Many parents are finding themselves at a loss in helping their children cope with the radically altered way of life during this pandemic. I had the chance to speak to long-time Team Atomica athlete and school and clinical psychologist, Dr. Alisa Kenny Bridgman, on this very issue. When not running, swimming, or biking, the co-founder of an independent pediatric psychology clinic in mid-town Toronto, works in private practice. She specializes in treating anxiety and depression in youth, as well as conducting diagnostic assessments. Alisa and her husband have three daughters aged 10, 12, and 14. Like many of you, she is currently working overtime from home while homeschooling her children.

Anyone who has trained with Alisa knows what a rock she is for all those in her community. Her insight is invaluable and her capacity to meet people exactly where they are is exceptional.

Suzanne Zelazo: How has your practice changed over the last month? What is it like to treat virtually?

Alisa Kenny Bridgman: Our practice has changed dramatically in the last 4 weeks. We are not able to see clients in person, so we have moved all of our appointments to a confidential and secure video-conference platform. (We also do social-emotional and psychoeducational assessments and at this point, we are unable to do these virtually given a host of logistical issues.)

I find virtual therapy to be quite effective overall. There is a different feel to it and it has definitely taken some getting used to. Talking through a screen makes therapy less personal and there is a block to the energy that you get from the other person. Nonetheless, I find children of all ages (particularly those 10 and up) have adapted very well and are way more adept than I could ever be at using the virtual platforms (e.g., screen sharing, correcting video quality, etc.). Kids are really smart and have generally “pivoted” very well to on-line everything.

Younger children (8-12 range) have a harder time focusing during the sessions but are usually good for sessions up to 45 minutes. Teenagers can talk forever and their sustained focus on devices is very good (for better or worse, this is based on overuse of screens in their normal lives), so they can do their regular session times (one hour or more) with no problem.

SZ: What are a few of the most common challenges children and adolescents are facing at this time?

AKB: It has been really interesting. I have been noticing trends in the children/teens I work with and some of these are surprising me.

I treat many children/teens with OCD and this is a particularly hard time for those with contamination issues. It is not surprising that this particular group has worsened. They are generally responding well, though, to continued therapy with increased frequency of appointments.

Children with social anxiety seem to be doing well currently, as they are not dealing with their usual social demands and stressors. Extroverted and more social children are having a difficult time with social isolation and are missing their sports, friends, and school activities and structure. Children/teens with depression have shown both ends of the spectrum. Some are doing better because school and social pressures have lifted, but some are experiencing worsening symptoms of withdrawal as there is so little for them to do and we can’t encourage them out the door to engage as we normally would.

Interestingly, few children/teens have reported excessive worry about getting Covid themselves. The exception to this has been those who have been directly impacted by Covid with an ill family member or those whose parents are front line workers (particularly Doctors and Nurses).

I think we are in a bit of a honeymoon phase right now with social limitations, however, and the effects of isolation will likely become more prevalent in the coming weeks as their new reality sets in further.

In addition, distance-learning is also new to many children/teens and it will likely become more difficult in the coming weeks for children to focus during lengthier on-line lessons and stay motivated to complete assignments.

I think distance learning will prove to be effective for children who are in Grades 5-6 and up, who are high functioning in general, and also well-organized with strong executive function skills. Young children are having a harder time engaging in distance learning and the onus is falling on parents to provide 1:1 learning throughout the day. Children with Learning Disabilities or ADHD will very likely have difficulty navigating distance learning. Unmotivated teens with mental health issues will also struggle significantly.

SZ: What can parents do to offload some of the stress children are picking up from the media and their surroundings?

AKB: A few important considerations here:

1. Children should not be exposed to the news on a regular or constant basis. Children do not have the emotional maturity, cognitive capacity, or life experience to process imagery they see on the news in general, never mind now. They will obviously pick up on things through their friends and social media, but my recommendation is to turn off the things you can control (like CNN and CBC news in the background). I recommend this to parents too. Stay informed, but not at the expense of your own mental health. Check the news in the morning and again at the end of the day (but not too close to bed so that you can avoid an anxiety spike and subsequent lack of sleep and emotional drinking/eating late at night).

 

2. Children’s knowledge of Covid and its global impact should be on a “need to know” basis. It’s important to be honest and use direct language with children, but parents should not over-share or spend vast amounts of time during the day talking about the virus. Conversations should be around updating them on changing city practices and mandates, their own personal responsibilities with regards to safety, and daily routines and practices at home.

 

3. Children need to know that all they can control is their little corner of the world and be reassured that their family is observing government guidelines and doing their part. We are all doing this, so collectively as a society, we are all controlling what we can in a ripple effect. The rest is the rest and there is zero point worrying about things we cannot control or plan. When we worry in this way, it takes away the moments of joy and happiness we can all still experience in this exceptionally difficult time.

 

4. It is important that parents keep “adult” conversations to themselves as much as possible (re: finances, job situation, etc.). These issues will impact the children and family life in time, but it will be important to compartmentalize these conversations to some degree and share pertinent information with children only when necessary and timely.

 

5. “Parents’ moods are a child’s barometer.” Always remember that children have VERY big eyes and ears and will pick up on everything their parents are doing/saying. Parents will need to work extra hard to manage their own anxiety and fears so these aren’t projected onto their children.

SZ: Are there best practices for parents to help them in managing their own anxiety?

 

AKB: Yes, absolutely:

1. As parents, we need to put the oxygen masks on ourselves before we can help our families. We have to dial up our own inner strength and tap into our coping mechanisms. These are different for different people, but it boils down to outlets: lean on your fellow parent friends when you can (we are all experiencing variations of the exact same existence), stick with your workouts (but don’t beat yourself up if you feel drained and can’t get out of bed…..speaking from recent experience here!), have frequent Zoom calls with your friends and family, remember it’s totally fine (and highly recommended) to socially distance from your family and breathe in a quiet spot when you can (this has been A LOT of togetherness).

 

2. Set realistic expectations. You do not need to Marie Kondo your house or clean out the linen cupboard when you’re barely keeping your head above water with life, work, and homeschool.

 

3. Managing our anxiety as adults right now is really hard as this is not perceived or imagined anxiety, it’s the real deal. This is when we need to work on our ability to tolerate uncertainty. The crux of anxiety treatment is learning to sit with feelings of discomfort without having an adverse emotional reaction. This involves a high level of mindfulness and mental control. Control what you can, put the things you can’t control on the top shelf of your brain, and tackle one thing at a time.

SZ: Any tips on how to parent children in this time and manage their emotions and daily routines?

AKB:

1. Make sure children/teens understand that their own wellness is paramount to getting through this time. This involves taking care of their sleep, eating, and hygiene habits, exercising every day for at least 30 minutes, and reducing time on social media (some children need a social media diet-check their phone max 3x per day, phone goes to their parents every night at 9:00 pm or earlier). Think about wellness as the base of a triangle. The other things they have to do during the day (schoolwork, chores) will be much easier if the foundation of their daily lives is solid.

 

2. Children thrive on structure, so creating a daily structure (albeit looser than school) is imperative. It can just be dividing the day into three parts (morning, after lunch, after dinner) with a few tasks in each part, but some sort of structure is key. Just be careful not to be too rigid and detailed in creating structure and routines, as this can backfire.

 

3. Encourage your children to FaceTime friends and family members often. Children may want to do classwork in groups with their friends on FaceTime or Zoom and this helps keep social connections going.

 

4. Ask your child’s teacher if there are any younger students or more vulnerable children at their school who would benefit from having a buddy during this time. FaceTiming a buddy (to read to, do an art project with, or help with homework) is a great way to enhance social interaction and provide a bigger purpose to their day.

 

5. Older teens and young adults (who were living outside the home and at university and have been abruptly reverse-launched) will likely experience a phenomenon known as the “caged-tiger” effect. They will need high levels of daily empathy, support, and guidance in managing their new normal. Coming down hard on expectations and household requirements will absolutely boomerang on you and cause them to further retreat to their rooms.

**See “Quaranteenagers” video by Jennifer Kolari (Connected Parenting) on Facebook for her amazing advice on connecting with teens (and all children) using a combination of mirroring and effective behavioural techniques/limit setting.**

SZ: The media has been describing the discomfort we are all feeling as grief. What do you think about that and is it the same for our children?

 

AKB: I recently heard a term I really like: “shadow mental health pandemic” (a parent mentioned this term and I also found a variant of the term here). I think this term encapsulates the cycle of emotions we will experience in the shadow of this physical health pandemic.

Many of us are currently in an acute phase of mental health distress as we are dealing with very high levels of anxiety about the virus itself, as well as its very real impact on our daily lives and the world at large. This has caused us to be in an initial action-oriented and problem-solving mode.

When anxiety becomes overwhelming and prolonged, our bodies can shut down and we can become sad, and experience symptoms of depression and grief. So yes, I think the feeling of grief is very real for many of us. We are actively grieving for people who are sick and who have died. And we are grieving many aspects of our personal and work lives as well as freedoms that have changed very quickly (e.g., strained and even altered relationships with family members and friends, saying goodbye to luxuries like house renovations and travel).

Remember that children/teens are not little adults. Children experience anxiety, sadness, and grief in different ways than adults. There are a number of developmental differences depending on age and stage. I think in general, it’s very important to remember that children “puddle jump” between emotions far faster than adults do (see “How Children Grieve”).

They can express deep sadness one moment, and then jump to anxiety about something seemingly unrelated, then have a meltdown over a small thing, and then jump to happiness a bit later. It’s important to help your children ride these waves of emotions by staying calm and empathic, but also firm when they act out. It’s very hard not to be reactive (especially when our own nerves are fried), but we can work really hard to stay neutral AND set behavioural limits and boundaries at the same time (see Jennifer Kolari’s CALM parenting technique in this regard: connectedparenting.com).

As Brene Brown says (and I’m paraphrasing), we will need to sit with our children in the mud pit for a bit, and then activate them in their coping.

 

SZ: Any parting words?

AKB: The human spirit is remarkably resilient. We have all been through adversity in our lives in some form or another. Try to remember what good has come out of these periods (further self-understanding, increased empathy and compassion for our neighbours, renewed appreciation of our people and the physical world around us).

My colleague said it best: “We must all put our heads down and bear this storm. Like bamboo, we can bend but we won’t break.”

 

 

 

 

References:

Murray, Marie. “Parents’ Moods Are a Child’s Barometer,” The Irish Times (June 23, 2009).