Helping Families with Children and Youth Build Resilience in the Era of COVID-19Part II: Building Resilient-Coping in Families

Presenters: Kara Dean-Assael, LMSWJames Rodriguez, LCSW, PhD

April 2020

Agenda1. Discuss stress and resilient coping2. Common reactions for children3. The “Three Pillars of Resilience”: strategies to build resilient

coping in children and youtha. Safety

i. Routinesb. Regulation

i. Self-soothing and Pleasurable Activitiesii. Changing how you think

c. Connectioni. Staying connected to others

4. Discuss the importance of caregiver self-care and strategies for promoting it

Common Reactions in Children to a Crisis such as COVID-19: Signs of DistressEveryone reacts differently regarding big changes and uncertain situations. Most initial reactions are normal to an abnormal situation! Reactions may be immediate or delayed. Here are common reactions:

‣ Increased activity level‣ Trouble paying attention or concentrating‣ Withdrawal from activities they may like or withdrawing from family‣ Changes in sleep or eating habits‣ Heightened reactions to everyday sounds and events

‣ Fears and Worry• concern about the safety of family, friends, and pets (if you have them)• concern about sickness (or complaints of sickness) • increased fear of separation from loved ones‣ Regression: • Acting childlike/immature for age• Clinging to caregivers or siblings• Returning to behaviors from younger ages (i.e. sucking thumb)‣ Acting out• Aggression towards siblings, caregivers, or other family members• Tantrums or angry outbursts

Parent or Caregiver Stress

Family Stress

Child or Adolescent

Stress

Resilient Coping

Resilient Coping

Wise Mind

Logical Mind

Calm and Cool

Focused on facts

Planning

Focused Attention

Wise MindEmotional Mind

Emotion with Reason

Aware of Emotions and Able to Control

Solutions last longer

Hot

Reacts without Thinking Through

Facts are Distorted

Solutions are Temporary

Linehan, 1993

The Three Pillars of Resilience

Safety● routines● schedules● social distancing

Regulation● self-soothing

activities● pleasurable

activities● relaxation

activities

Connection● Connecting with

each other in our families and our communities

● Caregiver Self-Care

Safety

The Three Pillars of Resilience

Safety● routines● schedules● social distancing

Regulation● self-soothing

activities● pleasurable

activities● relaxation

activities

Connection● Connecting with

each other in our families and our communities

● Caregiver Self-Care

The Importance of Safety‣ When there are major changes in our families and the world

around us, it is important to remind children that they are safe.

‣ Despite a sense of chaos and uncertainty, we can support children and youth to feel safe with trusted adults.

‣ Regardless of their age, children and youth do need us to remind them of safety in times such as this COVID-19 crisis. We can help remind them of this with a focus on everyday routines and schedules along with helpful information.

Routines - New Ones and Old Ones‣ Routines and Schedules provide consistency and stability

• Daily schedules help everyone to feel safe. Let children help create their schedule so they also have some control and say.

‣ Work with children and youth to set up new routines• When to get school work done or study• Taking breaks - with pleasurable activities• Exercise or relaxation• Helping with chores related to health and safety (age appropriate)• Check-in Time and/or Worry time or News Time• Finding time for privacy - in small spaces

‣ Maintain other routines• Bedtime (*for younger children short-term changes are ok)• Meals (mindful of healthy eating)• Family time

Planning Routines and Managing Behavior‣ List all activities that are a part of your routine‣ Identify blocks of time to fill (i.e. school work time from 12-

3, family time from 6-8, etc.)‣ Give children and youth responsibilities‣ Give children and youth choices‣ Make sure that rules are clear (i.e. if you do not finish your

homework, you won’t get screen time)‣ Include time with each other in your routines - this is an

opportunity to build relationships with each other!‣ Remember social distancing or distant socializing!

Promoting Children’s Learning‣ To keep children engaged

• Stay in touch with child’s school to know assignments• Spend time to review their work to keep them on task• Have them teach you what they’ve learned• If necessary, access other online learning sites (i.e. Khan Academy)

‣ Include routines for learning at home‣ Consider the need and adjustment required for your child’s age‣ Look for ways to make learning fun

See resources at the end of the presentation

Pleasurable Activity PlanningFamily time activities‣ Movie night‣ Game night (board games, card games)‣ Religious activities (prayers and events on the Internet)‣ Cooking/baking

Age Appropriate Child/Youth Activities‣ Change the scenery (getting outside)‣ Reading‣ Watching T.V.‣ Listening to music‣ Video games‣ Contacts with friends via social media‣ Volunteer

See resources at the end of the presentation

Healthy Eating and ExerciseHealthy Eating‣ Monitor sugar intake‣ Stay hydrated with water‣ Following “My Plate”

Exercise‣ Walks‣ Chair exercising ‣ Online virtual exercise classes‣ Free workouts at anytime‣ Free yoga - that can help with relaxation as well

See resources at the end of the presentation

Keeping it DevelopmentalFor pre-school children:‣ Allow short-term changes to sleeping arrangements‣ Try online storytelling or activities together

For school-age children:‣ Assign household chores‣ Maintain or promote healthy habits or health promotion (e.g. hydration,

hand cleaning

For adolescents:‣ Engage in family chores, support younger siblings ‣ Start strategies to promote healthy lifestyles

Regulation

The Three Pillars of Resilience

Safety● routines● schedules● social distancing

Regulation● self-soothing

activities● relaxation

activities

Connection● Connecting with

each other in our families and our communities

● Caregiver Self-Care

The Importance of Regulation‣ Self-regulation is the ability to manage and understand our own

reactions and behaviors.‣ Self-regulation is important for development as it helps children with

connection, social skills, learning, managing stress and processing information.

‣ Self-regulation develops most in the early years and continues to develop into adulthood.

‣ Self-regulation is developed through talking about feelings and role-modelling.

‣ Co-regulation involves regulating with a trusted person. It can be helpful to regulate oneself by co-regulating. Developing self-regulation and co-regulation helps to improves our ability to respond to the appropriate information within our environment.

Regulation - Self-Soothing Activities‣ Breathing

• For children • For teens/adults

‣ Yoga‣ MeditationMindfulness for Teen‣ Progressive Muscle Relaxation -

• For children (Tin Man/Rag Doll)• For teens/adults

Engaging the Senses‣ Vision: Google pictures of a beach or sunset

‣ Hearing: Music, relaxing sounds, cooing babies, cats meowing, ASMR

‣ Smell: Fresh coffee (for older kids), baked cookies (for younger), lotions

‣ Taste: Drinks, foods, peppermint

‣ Touch: Cold water, warm water, soft plush toys

‣ Movement: Going for a walk, dancing, stretching

My behaviors,feelings,thoughts

Wha

t oth

er p

eopl

e

thin

k or

feel

The VirusThe Cure

Others Getting Sick

Other people’s

behavior

What Can I Control?

What Can’t I Control?

Coping Thoughts

Keeping it DevelopmentalFor pre-school children:‣ Encourage expression through play and storytelling‣ Plan calming, comforting activities before bedtime and give extra

support at bedtime

For school-age children:‣ Regular exercise and stretching (e.g. cosmic yoga)‣ Engage in educational activities (workbooks, educational games)

For adolescents:‣ Encourage discussion about COVID-19 but do not force‣ Focus on what you can and can’t control

Connection

The Three Pillars of Resilience

Safety● routines● schedules● social distancing

Regulation● self-soothing

activities● pleasurable

activities● relaxation

activities

Connection● Connecting with

each other in our families and our communities

● Caregiver Self-Care

The Importance of Connection‣ Social isolation

• Isolation depression• Isolation can lead to increased worries

‣ Connection• Allows for communication• Getting out of one’s head• Sharing the burden• Hearing how others are coping• Developing gratitude for what you have• Opportunity to support and comfort others• Opportunities for breaks and enjoyment• Increasing hope for the future

Connecting to Others ‣ Maintain Contacts with trusted friends

• Virtual hangouts: Zoom, Google Hangouts, House Party, Phone‣ Family Time/Activities‣ Virtual Play

• Virtual play dates• Gaming• Netflix Party

‣ Online Communities (e.g. Reddit)• Can join others (with caution)• Create your own

‣ Online Places of Worship‣ Online Support Groups‣ Place of Positivity

See resources at the end of the presentation

Keeping it DevelopmentalFor pre-school children:‣ Spend more time connecting when young children feel more anxious

or scared.For school-age children:‣ Maintaining contact with friends through telephone and social media.‣ Address any stigma or discrimination occurring and clarify

misinformationFor adolescents:‣ Maintain contact with friends through telephone, internet and video

games‣ Discuss and address stigma, prejudice and potential injustices

occurring during outbreak

Caregiver Care

The A-B-C-Ds of Self Care

‣ Awareness of one’s needs, limits, feelings, and internal/external resources.

‣ Balance of activities at work, between work and play, between activity and

rest, and between focusing on self and focusing on others.

‣ Connection to oneself, to others, and to something greater than the self.

‣ Develop a self-care action plan

Parent or Caregiver Stress

Family Stress

Child or Adolescent

Stress

Resilient Coping

Resilient Coping

Protect Your Physical and Mental Health

‣ Maintain old routines and develop new ones‣ Disconnect and reconnect. Friends, Extended Family, Supports‣ Exercise daily. Walks w/ Social Distancing, Upstairs/Downstairs, Chair

exercises.‣ Eat well. Limit high sugar intake. Stay hydrated. Avoid nervous eating ‣ Get enough sleep. Try old routines or make a new one.‣ Avoid alcohol and drugs. They don’t actually reduce stress and often

worsen it.‣ Practice relaxation exercises. ‣ Practice mindfulness

See resources at the end of the presentation

Coping with ACCEPTS‣ Activities - to distract yourself

‣ Contributing - help others

‣ Comparisons - think about those less fortunate

‣ Emotions - avoid guilt, change your emotion (watch funny videos)

‣ Pushing Away - the stress of the situation (schedule time to worry)

‣ Thoughts - replace your thoughts

‣ Sensations - intensify other sensations (cold water on face, eat ice)

Additional Coping Tools‣ Find what works for you!! ‣ Stress affects your entire body, physically as well as mentally. Some common

physical signs of stress include:• Headaches• Low energy• Upset stomach, including diarrhea, constipation and nausea• Aches, pains, and tense muscles• Insomnia

‣ Support regarding anxiety and stress - Call SAMHSA Disaster Distress Hotline: 1 (800) 985-5990 or text TalkWithUs 66746

‣ Support for victims: Call the Hotline at 1 (800) 799-SAFE (7233) or visit their website at https://www.thehotline.org/help

Summary ‣ Crisis is stressful but can provide an opportunity to teach coping

strategies‣ Focusing in Safety, Regulation and Connection can help to

minimize the development or worsening of problems‣ Coping involves proper planning. Take time to plan routines and

to plan for self-care‣ Use the suggestions made in this presentation but make sure the

plan works for you. You know yourself and your children best.

Thank YouVisit www.ctacny.org to view past trainings, sign-up for updates and event

announcements, and to access resources including COVID-19 related resources for mental health providers.

Please send any questions or feedback to ctac.info@nyu.edu.