While many different organizations offer helpful suggestions for talking with children about the COVID-19 crisis, few specifically address the unique challenges currently faced by military families. Therefore, we reached out to a few experts who work with children and adolescents to help us fill in some of these gaps. The following is an interview with Drs. Erynne Shatto and Kimberly Copeland, who currently both work at the Naval Medical Center in Portsmouth, Virginia.
What are some tips you would offer to military families during this time?
- Try to keep to a routine and schedule as much as possible. Children will be less anxious and have more predictable behavior when their environment is also predictable. Keep a schedule for waking, meals, and other main family events that are being maintained, even though you may not be going out of the house as often. Maintain any routines that you already have. If you do not have routines, start establishing ones that provide predictable comfort: bedtime routines, meal routines, wake-up rituals, and predictable sequences for transition times (e.g., when shifting from quiet time to work time, meal time to play time, etc.).
- Depending on the age of one’s children, collaborating on a new daytime routine and planned activities may give them something to look forward to. Also, posting these activities on a schedule or calendar in a central location (think the fridge) can assist with looking forward to and preparing for the week.
- Get creative about planning more “special time” and one-on-one activities if you have more than one child. If you are teleworking, make sure to “schedule” time with your children in much the same way you might schedule a meeting at work. These times can even be coupled with other activities outside of play, including household help or something the child might enjoy participating in.
o “Special time”: Even 5 minutes spent in one-on-one time will help your child feel special, heard, and included. Make sure special time is spent in activities your child enjoys. It is also important to engage in activities that don’t encourage you to overly direct the activity or make too many demands, but instead give you opportunities to enjoy your child and praise them for their ideas, good behavior, and ability to play well (e.g., sharing, taking turns).
- Catch your child being good. Don’t forget to give labeled praises so your child knows exactly what you like about their behavior, and how to please you again. During times when families are spending more time together, cabin fever can promote more negative thoughts, feelings, and behaviors. One way to help with morale is for you to keep positive thoughts, behaviors, and feelings, and encourage your child to do the same by pointing out the things that are going well in your family and with your child. For example, for young children, you might say: “Thanks for helping me pick up!” For older children, you might say: “Thank you for helping me with the chores. It’s been hard to keep things neat with all of us here all the time, so your hard work really helps!”
- Be creative and spontaneous! As tempting as it may be, try to refrain from utilizing all of this time as a personal “catch-up time” and reframe it as “special family time.” This may be easier said than done, but it’s well worth it when you realize you have captured some moments with your child and created memories while cooped up inside. For example, rather than having perfectly organized cupboards, this time can be additional time with your children. Limit alone time activities to keep children engaged. This means setting a limit on the amount of time your child may be watching TV or playing video games alone. Additionally, with iPad or phone use, setting times during which they can communicate with peers will be helpful.
What can parents do to help their children if they are worried?
- If your child is worried, make sure you are doing three things:
- Talking with your child about their fears and giving good information that is honest, but not overly detailed or scary for their developmental age.
- Monitoring the amount and kind of information they are receiving, and discussing with them the information they are learning, so you can correct any misinformation or address concerns they might not otherwise vocalize.
- Encourage your child to express their feelings by asking how they feel and accepting their feelings nonjudgmentally. For children who are having trouble expressing their feelings, coach them by labeling the emotions you can see they are having based on their behaviors.
- Do not assume you know the reason for the anxiety. Very young children may have magical beliefs about the situation – they may assume that they did something wrong causing the negative events to have happened or that they have to act in a certain way to keep things going well. Early elementary-age children may have fears of separation or be concerned about the well-being of family, friends, and pets. Children in middle childhood may be very distressed about not seeing friends and may worry about the wellbeing of their friends. Middle childhood kids are also building lots of competencies through clubs, sports, dance/music lessons, and other activities. They may feel displaced if they aren’t going to these activities. Try to find ways they can still engage in these activities while at home (e.g., YouTube video lessons, practicing their skills at home, etc.). Older children may worry about contamination, germs, sickness/illness for themselves and others close to them.
- Remember that your child might be tuned into your own anxiety. Managing your own stress as a parent might mean reaching out to other adults for support (within the parameters that social distancing requires) and finding other skills that work for you. Positive coping skills help parents with their own self-care and also demonstrate good modeling of behaviors for your children. You don’t need to be perfect, just do your best and be sure to explain if you have had some difficulties (and note how you plan to do better). Keeping communication open to allow children to discuss what they might hear from the media or their friends will help.
Do you have any special advice/suggestions for military families who have a Service member currently deployed?
- Due to operational changes, some military family members may experience more unpredictable schedules and disruptions in communication. Explaining this may help children to realize that this is situational and doesn’t mean that the deployed Service member doesn’t miss them or is in imminent danger.
- Encourage different forms of communicating at this time. If the Service member is not available via phone or Skype, encourage your child to write emails or letters, keep a “shared” journal, etc.
- If you do not have a family member who is currently deployed but may be soon, prepare your children for the possibility of a sudden deployment or changes in duty schedules. Due to the day-to-day adjustments being made for COVID-19, when and where a Service member might be needed can change rapidly. Letting your child know that this is a possibility can help them know what to expect and minimize unpleasant surprises.
- In general, we recommend the same strategies for families under these conditions as those mentioned above (e.g., keeping a routine and schedule, making use of special time, talking with kids about changes honestly, promoting family discussion, and helping children emotionally through coping skills and natural supports).
PCS moves have been cancelled, school is out, and schedules are disrupted. What can military families do to manage the uncertainty?
- If children are home, establish a schedule that includes the important things in their lives. For instance, have a set learning time. Your children may be able to complete work the school has sent home, engage in online learning platforms, or complete worksheets/workbooks that are available online or through online order and delivery services. It will help your child to see that you are maintaining as much normalcy as possible by demonstrating that school and other important family activities and values continue despite uncertainty.
Are there specific mental health signs and symptoms a parent should look out for that would require immediate intervention? How can we tell if children are just worried and antsy versus a child in a mental health crisis?
- Use natural resources first. Children learn how to handle and cope with hard things by seeing how those around them deal with them; they look to see how people in their natural support circle bridge gaps, unify, and mobilize to handle stressors. If your child is experiencing thoughts of death, self-harm, or harming others, you should seek mental health care. Children may experience reduced functioning temporarily as they meet the stressors and should be allowed to have some time to bounce back and make use of their own coping skills and the support of loved ones and friends. If your child’s functioning isn’t moving in a more positive direction after several weeks, increase your support, ask the child what would help, and encourage them to change unhelpful thoughts, talk to someone they trust, and do things that provide opportunities to experience positive feelings. If improvement is not seen after this, seeking professional help should be strongly considered.
- An app that helps kids learn how to change unhelpful thoughts is called the Triangle of Life. It is a game appropriate for ages 7 and up. Younger children may have difficulty with the motor skills required to move the characters through the video game. The app was developed to support children engaged in cognitive behavioral therapy. It is not a replacement for professional help, but it can help your children learn to engage in more helpful thinking styles. [The Triangle of Life app is free to download on both Android and iOS platforms.]
- Teach your child coping skills and help them practice them. Coping skills should be practiced when a child is NOT distressed so that the skill is learned and mastered and then is ready to be accessed when the child is upset at a later time.
o The most basic coping skill is belly breathing. Belly breathing can be learned by having your child lay flat on the floor and practice breathing with their belly. After they get used to breathing with their belly and not their chest, have them practice taking in a full breath, holding it for 3 seconds, and then doing a long and slow exhale. Children can practice belly breathing using bubbles, blowing up balloons, or by breathing on pinwheels.
o Belly breathing done correctly while using bubbles means that the bubbles are uniform in size, get so large they suck back into the wand, or that one very large bubble is made. Chest breathing, the kind that is not helpful, will make bubbles of varying sizes and demonstrate that the child has not yet mastered the skill.
o With balloons, belly breathing should result in slow gradual balloon growth, while chest breathing would result in halting increases in balloon size. (It is important to remember to make sure to supervise young children with balloons.)
o YouTube has child relaxation training videos such as Progressive Muscle Relaxation, stories to promote relaxation for sleep, and belly breathing activities. Make sure that you view the video prior to showing it to your child so that you know exactly what your child will view. Practice the skill together for about 5-10 minutes three to seven days a week.
Erynne H. Shatto, Ph.D., is a clinical psychologist specializing in child psychology and trauma across the lifespan. She provides services to military families through clinical research, therapy and assessment, and supervising/training mental health providers in training to work with military families. Her current work station is Naval Medical Center Portsmouth.
Kimberly Copeland, Ph.D., is a Military Internship Behavioral Health Psychologist with the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. Physically based at Naval Medical Center Portsmouth, she is an integral part of the core training committee responsible for teaching and supervising Interns and fellows in the Navy’s APA-accredited Pre-doctoral internship and Postdoctoral fellowship programs.