Supporting Mental Health During Separation

The COVID-19 pandemic has presented many challenges and concerns for parents, one of which is the possibility of separation due to the need for hospitalisation or isolation of the child or parent. While it is best for the child to remain with a trusted adult, in case of separation, it is essential we foster resilience.

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Supporting your child during separation

  • Maintain daily contact with the medical team
  • Maintain daily virtual calls or messaging with your child
  • During your virtual calls engage in comforting contact i.e. singing, playing games, reading, or chatting
  • While difficult, try to keep your emotions in check during the call. Let your child know how difficult the separation is for you as well, and how much you miss them. Allow them to express their feelings as well. But try to boundary your distress during these interactions.
  • Keep track of existing policies around parent-child separation and make it a priority to be with them

 

Supporting your child in expressing their feelings

Whether it is following a separation or due to the fear and anxiety of separation, it is important for children to be able to openly express their feelings. For children at every age, invite them to express how they are feeling, allowing them to explore what they are experiencing and the emotions that come with that. Listen and validate their feelings.

  • With younger children, you can use play or storytime to help them talk about how they are feeling, for example using characters from their play or stories to explore emotions.
  • While older children may appreciate it when parents are forthcoming, open and non-judgemental. Listen, normalise and validate their feelings, rather than dismissing or minimising them.

The most important elements are to listen to them and allow them to be heard, and not jump into “fix-it mode”. What they likely need from you is a secure space to explore and express their feelings and emotions.

 

Good opening lines at any age:
  • “How does [that] make you feel?”
  • “Tell me more about that [emotion they are experiencing]”
  • “Where do you feel that [emotion] in your body?”
Do validate:
  • “That must be very difficult for you”
  • “I can see that this has been very upsetting for you”
  • “It is ok to feel [sad, mad, angry, frustrated] right now”
Don’t:
  • Dismiss or minimise their experience – “You are fine” “You don’t have to worry about that” “that’s silly”
  • The notion that expressing their emotions is wrong “big girls/boys don’t cry”, “don’t be a baby”, “you are being a drama queen”

 

Fostering Resilience

  • Provide reassurance. Once you have explored their feelings and concerns, explore with them what they can do and what is being done to keep them safe. Provide them with options to let them make decisions (ie. their clothes for the day, their meal choice, weekend activities), this will allow them to regain a sense of control.
  • Ensure that a regular routine is being maintained. Structure and routine give children (and all of us) a sense of security and control, particularly during uncertain times.
  • Help them to remain connected to their friends and loved ones 
  • Model healthy behaviours (exercising, sleeping well) and engage in these strategies as a family – like hiking, mindfulness or yoga

 

Positive Role Modelling

  • Be mindful of your own behaviours and thought processes. What are you focused on and what behaviours are you modelling to your child?. While you want to encourage the validation of the anxiety that your child may be feeling, you also want to model positive and adaptive ways of coping with anxiety.
  • Model being calm. Set a boundary of sharing your worries with your children, and if you are feeling overwhelmed and anxious, seek support or ground yourself in the present. Your children are very likely to notice how you respond to stress and anxiety. Will your children see that their parents were able to manage their anxiety or will they learn that the world they live in is a scary place?
  • Managing anxious feelings is not just about removing the stressor. Managing anxious feelings is about learning to manage and cope with the fear and intolerance of uncertainties.
    • Managing fear. As a parent, you can model this by talking to your child about how you cope with feelings of anxiety and how that makes you feel ( e.g., “when I feel worried, I’d like to lie on my bed or go to my happy place. This makes me feel safe and grounded’)
    • Accepting and tolerating uncertainty. Explore with your child a backup plan – e.g.,” if there are still restrictions in restaurants by your birthday next month, and we cannot celebrate at your favourite restaurant with your friends, what would you like to do instead?”
    • Intentionally affirm that there will be uncertainties but that you will tackle it as a family – e.g, we are not entirely sure what will happen when we return to HK in August, but we know that there are ways around it and we will make it work! Do you want to tell me what you are worried about?”
  • Be mindful of how much you are talking about your own fears or COVID-related anxiety. Be intentional in looking at the bigger picture and figuring out what you want to prioritise during this particular stage in their psycho-social development. What are some things you could cultivate, as individuals or as a family, during this difficult time? Is it solely to keep them healthy at all costs, or do you also want to emphasise connectedness, family communication, empathy for others, developing their personal strengths
  • The children are listening. Be mindful in your conversations with other adults when your children are at earshot. Children often listen in to or pick up bits of conversations without fully understanding what adults are saying.
  • Foster hope. Encourage conversations that are more hopeful and try to get the children to see the silver lining amidst all the uncertainties. To do so, you have to see and believe in it first!

 

Identifying When Your Child is Struggling

The most important thing to look out for is a change in behaviour, and this is applicable at every age.

 

For all ages

  • Physical complaints: such as headaches, stomach discomfort, changes in appetite or sleep (physical symptoms need to be assessed by a medical professional to ensure there isn’t a physical health problem)

Younger children (Age: 10 and under)

  • More clingy, or anxious to separate from you
  • More explosive in their reactions, having more meltdowns
  • More withdrawn, not wanting to socialise
  • Frequently speaking about the event or playing it out
  • Regression, such as bedwetting for children who have been toilet-trained, using soothers (or other comfort measures) that they have been previously weaned off, difficulty sleeping on their own
  • Engaging in angry or sad play, children will often express themselves in play, so pay attention to what they are saying when playing

Adolescents & Tweens:

  • More irritable or angry
  • Increased mood swings (beyond what you normally would expect)
  • Increasingly withdrawn and isolated, not engaging with family or friends
  • Changes in motivation or lack of interest in things
  • Struggling with concentration and task completion
  • Substance use
  • Increased tech use (social media or gaming)

 

Taking Care of Yourself

While it is important to “keep it together” for the children it is also important to show them that it is ok being vulnerable and it is ok to struggle. Let them know that this is a difficult time for you as well, and share with them (in a developmentally appropriate way) how you are feeling. This will model to them healthy ways to express themselves. But also let them know and show them what you are doing to take care of yourself (exercise, connecting with loved ones, practising mindfulness). You can also do some of these practices together, like going for a walk or hike or practising yoga together. But make sure you are also engaging in self-care that doesn’t include your children. Recharging your own batteries is just as important, as your own wellbeing will set the tone for your children and impact how they perceive and react to the current situation.

 

Taking care of yourself during separation

  • Maintain daily contact with your child 
  • Identify a trusted support person for you to speak to about how you are doing. This can be a close friend or family member or a mental health professional
  • Mindfulness and breathing exercises. This will be an anxiety-provoking time which may present with symptoms of anxiety such as racing thoughts, difficulty focusing and physical symptoms such as a racing heart and aches and pains. To help manage these symptoms use mindfulness and breathing exercises to help ground you at the moment and improve those symptoms. There are lots of free mindfulness and breathing exercises on YouTube videos and Apps that you can use. We are also including a simple exercise you can use below.
    1. Place the index finger of your hand onto the palm of the other hand. Slowly begin to trace the 8 shape on your palm. Notice what it feels like to trace the shape.
    2. Now turn your attention to your breathing. As you slowly breathe in, circle your finger to the left part of the 8. Notice how it feels as the air enters your mouth and your lungs.
    3. As you breathe out slowly, circle your finger around the right-hand part of the 8. Notice how it feels as the air leaves your lungs and mouth and your stomach relaxes.
    4. If you find that you are thinking about something else, that is fine, notice it and then turn your attention back to the lazy 8s.
    5. Keep doing this for a few more moments, just tracing your finger, noticing your breathing, and bringing your thoughts back to the way that this feels.
  • Restful sleep is essential. Getting a good night’s sleep will be one of the most important but most difficult things to achieve during this time. To help support better sleep try to follow the tips we provide below, however, know that it is likely that your sleep will be disrupted during this time and it is understandable, as a separation from a child is one of the most distressing experiences a parent can go through. Be gentle with yourself and know that you are doing your best in a difficult situation.
    • Set a sleeping ritual by doing something that helps you unwind before your bedtime (i.e. a bath, mindfulness meditation, breathing exercises, yoga, a walk)
    • Avoid social media or excessive screen time right before bed, as this can increase anxiety levels
    • Avoid drinking caffeinated drinks in the evening
  • Find ways to exercise. Exercise can be very effective stress coping strategy
  • Communicate with your partner and ensure that you and your partner are supporting each other during this difficult time

 

Take care of yourself after you are reunited

  • The time after you are reunited with your child a lot of your focus and energy will be on supporting your child. During this time make sure you take time to take care of yourself, carving out time for self-care so that you can have the energy to be more present for your child. Self-care can include exercise, engaging in activities you enjoy (this can be artistic, athletic or academic), and connecting with loved ones.
  • Take the time to talk and express how you are feeling with a trusted friend or family member or seek professional support to process the trauma you have been through
  • For general coping our team has developed a self-help guide which you can access here.

Don’t underestimate the impact that a parent’s poor mental health can have on a  child. When you take care of yourself you will be a more present parent to your child and your child can learn these behaviours from you.

 

Supporting your child after you are reunited – taking a trauma-informed approach

  • Help your child feel safe. Reassure them that they are safe and let them know that the separation was not their fault. Let them know that you love them and that you are there to support them.
  • Give your child opportunities to express their feelings and talk to you about how they are feeling. Encourage those who want to talk about their experience to do so, but give them space if they are not yet ready to talk about what happened or how they feel.
  • Validate their feelings, letting them know that it is ok to feel scared, sad or upset.
  • Provide comfort. Particularly for younger children, provide them with things that comfort them (e.g. favourite foods, soft toys, books, music). Offer to play, hug, read or spend time with them, but do not force any of these things on to them.
  • Ensure that a regular routine is being maintained. Structure and routine give children a sense of security and control, particularly during uncertain times.
  • Set aside quality time to spend as a family doing activities your child enjoys. Giving them back a sense of control and mastery to choose an activity they like.
  • Seek professional help if your child continues to struggle or if you are having a difficult time supporting them. 

 

 

Seeking Professional Support

If you or your child’s struggles appear to be beyond the support you can give and you have tried various coping strategies with little or no improvement, it is important to seek professional help (earlier rather than later). A good place to start is the child’s GP or Paediatrician to get an initial assessment on how they are doing, and they can discuss the next steps with you. Some routine modifications or adjustments may be suggested, or they may recommend seeing a counsellor, psychologist or a psychiatrist. Your GP/Paediatrician can help you navigate the first steps in getting the support you or your child needs, bearing in mind this will differ between the public and private care systems.

Online resources

Younger children:

UNICEF guide for parents: https://www.unicef.org/parenting/coronavirus-covid-19-guide-parents

American Psychological Association – A Kid’s Guide to Coronavirus: https://www.apa.org/pubs/magination/covid-19-help-kids-cope

Lion’s Clubs resource for Caring for Children with COVID-19 A Psychological Guide: https://www.lionsclubs.org.hk/Covid_Child_PsychologicalGuide/COVID19_eBook.pdf

Centre for Child and Family Science from the Education University of Hong Kong: https://www.eduhk.hk/ccfs/fight-coronavirus-together/

Adolescents:

Coolminds – Young Person’s Guide to Staying Well: https://www.coolmindshk.com/en/resource/staying-well-during-the-coronavirus-outbreak/

Coolminds – A guide for parents: https://www.coolmindshk.com/en/resource/the-mental-health-effects-of-covid-19/

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