DALLAS – Whether it’s after a natural disaster, a fatal shooting, or a tragedy closer to home, parents may find themselves trying to navigate difficult conversations with their children. What to say is just as important as what not to say, according to experts at UT Southwestern Medical Center. Children are naturally curious and may have questions, or they may be worried about their own safety.
Beth Kennard, Psy.D., is a Professor of Psychiatry and member of the O'Donnell Brain Institute. She is Director of the Doctoral Program in Clinical Psychology and a Distinguished Teaching Professor.
To learn how to best handle these discussions, we spoke with two faculty members in UT Southwestern’s Department of Psychiatry who have spent decades working with children.
Beth Kennard, Psy.D., is a Professor of Psychiatry and member of the Peter O’Donnell Jr. Brain Institute. She is Director of the Doctoral Program in Clinical Psychology and a Distinguished Teaching Professor. As a licensed psychologist, Dr. Kennard has more than 30 years of clinical experience with children and adolescents. She is also Director of the Suicide Prevention and Resilience Program at Children’s Health.
James Norcross, M.D., is a Professor of Psychiatry, Chief of the Division of Child and Adolescent Psychiatry, and a member of the O’Donnell Brain Institute.
What should parents consider before talking about a sensitive topic with their child?
Dr. Norcross: The first thing to consider is the developmental level of the children so that you can provide answers and information at their level of understanding. All children, regardless of their age, should be encouraged to express their reactions to the event, and parents should feel free to talk about their emotions.
Children are typically worried about their personal safety after experiencing a traumatic event. As parents, you should provide reassurance that they are safe and that you are there to protect them from harm.
James Norcross, M.D., is a Professor of Psychiatry, Chief of the Division of Child and Adolescent Psychiatry, and a member of the O'Donnell Brain Institute.
How should I start a difficult conversation with my child?
Dr. Kennard: I typically start by asking children to tell me their understanding of what happened and what questions they have. This allows you to adjust your responses to their concerns and level of understanding. Additionally, assume that more questions will come after they begin to process the event and/or experience others’ reactions to the event.
If it is an event that has been televised or covered in the media, limit your child’s repeated exposure to it.
What are some tips to ensure the conversation benefits my child?
Dr. Kennard: Reassure your children that they have your support and that you are there to take care of them. As Fred Rogers of the long-running TV show “Mister Rogers’ Neighborhood” would say, “Look for the helpers; there are always helpers around.” Pointing out the positive responses in these events, such as communities uniting or people taking heroic actions, is also important.
Let them know that there are no wrong feelings and that people can react differently. Be open to opportunities to talk about the event.
Are there times when it’s better to avoid talking about a sensitive topic altogether?
Dr. Kennard: If your child becomes very emotional or disruptive, it is fine to pause the discussion with an invitation to revisit the conversation at a later time. Some families benefit from using an “emotional thermometer” as a way of assessing the distress level of their child. For example, ask, “On a scale of 1 to 10, with 10 being the highest level of distress, where are you on the scale right now?” If the child is very high on the scale, it might be good to discuss ways that the child can lower the distress. “What can you do to get the distress down to a 5?”
What are some ways that I can show my child that I am listening?
Dr. Norcross: I recommend using both verbal and nonverbal behavior to demonstrate you are listening. Maintain eye contact while the child is talking, and remain free from distractions such as cellphones or social media. Respond first by repeating what you heard the child say and maybe ask, “Did I get that right?” before responding.
How should I respond to my child’s concerns?
Dr. Norcross: Let them know that it is normal to have negative emotions such as fear and anger. In addition, talk with them about ways that you manage these emotions and identify positive ways to cope, such as getting exercise, doing something active and fun, or getting together with friends.
Any advice for what not to do when having these kinds of conversations?
Dr. Kennard: Parents should make a safe space to discuss their children’s reactions to the event. It can be hard to hear your children express their distress. Avoid the “pull” to tell them how to feel or to dismiss their feelings. Use active listening, which is saying back to them what you heard them say and allowing space for them to correct your understanding. Demonstrate confidence in your ability to keep them safe, and model that it is OK to talk about emotions and about how to cope with difficult emotions.
If I think my child might be anxious or scared, what signs or changes in behavior should I watch for?
Dr. Norcross: Changes in behavior such as regression to an earlier stage of development, changes in eating or sleeping patterns, somatic complaints such as stomachaches or headaches, or disruptive behaviors may be observed. In addition, some youth may not want to go to school, have poor school performance, have trouble concentrating, or have no interest in activities that were once pleasurable.
What strategies for coping or reassurance would you recommend I give my child?
Dr. Kennard: Engaging in relaxation, participating in pleasant activities, and using problem-solving strategies can be important means of coping. Resist telling your children how to cope and instead allow them to come up with some strategies that they can use to lower their level of distress. Try to maintain a normal routine and resist the temptation to allow your child to avoid fearful situations, which likely will compound the problem.
How do I know when my child might need outside help?
Dr. Norcross: Persistent changes in mood or behavior may be a sign that additional help is needed. Talking with your pediatrician to screen for depressive or anxiety symptoms and the potential need for treatment can be helpful. Treatment with a mental health professional may be warranted if symptoms persist and result in impairment in school or outside activities, family conflict, or interpersonal problems.
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UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.