How to help your teen cope with COVID-19 cancellations

By Dr. Mery Taylor, pediatric psychologist at CHOC Children’s

To high school seniors, schools being closed doesn’t equal a vacation – to them, this is time they won’t get back with their friends.  It’s normal for teens to feel anxious during this period of their lives, as they close one chapter and begin another. However, teens may feel especially anxious as they realize they may never walk through their high school hallways again, attend prom, perform in their final theater production, compete in their final season, or celebrate graduation.

If you’re a parent or guardian of a teen who is struggling with a loss of control and trying to cope with cancelled celebrations, here’s tips for talking about it and coping.

Allow your teen to grieve

For most high school seniors, sometime in March 2020 they unknowingly experienced their last regular day of school with so many things left undone. I’m sure there were tears shed as this realization set in, along with confusion, anxiety and despair at the loss of their senior year.

During this time, it will be important to allow your student to cope and grieve in her own way. Some students will cope by throwing themselves into their academics, focusing on end of the year projects, and last-minute scholarship applications. Others may struggle through the typical stages of grief — denial, anger, depression, bargaining and acceptance. It is typical to jump back and forth between these stages.

As a parent, you may find yourself in a similar boat — accepting the new normal, only to be saddened the next day when you realize another disappointment due to COVID-19. This is normal. Many people feel like this when experiencing a loss of control over their circumstances.

Use dialectical behavioral therapy (DBT) skills to help you feel back in control

During this time of uncertainty, your teen may be struggling with a loss of control. Using skills associated with dialectical behavioral therapy (DBT), you and your teen can help to regain that lost sense of control.

  • Accept your emotions — What you are going through is not normal. What is normal is feeling emotional in these circumstances. Remember, you are the boss of your emotions. Name the emotion and put a label on it. Take a break and spend some time soothing yourself. The idea is to not let your emotions stop you from doing what you can.
  • STOP — This stands for stop, take a step back, observe and proceed Take a step back and observe your emotions. Let your emotions calm. Then observe the situation as you would if it were someone else facing it. What would you tell someone else to do?
  • Practice radical acceptance — Radical acceptance is the complete and total acceptance of reality. This means that you accept the reality in your mind, heart and body. You stop fighting against the reality and accept it.
  • Use your wise mind —Make decisions about the situation with your wise mind. Your emotion mind will urge you to give up, act impulsively, rage, or give up when faced with disappointment. Wait for your wise mind to be in charge. Your wise mind can take in new information, be flexible in considering alternatives, and be creative in thinking of solutions.

Marking this milestone

Taking the time to celebrate milestones is an important stepping stone in a person’s life, and an opportunity to observe achieving a goal or the fact that someone is entering a new stage in life. A high school graduation marks a time of academic success and transition to adulthood. Even though the current senior class’ year was cut short, it does not make their efforts any less significant.

Senior commencement ceremonies have always been just as much about the students’ past accomplishments as a view toward their future. Particularly, in these times, it will be important to highlight their strengths and virtues as they enter the adult world. Finally, marking this milestone is also an opportunity for the caregivers, teachers, family and friends, who have watched them grow and work hard for this moment, to share in the student’s triumphs and acknowledge their hard work.

The celebration

The celebration or milestone you and your student had originally envisioned may not look the same today, but it can be just as memorable. Take time to talk through what is important to you and your student and find creative ways to make it happen. Here are some ideas to get you started:

  • Mom wants pictures — While practicing social distancing, find a friend or hire a photographer to shoot pictures of your senior in a cap and gown in a lovely outdoor setting.
  • The student wants to dance — Use Zoom to meet up with friends and have a virtual prom.
  • Teachers want to see you in your cap and gown — Organize a drive-by parade around the school.
  • Dad wants to brag — Use FaceTime or Zoom to connect with family and friends. Think about putting a slide show together of your child through the years. Senior, don’t forget to wear your cap and gown.
  • Friends want to graduate together — Create a virtual meetup on Zoom, or practice safe-distancing in a park to ‘move the tassel’ from right to left and throw your caps in the air.
  • Siblings want to participate — Decorate the family car, driveway or front lawn with well-wishes.

Congratulations to the senior class of 2020! Best wishes for your new adventures.

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Cómo hablar con los niños sobre la decepción durante COVID-19

Por la Dra. Mery Taylor, psicóloga pediátrica en CHOC Children’s 

Con las escuelas cerradas y la práctica del distanciamiento social en vigencia, es ciertamente comprensible que los niños se sientan decepcionados en este momento por perderse las fiestas de cumpleaños, las excursiones o las vacaciones que habían estado esperando.  Si su hijo o adolescente se siente decepcionado en este momento, permítale expresar sus sentimientos y validarlos.  Comparta sus propias decepciones y cómo usted maneja sus sentimientos.

Como padre, es difícil ver a un hijo experimentar la decepción.  Como adultos, tenemos la perspectiva de saber que habrá otras fiestas de cumpleaños, excursiones y celebraciones en el futuro.  Durante este período, los niños se sentirán más reconfortados con  las palabras de seguridad de los padres expresándoles que pasarán juntos estos tiempos difíciles y que finalmente la vida volverá a la normalidad.

Recuérdeles a los niños por qué las cosas han cambiado

Puede ser útil recordarles por qué las cosas son diferentes en este momento.  Recuérdele a su hijo que, como comunidad, nos estamos uniendo para “aplanar la curva” y evitar la propagación de COVID-19.

Hable sobre los cambios de planes lo antes que pueda

Para la mayoría de los niños pequeños, será útil comenzar a hablar sobre los cambios de planes más vale temprano que tarde.  Comience despacio y vuelva al tema varias veces, cada vez agregando un poco más de detalle.  Solicite la opinión de sus hijos sobre cómo pueden cumplir con el evento, aunque es posible que no puedan ir físicamente a ningún lugar o tener interacciones en persona. Por ejemplo, ¿pueden crear una tarjeta de cumpleaños para un amigo cuya fiesta fue cancelada y enviársela por correo, y llamarlo o hacer un chat de video para desearle un feliz cumpleaños?

Limite la exposición de los niños a las noticias

En este momento, la mayoría de los niños están en casa sin poder ir a la escuela y está claro que algo ha cambiado drásticamente en su mundo. Si bien es importante mantener a los niños muy pequeños alejados de las noticias diarias que pueden incluir el número de muertos y las especulaciones, los padres deben ser honestos sobre lo que estamos tratando de lograr mediante el distanciamiento social.  He aquí una explicación del distanciamiento social. Podría ser útil preguntarles lo que ya saben, desacreditar información errónea y proporcionar información adicional para una mejor comprensión y aclaración.

Consejos para niños mayores

Es probable que los niños mayores y los adolescentes sean más conscientes de que hay ocasiones especiales que quizás nunca regresen, como bailes escolares, representaciones teatrales y graduaciones.  Asegúreles que su escuela y su maestro harán lo que puedan para resarcir esto.

Deje que usen su imaginación

Diviértanse pensando en fiestas de cumpleaños con maquillaje, excursiones y otras reuniones con familiares y amigos.  Permítales usar su imaginación sobre las decoraciones que tendrían, la comida que comerían y las personas que más quisieran ver.

Celebre los eventos especiales de una manera creativa:

  • Organice una fiesta virtual: arme un telón de fondo, haga una lista de reproducción de música y cree un juego temático.
  • Únase con los amigos para un recorrido virtual por el museo. Muchos museos y otras atracciones ofrecen visitas virtuales gratuitas durante este tiempo.
  • Ayude a su hijo a preparar una comida o un postre particular para las vacaciones o para un día especial.
  • Salga a la naturaleza para una aventura única con aquellos con quienes vive.
  • Llame a su amigo en su cumpleaños y cántele “Feliz cumpleaños”.
  • Comparta una comida virtual con amigos y familiares.
  • Organice una noche de juegos virtuales.

Crear hábitos de resistencia

Aunque esta pandemia no es la situación que hubiéramos elegido para que nuestros hijos se enfrenten, experimentar eventos adversos, con el apoyo de sus padres, ayudará a los niños a desarrollar la capacidad de resistencia. Ellos podrán mirar hacia atrás en este momento y reflexionar sobre cómo fueron creativos para encontrar formas de conectarse con sus amigos en línea, cómo encontraron nuevas formas de entretenerse en casa y cómo perseveraron ante nuevos desafíos, como asistir a la escuela por internet.

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How to talk to kids about disappointment during COVID-19

By Dr. Mery Taylor, pediatric psychologist at CHOC Children’s

With schools closed and the practice of social distancing in effect, it is certainly understandable for children to feel disappointed right now about missing out on birthday parties, field trips or holidays they had been looking forward to. If your child or teen feels disappointed right now, let her express her feelings, and validate them. Share your own disappointments and how you are managing your feelings.

As a parent, it is difficult to see your child experience disappointment. As adults, we have the perspective of knowing that there will be other birthday parties, field trips and celebrations in their future. During this time, children will be most comforted by parents’ words of reassurance that you will get through these challenging times together, and that life will return to normal eventually.

Remind children why things have changed

It can be helpful to remind them about why things are different right now. Remind your child that as a community, we are coming together to “flatten the curve” and prevent the spread of COVID-19.

Discuss changes in plans earlier vs. later

For most young children, it will be helpful to start to discuss changes in plans earlier than later. Start slow and return to the topic several times, each time adding a little more detail. Ask for your children’s input on how they can still honor the event though they may not be physically able to go somewhere or have in-person interactions. For example, they can create a birthday card for a friend whose party was canceled and mail it to them and call or video chat them to wish them a happy birthday.

Limit children’s exposure to the news

At this point, children are home from school and it is clear that something has drastically changed in their world. While it is important to keep very young children away from the daily news which can include death tolls and speculations, parents should be honest about what we are trying to accomplish by social distancing. Here’s an explanation of social distancing. It could be helpful to ask them what they already know, debunk misinformation, and provide additional information for better understanding and clarification.

Advice for older children

Older children and teens are likely more aware that there are some special occasions that they many never get back, such as school dances, play performances and graduations. Assure them that their school and teacher will do what they can to make it up to them.

Let them use their imagination

Have fun thinking about what makeup birthday parties, field trips and other gatherings with family and friends would look like. Let them use their imaginations on what decorations they would have, food they would eat and people they most want to see.

Celebrate special events in a creative way:

  • Host a virtual party — decorate a backdrop, make a music playlist and create a themed game.
  • Join friends for a virtual museum tour. Many museums and other attractions are offering free virtual visits during this time.
  • Help your child prepare a special meal or dessert for the holiday or special day.
  • Go into nature for a special adventure with those you live with.
  • Call your friend on their birthday and sing them “Happy Birthday.”
  • Share a virtual meal with friends and family.
  • Host a virtual game night.

Building resiliency

Although this pandemic is not the situation that we would have chosen for our kids to face, experiencing adverse events, with their parent’s support, will help kids build resiliency. They will be able to look back on this time and reflect on how they were creative in finding ways to connect with their friends online, how they found new ways to entertain themselves at home, and how they persevered over new challenges, such as attending school online.

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Mindfulness Tips for Teens

Teens’ mental health is as important as their physical health. It’s not always obvious when a teen is struggling emotionally, but recognizing the symptoms and seeking early and effective mental health services are important to prevent more serious mental health issues.

Parents should talk to their teens and foster a relationship based on open communication. Seek to understand how your child is feeling, without judgment, before you try to fix the problem.

As a pediatric psychologist at CHOC Children’s Hospital, Dr. Mery Taylor helps teens and their families who are facing a variety of mental health challenges. Typical concerns or issues teens seek treatment for include:

  • Anxiety
  • Depression
  • Difficulty coping with stressors such as: chronic illness, a life or family change, a social or school concern, and grief and loss
  • Disruptive behavior disorders, including attention deficit/hyperactivity disorder (ADHD) and oppositional defiance disorder (ODD)
  • Eating disorders

“Throughout my ten years at CHOC, a majority of teens I have worked with have come to me for pain issues, anxiety, depression, eating disorders and difficulty coping with stress,” says Taylor. “I have also seen an increase number of transgender youth and parents seeking services.”

mindfulness
Dr. Mery Taylor, pediatric psychologist at CHOC Children’s

What is mindfulness?

Practicing mindfulness, or relaxation techniques can help teens build coping skills to address issues, such as anxiety disorders. It’s very easy to get wrapped up in our emotions and not see our way out of them, says Dr. Taylor.

“The more we attend to the fear, the more power it gets and we can become paralyzed about what to do, or avoid aspects of our life in attempt to manage the anxiety. We can get stuck on a cycle of trying to avoid our anxiety and forget to live life. At times, we allow our negative thoughts and emotions to dictate our actions without stopping to assess if they are valid and irrespective of the consequences. For example, we might avoid going to school because we don’t feel we have studied enough for a test and then end up missing out on important instruction for another class. Mindfulness makes us stop for a minute and check in with ourselves,” says Dr. Taylor. “Mindfulness asks us to be curious of our thoughts and feelings without judgment or action—to just be in the moment. Developing acceptance and compassion for the painful parts of our inner emotional life can weaken the power of the anxiety. Once weakened, we can better manage our fears.”

Tips for practicing mindfulness:

  • When something is bothering you, shift that attention to yourself, rather than what you’re reacting to.
  • Stop for a moment to center yourself, by addressing and labeling those sensations (fear, worry, anger). Validate these feelings to ourselves can help to lessen our fight or flight reaction.
  • Now turn to your attention to your body. Identify the sensations going on in your body. All emotions are experienced as sensations in our body.
  • If you find yourself attending to the thoughts or feeling again, gently bring your focus to your body sensation (e.g., muscle tension, heartbeat, etc.).
  • Practice relaxation techniques to calm the nervous system, to stop the nervous reaction and respond more cognitively. For example:
    • Autogenic relaxation. Autogenic means something that comes from within you. Visualize a peaceful setting. You can repeat a phrase such as, “I am relaxed” to invoke muscle tension release. Focus also on breathing slowly and evenly.
    • Progressive muscle relaxation. In this relaxation technique, you focus on slowly tensing and then relaxing different muscle groups in your body. You can start with clenching your hands into a fist and then relaxing them. Focusing on the difference between muscle tension and relaxation, will help you become more aware of physical sensations.
    • Form a mental image of a place that find to be peaceful and calming. To relax imagine yourself exploring this place. Try to incorporate as many senses as you can, including smell, sight, sound and touch on your journey. If you imagine relaxing at the beach and feel the cool sand on your felt, and sound of the crashing waves
    • You probably already know other things that calm you (e.g., listening to music, taking a shower, walking your dog, etc.). You can do those things too.

Parents can help facilitate mindfulness.

“Being non-judgmental is a big part of mindfulness,” says Taylor. “It’s important to accept that we do what we can, and that we have limitations. It’s important to acknowledge everything you have going on in your life that’s happening at once, and to give yourself a break.”

“A parent might acknowledge and normalize the anxiety associated with college applications as a way to show compassion and thereby minimizing the urgency that the teen feels. Once more calm, the teen can focus on the college application, instead of attending to the distressing thoughts and feelings.”

Parents hoping to teach mindfulness practices to their teens are also encouraged to model the behavior themselves, says Taylor. Remind teens that practicing mindfulness can also improve concentration at school and improve performance.

CHOC believes mental health treatment should be fully integrated with physical health treatment. Our psychology team works closely with patients’ medical teams to attend to emotional, behavioral and developmental needs through inpatient and outpatient therapy. Our goal is to foster the whole well-being of the teen and family.

CHOC psychologists have recorded a library of guided imagery audio tracks to help children and teens relax, manage pain, ease fears and anxiety, fall asleep easier and more:

Experience guided imagery as a healing tool

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