How to Talk to Kids who are Worried about the Coronavirus

Over the last week, I’ve seen an increase in kids (and adults!!) who are worrying about coronavirus. The concerns about the coronavirus aren’t so different from other (what I call) “existential” worries - gun violence, global warming, politics. Kids know just enough of what’s going on to know that there is a real danger without the actual ability to mitigate that danger fully. So, I have parents asking me, “What do I tell X about corona? He’s afraid to go out.”

I was just about to post an article on my thoughts, when I discovered an excellent article from Seattle Children’s Hospital (incidentally also where I completed my residency and fellowship) about what to do. This article focuses on the coronavirus specifically, but I think the approach of gathering facts, answering questions (without reassuring or making impossible promises), and assuming normal daily life is pretty much spot on:

Link to article here

The Not-so-Harmless YouTube videos your kids are watching

I was in a session about a year ago when a mother asked me if I had heard of the “latest thing that all the kids these days are watching on YouTube.” I’ve heard of some weird stuff, but what she was telling me about did sound pretty odd - the latest craze she was referring to? Kids watching other kids (or adults) open up toys in boxes and packaging.

For. Hours. On. End.

While such videos seemed pointless to me, I kept an open mind and watched a few. After 10 minutes, I started to understand the obsession. The presenters are incredibly enthusiastic (there is SO MUCH COO’ing), and there’s something really satisfying about watching people open up packages (in a lot of these videos, the package opening happens in a really careful and systematic way). Plus, these videos are a bit like window shopping - you get to see everything all shiny and new and it all looks so tempting and attractive.

Well, a recent study out of my alma mater, CU Boulder, suggests that these videos, unsurprisingly, are not good for your kids. These videos are, after all, a clear reminder of the haves and the haves not:

https://www.colorado.edu/today/2019/12/03/unboxing-videos-fueling-kids-tantrums-breeding-consumerism

I’ve also heard some parents say they have found some toy opening videos that initially seem innocuous but then cut halfway through to really disturbing/frightening content. I have no idea why people would want to do that, but it’s all the more reason to monitor what your kids are watching, however innocent it may seem.

Another parenting principle: It's not just what you say that matters, but HOW you say it.

When providing parent coaching, I often find that many parents already know what to say when their children are upset or distressed. Many of them provide thoughtful emotion coaching (i.e., helping their child identify the emotion they feel or giving words to what their child is feeling), and many also express appropriate empathy (i.e., "You must be so upset about that - I’m so sorry you’re sad!”). Some praise when they see their children respond to difficult emotions in a positive and effective manner (this makes me especially happy to see!).

While I definitely focus on the content of a message, I also spend a lot of time helping parents evaluate how they talk to their children. When I say how, I mean specifically the tone, feel, and emotional delivery of what they are saying.

It’s important, especially for little ones, that the intensity of or emotion in your voice matches what they are feeling. Can you imagine if you were seriously upset about something and were talking to a friend about it who responded in a totally flat and blase voice “Oh, I’m so sorry. That’s so terrible.” The content would be totally spot on, but the emotional intensity and meaning behind it would leave you feeling totally unsatisfied, if not dismissed. It’s the same for children - when they are upset, it’s important that you match their intensity and tenor, as this helps them feel heard and validated.

It can be difficult doing this when your child is upset about something that feels unreasonable (some parents tell me they feel like their kids’ requests are outright insane). I’m not asking you to agree to their demands, I’m asking you to acknowledge and agree to how upset or distressed they are when they don’t get what they want. Validating their emotions doesn’t mean you have to agree to what they want. This can be hard for parents, as many have asked, “Well, if I say that it’s okay for her to feel upset, doesn’t that mean I need to give into what she wants?”

Not necessarily. As adults, we often encounter disappointments. The important thing isn’t that we can always change circumstances to be in our favor, it’s that we learn to deal with feelings of sadness, disappointment, anger, etc. that arise as a result of these trials and tribulations. By holding the line and validating our children’s emotions, we are starting to teach the early lessons of facing the realities of life while being able to manage difficult emotions.

I’ve run into the effects of incongruence between message and delivery with kids who tell me that their parents don’t “get” that they are sad, anxious, or upset despite the fact that the parents saying all the right things. Sometimes it’s just a matter of parents tweaking how they speak to their kids - lowering their pitch, softening their tone, slowing their speech, adding a bit of sadness - for kids to really feel heard and understood.

I recently came across a research study by Weinstein and colleagues (2019) in the journal Developmental Psychology, titled Listen to your mother: Motivating tones of voice predict adolescents’ reactions to mothers. As I discussed above, tone matters early in childhood when validating and emotion coaching, but it also continues to matter in adolescence, and in positive interactions. In this study, mothers of teens provided motivational instructions (e.g., “Do well in the play) in a variety of tones - supportive, neutral, and controlling. Unsurprisingly, the teens who had mothers provide the instructions in a supportive voice tended to report having more positive emotions, more closeness with their mothers, and were also more engaged than the teens whose mothers used a controlling voice.

Taken together, this study (and many before it) tells us that it’s not just how parents talk when dealing with difficult situations that matters, but also how they express provide encouragement and support that matters. Parents sometimes ask me how they will know they get it right - I ask them to practice with me in session (role playing helps A LOT!), and to practice with each other and give each other feedback. I’ve had parents come back to tell me that it not only helps how they relate to their kids, but how they relate to each other - that doesn’t surprise me. At the core, all people, children and adults alike, want to feel like our emotions are reasonable, acceptable, and understandable. Having that message delivered in a way that resonates goes a long way to help achieve that.

Why Child Therapy Often Involves Parent Therapy

Today, I’m writing about a question I get asked very often in my practice. I’ve invited my friend and colleague, Dr. Craig Springer, PhD, to join me in writing this article. Dr. Craig is a brilliant psychologist who worked for years in academia before establishing a flourishing child, adolescent, and adult practice, the Good Life Center for Mental Health (https://goodlifecenternj.com/), in Cranford, New Jersey. We met years ago through a good friend, and now here we are, both in private practice. I was talking to Dr. Craig the other day when I mentioned that parents often ask me why they need to be involved in their children’s therapy. In response, Dr. Craig shared that parents often expect to drop their children off and do not know why they need to be involved in treatment.

While I appreciate that parents want to give their children space and confidentiality, I think it’s important to discuss just why child therapy necessitates parent involvement.

First – Particularly with respect to younger children, it’s incredibly hard for children to change their thoughts and behaviors on their own. There are entire therapies that focus on changing how adults behave and think, and even those can take a while to implement. Young children have limited insight into their thoughts and feelings, and even more than that, their brains are still developing. How many of us have tried to ask children post-tantrum why they were angry, only to receive an incomprehensible answer. While parents find this frustrating to no end, many children truly don’t understand the cause and effect that lead them to be angry.

So, given how hard it is for adults to change unhelpful patterns and thoughts, one can imagine that it’s necessarily even harder for little kids to simply stop their behaviors and change. Teens might have more insight and talk like they know what they are doing, but countless studies have established that the teenage brain is still in a state of development (see Arain and colleagues, 2013, Casey and Caudle, 2013) across many domains – complex reasoning, self-control, and emotional maturity. Given the still maturing brain, it’s developmentally unreasonable for us to expect kids to just learn to change on their own.

Second – Without a question, parents have the most significant impact on their children. Parents are often the main attachment figure (because of this, most children are really motivated to please their parents), have had the most time with their children across different settings and environments, and know their children’s’ strengths and weaknesses the best. Therapists often only have 1 hour a week with a child. Although we can teach and practice skills and tools, parents must be the ones to help them generalize those behaviors and can also set up an environment filled with rewards and consequences for reinforcing effective behaviors. If, in my work with parents, I can teach them the skills and tools to set up a positive environment and model more adaptive behaviors, this change will inevitably trickle down to their children (research also supports the importance of parent involvement, beyond just facilitating how kids make it to/from therapy – Haine-Schlagel & Walsh, 2016).

Third – A supervisor of mine once said that I cannot change children’s behavior without changing the family system. What he meant by that is that every person in a family plays a specific role and that an individual’s role cannot change if the family doesn’t change how it operates. The troublemaker child, for example, has no room or impetus to change her devious ways if the family continues to treat her like a truant. If the parents change how they operate, however, the family dynamic will shift, thereby giving each individual space to behave differently and try new ways of interacting. This significant of a shit can only be achieved through working with the parents.

Finally, change requires safety, trust and understanding. Children use their behaviors to express their thoughts and feelings and to have their needs met. Over time, they establish patterns of behavior to navigate their world and protect themselves from vulnerabilities, insecurities, or to cope with challenges. Trying to utilize a different way of interacting requires incredible amounts of courage. Parents, through their understanding, support, and reassurance can provide children with the necessary characteristics for change to take place.

Where did you learn that??!

While I’m a child and adolescent psychologist, I also spend a lot of time working with parents. This is because it’s hard for young kids to change their thoughts and behaviors on their own. Instead, parents have to be the one to set the environment to help kids do that. During our work together, parents often tell me that they want to change how they parent, but that it also feels overwhelming because there is so much to keep track of! There’s no doubt - it is a lot! Parenting is a full time job and studies show that parents today are busier and taking on more responsibilities than parents of the previous generations. We are more engaged in play and activities and working longer hours, all while we are less likely to live in communities where we have family members to help and support us.

When working with parents, I try to simplify all the steps they are taking into big picture principles. One of the most important ones is the Principle of Modeling. A lot of the smaller changes I try to implement can fall under the category of Modeling, which basically means to show your child how to behave in a way that you’d like them to behave. In other words, model for them the behavior you’d like them to learn and repeat.

This Principle can apply across many domains or problems. For example,

If you have an anxious child, you can show them how you too may have fears, but that instead of avoiding them, you face them and are working on tolerating your anxiety.

When you are angry, you can model taking a break or deep breaths instead of yelling or hitting.

If you tend to eat the same foods, that you try tasting different cuisines or flavors.

If want your child to use the cell phone less, make sure that you put the phone away during family time (e.g., meal times, movie night, etc). Put away your own phone while driving and in the evening hours. This can be an especially helpful way for parents to model ways of reducing cell phone consumption, without explicitly telling them what to do (which can be a huge source of discord between parents and kids). It also avoids the classic “Well, YOU DO IT” argument.

When you are hurt or sad, you practice talking about your feelings, instead of withdrawing or stonewalling.

Now, the catch of the Principle of Modeling is that it can also applies to less desirable behaviors.

Take a study recently published in the Journal of Experimental Child Psychology by Setoh and colleagues (https://www.sciencedirect.com/science/article/abs/pii/S002209651830540X). This study found that parents who were lied to by their parents, even if the intent was innocuous (e.g., if you swallow bubblegum, your belly will explode from the gum and you will turn pink) tended to lie more themselves as adults. Now, this is pretty scary stuff - parents tell little fibs all the time, sometimes because it’s just an easier way to get maximal impact (and cooperation), but also sometimes because it’s hard to tell our kids the truth (think the birds and the bees conversation). The point of this article isn’t to say that avoiding an honest answer here or there will cause ruination in our kids. I think of it more as a gentle nudge to remind parents to think big picture - what behavior am I modeling here, what is my kid learning from me, and what behaviors do I want them to learn?

As for how to answer tricky questions, I will get to that next time. But for now, the idea isn’t for parents to be perfect models. Mistakes will be made, guaranteed. Just sometimes though, if your kid is acting in a way you don’t approve of or like, take a pause and honestly examine- just where did they learn that behavior from? And what could I model differently for them?

• parenting
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