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The Pandemic and Kids' Mental Health
Discussion Guide

 

Contents

Note From the Author

The social isolation, uncertainty, and missed milestones brought by the pandemic left millions of children anxious and confused. Exhausted from the experience, it’s tempting for all of us – adults and children – to push away memories of these difficult months. But giving way to that temptation carries a high cost. When children are encouraged to talk about the experience and how it affected them, it will help them move through the traumas, build confidence, and equip them to cope with future difficulties. Our advisor Paula K. Rauch, MD, a child psychiatrist at Massachusetts General Hospital, explains: “When facing future tough times they’ll remember, ‘Oh yeah, we’ve done this before. I can do this.’“

 

Thirteen-year-old Megan, featured in our Teens segment, compares making sense of the pandemic experience to reading a book: “You have to understand the first chapter for the rest of the chapters to make sense.”

 

We’ve all lived through a host of challenging events the past several years. When faced together, this presents a unique opportunity for families to strengthen their relationships and their emotional well-being. The Pandemic and Kids' Mental Health offers parents and other caring adults the information, skills, and actual words they can use to engage children in resilience-building conversations.

 

We are grateful to Dr. Rauch for her sharing expertise and guidance in the creation of our program.

 

We wish you the best.

Jeanne Blake

Jeanne Blake

Jeanne Blake is the CEO and President of Blake Works, an executive leadership and communication firm. Jeanne is an executive advisor and coach, author, former award-winning medical television journalist/news anchor. She is an honorary trustee at McLean Hospital, Harvard’s largest psychiatric teaching hospital, and an affiliated faculty member of the Division on Addictions at Harvard Medical School. Jeanne has appeared on Oprah, the Today Show, CNN, and been featured on NPR, The Boston Globe, USA Today and Bloomberg Radio. She is the creator and executive producer of The Pandemic and Kids’ Mental Health.

Paula K. Rauch, MD

Dr. Paula K. Rauch, a child psychiatrist, is the Founding Director of the Marjorie E. Korff Parenting At a Challenging Time (PACT) program. She specializes in the impact of medical illness on families and on the emotional health and well-being of children. She is an Associate Professor of Psychiatry at Harvard Medical School and the inaugural incumbent of the Timothy Christopher Davidson Chair of Psychiatry at the MGH. Dr. Rauch is the advisor to Blake Works’ The Pandemic and Kids’ Mental Health.

 

Blake Works

Blake Works is a leadership communications consulting firm. We partner with companies internationally to provide executive leadership and communication coaching. We also lead interactive workshops to strengthen team alignment and their capacity to influence and persuade all key stakeholders.

 

Blake Works is the producer of The Pandemic and Kids' Mental Health and the Words Can Work library of evidence-informed multimedia used by organizations internationally.

 

You can learn more at www.blakeworks.com.

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Ways to Use The Pandemic and Kids' Mental Health

The Pandemic and Kids’ Mental Health was created for viewing by groups of parents and other caring adults. It can be used in the workplace, schools, and community workshops. It’s also appropriate for family viewing and discussion at home.

 

Companies offer our program to employees and host “watch parties.” Employees view a video together and candidly discuss their experiences raising children and teens.

  • Biotech company employees candidly shared their pandemic experiences after watching a segment of our program. When a mom described life in the pandemic with her six-year-old, a colleague acknowledged her struggles. The mom later said she felt validated, and since, is more motivated and engaged at work.

 

  • The Chief Talent and Equity Officer of a law firm said the program is a valuable resource for attorneys and staff that provides practical guidance to use in the pandemic and across the parenting journey.

 

Schools offer our program to faculty, staff, and school communities. They host “watch parties,” which include dynamic group discussion about responding to the needs of their children and of students.

  • The principal of one school says the hopefulness of our program inspired their school community’s families to share their own experiences at “watch parties” featuring the videos. Families gained tools they can use to support children now and in the future.

 

  • The Director of Counseling at a middle school showed our Preteen video to students who were inspired to offer this guidance to parents: “Validate our feelings,” they said, “Don’t try to protect us by sugarcoating the pandemic experience.”

 

Parents view and discuss our program with a spouse or partner, friends, or their children.

  • A father of three watched The Pandemic and Kids' Mental Health and felt relieved to learn that other families faced similar challenges to his own. Using the strategies for talking with kids he found that simple conversations help allay his daughter’s anxiety.

 

  • A mom watched the Teen video with her 12-year-old son who responded, “Wow, I'm so glad somebody finally understands me.” The mom was stunned – she thought she and her son were communicating well. She dug deeper into how her son and three other children felt. As a result, she listens more intently, and her children share more openly.

 

As you prepare to facilitate a group conversation, you can select the video segment most appropriate for your group. Many parents gain valuable insight from watching all three videos – regardless of their child’s age. Discussion questions and proposed responses are offered for each segment. Participants often say our sessions marked the first time they have talked openly about their experiences raising children and teens  in the pandemic. These candid conversations often create a strong sense of community. You may find that an hour-long session allows for only one or two discussion questions. We recommend reviewing and selecting questions prior to your event  – then being flexible to allow a spontaneous conversation to evolve.

 

The content of The Pandemic and Kids’ Mental Health is for informational purposes only. It is not intended to replace professional advice. For specific issues, please consult a health professional.

 

Note: The Pandemic and Kids’ Mental Health includes copyrighted materials. Broadcast, cablecast, duplication, Internet, and Intranet or commercial use in trainings or presentations is prohibited. For further information contact Blake Works at 978.282.1663 or info@blakeworks.com.

 

 

Using this Guide

This guide is designed to help you lead discussions with groups of parents and other caring adults.

Impact on Participants

Viewers will feel a variety of emotions as they watch the program depending on their own experiences in the pandemic. We suggest providing viewers with a list of community resources, including counselors and other health professionals, and mental health organizations. A list of resources is available under each video segment on the home page.

Video Segments

Preschoolers

This video segment features three-year-old Max and his parents; Ruth, 105, who recalls the flu pandemic of 1918; and Arielle, the mom of two young sons. Dr. Archana Basu, a child psychologist at Massachusetts General Hospital, shares her insight and guidance.

 

Preteens and Elementary-aged

This video segment features eight-year-old Jaziel, his 13-year-old brother Stephen, and their mom. Also featured are 12-year-old Charlotte, her friend Victoria, and Charlotte’s mom and dad. Dr. Paula Rauch, a child psychiatrist at Massachusetts General Hospital, shares her insight and guidance.

 

Teens

This video segment features 13-year-old Megan, her mom, and 17-year-old Cedric. Dr. J.J. Jenkins, a child psychologist at Massachusetts General Hospital, shares his insight and guidance.

Developmental Milestones

The pandemic and other crises experienced by children and adolescents are superimposed on a child’s normal developmental challenges. By knowing what to expect at different stages of a child’s development parents – and other caring adults – may be better equipped to respond to their child’s particular needs during challenging times.

 

Preschoolers (3–6 years)

Children this age rely on predictable routines and consistent loving limits to feel secure. They weave together facts and fantasy to understand what they see and hear. Parents may notice a child’s play may include current events and parts of life he or she finds challenging. By observing play, and asking inviting questions, parent can uncover a child's misconceptions or worries. Children of all ages take their emotional cues from parents, but children this age especially rely on a parent's calm voice and body language to feel reassured and safe. In the face of adversity, your child may regress and exhibit earlier behaviors such as more accidents after being toilet trained or more difficulty falling asleep alone. These signs of stress are common and usually resolve with extra attention to stay calm, maintain regular routines, and preview changes with your child.

 

Elementary School–Age Children (7–12 years) 

Elementary school-age children are learning many new skills in the classroom, in afterschool activities and in relationships with peers. Peer relationships, including establishing a best friend or friends, are important. Supporting these connections during a challenging time is key. Children this age are hopefully learning that when they try hard, their skills improve. Parental support is often needed for a child to persevere and achieve this goal. At this age, children are tuned into rules and fairness. When they believe others aren’t following the rules, they are distressed – particularly when “rule breakers” appear to escape consequences. It is common for children to question rules, especially when other families live by different rules. You can explain how you make important decisions while modeling respect for those who make different choices. This can be challenging when parents, too, feel frustrated by others’ decisions.

 

Teenagers (13–19 years) 

Teens are developing new cognitive capacities, including the ability to imagine something from many perspectives and long into the future. They often feel intense emotions and may be idealistic, compassionate, and attuned at one moment and suddenly moody and self-absorbed. Recognizing that both versions of their teenager are normal can help parents manage their expectations through the ups and downs of adolescent behavior. Adolescents are establishing new identities and typically look to their peer group for connection and a sense of belonging. Romantic relationships may emerge and can be extremely intense. Even ending a short relationship can be very painful. Adolescents move back and forth between independence to dependence with the support of parents. Listen carefully to learn from your teenagers. Their experience is different from yours as a teen. Be mindful that children often experience worry about them judgment, which may shut down communication. Adolescence is a time when stress is common and anxiety and mood disorders – including substance abuse – may emerge. If you are concerned about your teen, talk with your pediatrician, school counselor, or a mental health provider.

 

By Dr. Paula K. Rauch

 
 

Video Segment: Preschoolers

Introduction

This is a program about how talking with children about the ups and downs of the pandemic can help them strengthen their resilience. Understanding a child’s experience and how to effectively engage with them strengthens a child's relationship with a parent or another trusted adult. A child’s resilience depends on caring adults being tuned into them. In this video segment, we meet three-year-old Max and his parents who describe their pandemic experiences. We also hear from a mom of two young sons, and from a 105-year-old survivor of the 1918 flu pandemic. Dr. Archana Basu, a child psychologist at Massachusetts General Hospital, shares insight and guidance. Let’s watch the video.

 

View Preschoolers video segment                      Length: 18:40

 

Begin discussion by saying

Let’s talk about Max’s response to events in the pandemic and how his parents dealt with it.

 

Ask participants

  • Max cried when he told his mother his version of Peter Rabbit. That’s when she realized he’d overheard conversations about COVID-19. How did you realize your child had overheard conversations or picked up on news about the pandemic?

 

  • What are ways you engaged your children to identify misinformation or confusion about the pandemic and its impact at home or in your community? How did you reassure them?

Response: Our brains detect and respond to changes in our environment. As Dr. Basu says, “Even infants sense the emotional climate around them and changes in the tones of their caregivers.” We can support children by offering factual, age-appropriate information. Max’s mom acknowledged Max’s worries and offered realistic reassurance by explaining that everyone was working together to stay as safe as possible. Letting Max know he could take steps to stay safe – mask wearing and handwashing – gave him a sense of control.

 

  • As children often do, Max acted out his worries through play by holding a “coronavirus protest.” How did his mom use this opportunity to engage with Max?

Response: Liz joined in the play. She listened carefully to gain insight into Max’s thinking and followed up with age-appropriate information about his misconceptions.

 

  • When hiking, Max steps off the path as someone approaches. His parents worry that learning to keep distance from people in the pandemic may have long-term effects. What long-term impact do you worry the pandemic may have on your child?

Response: Children learn early on about not talking to strangers, so being wary can be protective and a natural part of a child’s development. The key is to stay aware of a child’s new behaviors, engage to understand his or her thinking, and correct misinformation when necessary.

 

  • Max’s grandmother wrote a story comparing COVID-19 to scarlet fever – an illness Max’s great grandmother survived. How have you used storytelling to help your child create a narrative about the pandemic – or any other challenging event?

Response: Intergenerational storytelling increases child resilience – particularly when a story incorporates a challenge faced, lessons learned and a positive outcome. This reminds children that their parents and grandparents have struggled and eventually arrived at a safer place.

 

  • When Ruth’s father died from the Spanish flu, it wasn’t openly discussed. She says this significantly impacted her life. Why is it important to process negative events?

Response: Traumatic memories live on in our minds. When we can talk about challenging experiences, we feel connected and less alone with our worries. When we help children create a narrative around their experience, they understand their feelings, what’s safe or not, and when to worry versus feel secure. Children need a chance to revisit big events throughout their development. Ruth missed out on processing her father’s death when it happened and throughout her childhood. So, it remains an unresolved traumatic experience.

 

  • Arielle demonstrates that when we experience stressful times, it’s important to talk openly with loved ones and ask for their help. How can this be helpful to children who observe it?

Response: It’s important for adults to model healthy ways of handling stress. We want children to learn that during hard times, people who care for each other ask for and give support. This is an important life lesson.

 

Remind participants

Some parents worry that talking with children about their pandemic experiences will stir up anxiety or prolong negative memories. The truth is that by discussing what was hard, and lessons learned, children will better understand their experiences. This enhances their ability to face future adversity with confidence.

Video Segment: Preteens and Elementary-aged Children

Introduction

This is a program about how talking with children about the ups and downs of the pandemic can help them strengthen their resilience. Understanding a child’s experience and how to effectively engage with them strengthens a child's relationship with a parent or another trusted adult. A child’s resilience depends on caring adults being tuned into them. In this video segment, we meet children and parents who describe their pandemic experiences. Dr. Paula Rauch, a child psychiatrist at Massachusetts General Hospital, is also featured. Let’s watch the video.

 

View Preteens and Elementary-aged Children video segment                Length: 21:00

 

Begin discussion by saying

Let’s talk about the children’s comments and how their parents responded.

 

Ask participants

  • Jaziel was surprised and upset when soccer was cancelled, and classes went remote. How did his mom Kristel respond?

Response: Kristel gave Jaziel time alone to pause, calm himself, and figure out his feelings. Then, together, they could talk about next steps that might help him feel better. Not every child can calm him or herself in every situation. But it’s important to give them the space to try, so this becomes a habit for life. Even suggesting to an upset child that he take a couple of breathes can help him self-regulate and feel calmer.

 

  • When Stephen feels anxious, Kristel tunes in and spends extra time with him. How is this helpful to a child?

Response: By acknowledging Stephen’s struggles, Kristel validates his emotions. As a result, he is comfortable sharing that he feels “insanely lonely” and this helps Stephen feel less lonely and anxious. Open communication also will help Kristel notice when her son may benefit from professional help.

 

  • What strategies have you used to encourage your child to open up when he or she may not feel like talking?

Response: It’s helpful to Identify times your child is most likely to talk – during a walk or while you’re making dinner. Sometimes you can let your child initiate conversation. Other times you can ask open-ended questions: “What was the best part of your day?” “What was most frustrating?”

 

  • Charlotte found the news to be overwhelming. At times, she asked to limit news exposure or to avoid certain topics during family dinners. When there are high-stress world events, how do you balance the realities of those events with the need to create a safe, secure environment for your child?

Response: Charlotte wasn’t asking her parents to ignore or deny news events. Charlotte recognizes it’s important to have time when she isn’t flooded with upsetting news. Having a balance is key. Parents can help children identify relaxing activities that help them shift gears, such as hiking, listening to music, or playing a game with a sibling or friend. Parents model how to make emotionally healthy choices when they do the same.

 

  • Children need a trusted source of information to help them make sense of their world. How do you discuss news events, in age-appropriate ways, so children have context for their experiences and feel secure?

Response: It’s important to check in to learn what your child is hearing about current events. You can discuss what may be upsetting them and where to find quality information. Children this age can benefit from creating an action plan in response to upsetting news, such as moving a scheduled event outdoors vs indoors or donating to the Red Cross to support victims of a tragedy. Even small actions you take together can improve your child’s emotional well-being.  

 

  • Charlotte cited the social injustice protests as a source of her worries. How did your child talk about the confluence of global events during the pandemic?

Response: When children struggle, they may be responding to a combination of events. Helping children tease out the source of their distress can help them feel less confused and overwhelmed. Open communication provides an opportunity to identify what is front and center from a child’s perspective. One family shared this example around mask wearing: The parents worried about COVID infection. Their son worried about the impact of disposed masks on the environment. You can only identify a child’s true worries – which may vary day to day – through ongoing, honest dialogue.

 

  • What role does social media play for your child as he or she learns about current events and interacts with peers?

Response: Social media has both risks and rewards. Dr. Rauch says parents need to help children seek a healthy balance. Many children maintain important connections with peers through social media. Victoria uses it to support her friends. But interactions are not always positive. Some children recognize that at times they feel worse on social media and will benefit from parents’ encouragement to take a break from it.

 

  • When children learn they can positively impact their world they develop agency. Agency is feeling empowered to make meaningful changes in your world. It’s the opposite of feeling helpless. One way to develop agency is by doing things for others. How have you encouraged your child to make a difference in another person’s life?

 

  • It's important for parents to model healthy responses to   stress. How have you talked candidly about your own emotions while conveying a sense of hope?

Response: As Dr. Rauch says, it’s important for children to understand that emotions  are natural and come in waves. She offers this example, “I was expecting an important call this afternoon and it didn’t happen. I feel annoyed. I am going to listen to my favorite music to let this frustration wave pass.”

 

Remind participants

When there is a sustained change in a child's mood, which lasts more than a couple of weeks, and the parent’s support isn't changing that, it’s time to seek guidance of a pediatrician or a mental health professional.

 

 

Video Segment: Teens

Introduction

This is a program about how talking with children about the ups and downs of the pandemic can help them strengthen their resilience. Understanding a child’s experience and how to effectively engage with them strengthens a child's relationship with a parent or another trusted adult. A child’s resilience depends on caring adults being tuned into them. In this video segment, we meet teens and parents who describe their pandemic experiences. We also hear from Dr. J.J. Jenkins, a child psychologist at Massachusetts General Hospital. Let’s watch the video.

 

View Teens video segment                    Length: 17:30

 

Begin discussion by saying

Let’s talk about Megan’s and Cedric’s responses and how their parents supported them.

 

Ask participants

  • Many young people described feeling overwhelmed during the pandemic. When Megan talks openly with her mom, it lightens her mood. How do you encourage your teen to be open with you?

Response: Asking open-ended questions can encourage a child to talk. You can ask, “What was the best part of your day today?” or, “What was rough about school today?” To help teens continue to process their pandemic experience parents can ask “How did today compare to how things were in the beginning of the pandemic?” The key is to listen with genuine respect and curiosity and resist interrupting to tell your child what to think, feel, or do.

 

  • Many children cited the social injustice protests during the pandemic as a source of their worries about the world. How did your child talk about the confluence of events during the pandemic?

Response: When children struggle, they may be responding to a combination of events. Helping children tease out the source of their distress can help them feel less confused and overwhelmed. Open communication provides an opportunity to identify what is front and center from a child’s perspective. A parent might be most worried about the health of a grandparent, while a teen might be most worried about whether masks will be required for a certain event.

 

  • What role does social media play for your child as he or she learns about current events and interacts with peers?

Response: Social media has both risks and rewards. Dr. Rauch says parents need to help children seek a healthy balance. Many children maintain important connections with peers through social media. But interactions are not always positive. Some teens recognize that at times they feel worse on social media and will benefit from parents’ encouragement to take a break from it.

 

  • Dr. Jenkins says teens need adults other than their parents with whom they can talk. Who are adults in your teens’ life you encourage them to turn to for emotional support?

Response: There may be times your child is more comfortable confiding in a neighbor, coach, or trusted family member. Helping your child create a trusted network of support is an investment in his or her well-being.

 

  • Some parents believe their teen overreacted to missed activities through the pandemic, such as a theater production, birthday party or sporting event. Why is it important to treat these missed opportunities as bereavement?

Response: Teenagers have the capacity to imagine the future and often set long-term goals. Missing out on something they’ve worked for, such as a graduation party or important game, is an enormous loss . Track was an important part of Cedric’s identity. When we minimize their disappointment or trivialize it, we invalidate the teen’s experience. This can lead the child to feeling shame. However, when we honor their perspectives, we facilitate honest communication and increase their teenager’s sense that we “get it” and can be trusted and confided in.

 

  • As young people process losses, it’s important to help them identify future milestones they’ll enjoy. How can this be beneficial?

Response: As Dr. Jenkins says, the trusted adults in kids’ lives serve as binoculars – helping youth see and be hopeful about opportunities ahead. This can help them develop a sense of optimism and prepare for the long game.

 

  • Hard times present opportunities to learn new life skills. Megan learned she’s resilient and can find the good in difficult situations. What would your child say were silver linings in the pandemic?

 

  • How will realizing he or she found good in a difficult situation help your child navigate future hard times?

Response: Identifying unexpected positives in difficult situations helps children sustain hope. Megan remembers making pizzas with her family. Cedric grew closer to his parents  and compensated for his losses by building a computer. Identifying silver linings gives children confidence that they can endure more than they may imagine.

 

  • Have you ever talked with your child about a tough time you experienced  and a surprisingly positive outcome from that experience?

Response: Intergenerational storytelling increases a child's resilience – particularly when a story incorporates a challenge faced, lessons learned, and a positive outcome. This prepares teens to persist in the face of obstacles.

 

Remind participants

Resilience is not being unaffected by adversity. Rather, it’s learning from your experience, gaining confidence to persevere through difficult times, and believing that good things can come from struggles. That’s why it’s important to engage with children to talk about – rather than try to forget – some of their difficult pandemic experiences.