Promoting psychological recovery and wellbeing

Six helpful evidence-based principles to support the psychological recovery of children and young people affected directly or indirectly by coronavirus related illness.

Exactly how these principles are best applied will be depend on various things, including who was affected by the coronavirus pandemic, how severely they were affected, and how old the child is.

Generally speaking, the help described below is best provided by people that a child already knows, loves and trusts, such as their family members and carers. The role of professionals is most likely to be that of supporting the adults around the child, rather than direct work with the child. If a child’s carers are taken ill, or if they are struggling, they may need to think about bringing in some additional direct help.

To support psychological recovery, simply consider what can be done to help a child to:

1. Feel safe

A child might need more information about the illness, and about the recovery. The trick here is to ensure that even young children are able to ask questions and to get honest and helpful answers (rather than have to create their own). They might need to know how safe their loved ones are, particularly those adults on which they depend, and who will look after them if any carers are ill.

A child may need more attention – both in terms of quality and quantity. So adults might need to be more available than before. When they are with a child, adults may need to ensure that they are particularly focused on the child and not distracted. That doesn’t mean that adults have to drop everything and be available 24/7. But it does mean that adults may have to manage a child’s expectations by being clear about their availability and finding some time when they can be truly focused on the child.

A child might also need to know that it’s ok to be upset – that’s nothing to worry about. It’s understandable to have bad dreams, and it’s normal if they have memories that are not very well behaved and keep popping up – that’s their mind’s way of helping to sort the events out, so that they can be put behind them. These sorts of difficulties (or symptoms) are to be expected in the days that follow. Such difficulties would be normal in the following weeks, and understandable in the first few months. Not many children would have symptoms continue for months, so that might be when some additional specialist support should be considered.

2. Feel calm

This is closely dependent on feeling safe, but what else can help a child to feel calm? Stories, music, physical activity, cuddles, TV, craft, yoga? The trick here is not to be prescriptive, but for those around the child to be creative. After all, they know the child best, and they will have the best ideas about what will help. For example, the Unworry Book has LOADS of ideas – because one idea does not work for every child, so this book allows children to pick and choose, and try things out to see what works.

It’s also important to ‘evaluate the outcome’ – what works for a particular child and what doesn’t? You might need to step back and review if the strategies you are adopting are helping. This is not just about providing activities to manage feelings. It is also about accepting and validating the child’s feelings, as this can be a very powerful way to help them not to be overwhelmed by their strong feelings.

3. Feel socially supported and connected

Social distancing does not have to mean social isolation. If a family has been directly and severely affected, they may feel somewhat out of touch, they may even have been deliberately isolated. The family may have to be creative about how they can maintain social connections with important people (including friends, even for young children). Some children feel awkward when they interact with others by video rather than directly, so they may need some help. Some children are more happy sending video messages back and forth rather than having an actual interaction in real time. Other children like having adults organise their video interactions by providing them with a structure and suggesting some games that lend themselves to remote contact. We’ve included a list of games at the end of this article.

Social distancing does not have to mean social isolation.

David Trickey

4. Feel in control

There is so much going on that will inevitably make people feel out of control. In reality, there are many things over which people do not have control, but there are plenty of things over which people do have control, and it can be helpful to remind people of this. One way of demonstrating this with children is to give them choices. How would they like to schedule games or activities? What would they like to do or eat? What do they want to play with? Where do they want to be? This can help create a sense of agency and control for the child.

5. Feel hopeful about the future

This is not about being dishonest, but it is about having a balanced view of the future and avoiding catastrophising. One way to re-balance children’s views about the future is to ask them what they are looking forward to when things are a bit more normal. How are they going to celebrate when lockdown ends? Can they plan some of those activities? What do they think they will have learned? Will some things be different? Is there anything good to have come out of this situation?

6. Make meaning of what has happened

How can children be helped to make sense of what has happened, and what is still happening, in a way that is both truthful and useful? Not by catastrophically exaggerating, and not by avoidantly minimising – but by being realistic, optimistic and balanced. This involves having conversations about what has happened, and what is continuing to happen. Problems can develop if adults try to avoid such conversations for fear of making things worse. It’s much better to have these conversations out in the open where adults can guide the meaning-making, rather than a child having to manage it on their own. A child may be trying hard to not think about something, but unhelpful thoughts can intrude and may be particularly potent at nighttime when children are on their own. Winnie the Pooh said “A thing when it is inside your head seems very thingish, but when it’s outside of your head and has other people looking at it, it doesn’t seem so thingish any more”. Finding the right time for such discussions and not missing the opportunities when they present themselves is usually better than forcing a conversation. Some adults can try too hard to ‘fix’ the problem, rather than beginning by being curious and listening carefully. If a child feels that the adult has really understood them, then they will be happier to open up, and more open to the adult’s guidance.

A thing when it is inside your head seems very thingish, but when it’s outside of your head and has other people looking at it, it doesn’t seem so thingish any more.

Winnie the Pooh

Ideas to help to structure children’s video interactions with friends and families

Many games that children would usually play when they are together can be easily adapted for remote contact. Here are just a few ideas that hopefully demonstrate just how easy it is.

Charades

Player 1 acts out a word or phrase, and player 2 guesses the word or phrase by watching the gestures.

20 Questions

• Player 1 thinks of a person, place or object, and tells player 2 whether it is a person, place or object.
• Player 2 asks player 1 questions, to which player 1 can only answer yes or no. In theory, the number of questions should be limited to 20 – but some flexibility is fine.
• Player 1 and player 2 then swap over and repeat until just before one of the children loses interest (if possible).
• You could keep score and see who gets the most points.

Two Truths and a Lie

• Player 1 shares three statements about themselves: two true ones, and one that is not true.
• Player 2 has to guess which one is not true.
• Player 1 and player 2 then swap over and repeat until just before one of the children loses interest (if possible).
• You could keep score and see who gets the most points.

Words Within Words

• Choose a word or phrase and see which player can make the most new words using the same letters.
• For example, the phrase Birthday Party could be used to make hat, bat, rat, ray etc.
• The player that comes up with the most words in one minute wins.

Read My Lips

• Player 1 silently mouths the words to a phrase, or lyrics to a song. 
• Player 2 has to guess what they are saying, just by reading their lips. 
• Player 1 and player 2 then swap over and repeat until just before one of the children loses interest (if possible). 
• You could keep score and see who gets the most points.

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Learn more

You can find related information and support in the Coronavirus and Trauma: Implications for Children and Young People resource.

This resource was generously funded by the National Lottery Community Fund and St James’s Place Charitable Foundation.