much as the illness or injury allows Keep them connected to family and friends. Help them get back to things they enjoy.
- Arrange for your child to talk to or spend time with friends.
- Help prepare your child to return to school; talk to teachers and the school counselor
For more tips for parents, read:
General (English / Spanish):
- After the Hospital: Helping My Child Cope
- Después del hospital: Cómo ayudar a mi familia a superar la situación
Illness:
Injury (English / Spanish):
- After the Injury: Helping My Child Cope
- Después de la lesión: Cómo ayudar a mi hijo a superar la situación
- After the Injury: Helping Myself Cope
Especially for kids after the hospital (English / Spanish):
- After the Injury: Tips for Kids
- What Do I Say? Talking About What Happened with Others
- ¿Qué digo? Cómo hablar con otras personas acerca de lo sucedido
- Making a Plan: Dealing with Things that Remind You of What Happened
- Desarrollar un plan: Cómo enfrentarse a las situaciones que se recuerdan lo que sucedido
- After the Hospital: Getting Back to a Schedule
- Después del hospital: Cómo retomar las actividades diarias
GETTING ADDITIONAL HELP
(Note: Many of these resources are in English and Spanish)
How do I know if my child needs additional help?
Some children will continue to have traumatic stress reactions for a while after an illness, injury, or hospitalization. These symptoms may get in the way of his/her normal activities. If your child seems to be bothered by constant thoughts or feelings about the event, or if you are concerned about changes in your child's behavior, you should seek additional help. A good place to start is to speak with a doctor or nurse, school counselor, or a clergy member about your child's specific symptoms and behaviors.
Find out more about when to seek help for your child / cuando buscar ayuda para su niño from the American Academy of Child and Adolescent Psychiatry.
How do I find the right help for my child?
The National Child Traumatic Stress Network offers step-by-step guidance / guiá para padres: cómo hacer frente a las situaciones traumáticas on how to find help for your child after a traumatic event.
A first step in choosing the right therapist is learning about the differences between types of mental health professionals. The Sidran Institute offers advice on seeking therapy specifically for posttraumatic stress.
Where can I locate a therapist near my family?
- American Academy of Child & Adolescent Psychiatry: Psychiatrist Finder / Cómo Conseguir un Siquiatra de Niños y Adolescentes
- American Psychological Association: Psychologist Locator
- American Association of Marriage and Family Therapy: Therapist Locator
- Mental Health America: How do I find treatment?
I don't have insurance. Can my child still get help?
- U.S. Department of Health & Human Services: Insure Kids Now / Departamento de Salud y Servicios Humanos de EE.UU.: Acceso al Cuidado Médico
- Children's Health Coverage: State Fact Sheets
- Centers for Medicare & Medicaid Services
- First Step: SCHIP Q&A
What kind of therapy is best for my child after a trauma?
The following types of treatment have been shown to be effective, and are commonly used to help children and families after a traumatic event:
- Cognitive Behavioral Therapies (CBT) helps children and families cope with the negative effects of traumatic life events by helping them build healthy skills related to their thoughts, feelings, and behaviors associated with trauma.
- Parent-Child or Family Therapies involve and address the child's, parent's and / or family's traumatic stress reactions, focusing on their impact on relationships between family members.
- Psychiatric medication for children and adolescents / Medicamentos Siquiatricos Para Ninos y Adolescentes may be recommended in some cases to treat symptoms that affect sleep, cause anxiety, or result in hyperactive behaviors.
Click here for more information about specific, evidence-based trauma treatments, as reviewed by the National Registry for Evidence-based Programs and Practices (NREPP) and by the National Child Traumatic Stress Network (NCTSN).
My child is starting therapy. What can I do to support him/her?
Once you have found a mental health professional to work with your child and family, it is helpful to learn what to expect before, during, and after therapy. The Substance Abuse and Mental Health Administration offers a helpful family guide on mental health services for children in Spanish: guía para la familia para la salud mental de sus hijos. Also, KidsHealth offers information about taking your child to therapy.
Different types of treatment may be used to help your child and family overcome trauma-related difficulties. The details of treatment (like what kind, how long, by whom) will vary for each child and family. Generally, treatment for trauma-related difficulties should: 1) directly address the traumatic experiences and your child's reactions to them, 2) include you as parent in the treatment in some manner, and 3) focus on reducing symptoms but also on helping your child cope and function better.
If you do not have insurance, it may be helpful to contact local therapists or agencies and ask if they offer a sliding fee scale or payment plan. Also, find out if your child or family is eligible for federal or state coverage like the State Children's Health Insurance Program (SCHIP). Find out more about access to care by visiting:
The following resources can help you locate mental health services in your area:
While doctors and nurses can help your child recovery physically, a mental health professional's job is to help your child (and family) recover emotionally. These professionals can be psychologists, counselors, psychotherapists, and social workers. When choosing a mental health professional for your child, it is important to find a provider who has the right training and experience in working with children and teens after trauma. Also, it is important that your child feels comfortable with his/her therapist.
RESOURCES FOR CHILDREN, TEENS, AND PARENTS
Resources for Children and Teens (English / Spanish):
Band-Aides and Blackboards is fun interactive website for kids and teens growing up with medical problems.
The Experience Journals are a collection of stories for children and teens living with physical or emotional illness.
KidsHealth offers online information about child health, behavior, and development for kids / niños and teens / adolescentes.
Starbright World® is an online social network for seriously ill teens and their teen-aged siblings.
Resources for Parents (English / Spanish):
The National Child Traumatic Stress Network (NCTSN) features a section on Resources for Parents and Caregivers / Información para Padres, Cuidadores y Familias in English and Spanish.
After the Injury helps parents understand their child's reactions to injury and learn what they can do to help their child.
Beyond the Cure offers information and resources, including teleconferences, for survivors of childhood cancer and their families. Listen to a teleconference presented by Anne Kazak, PhD, ABPP of the Children's Hospital of Philadelphia on Parenting a Child with Cancer: Have You Hugged Yourself Today?
The American Academy of Child and Adolescent Psychiatry (AACAP) features a section For Families / Para la Familia offering educational handouts in several languages on issues like childhood chronic illness and posttraumatic stress disorder.
The American Psychological Association (APA) has information and resources related to trauma, posttraumatic stress disorder, child issues, and a search for local psychologists across the US.
KidsHealth offers information about child health, behavior, and development for parents / padres.
The National Institute of Mental Health (NIMH) has created a booklet Helping Children and Adolescents Cope with Violence and Disasters: What Parents Can Do / Ayudando a Niños y Adolescentes a Superar la Violencia y los Desastres: Que Pueden Hacer los Padres.
