A guide to supporting families during Covid-19

03/06/2020

A guide to supporting families during Covid-19

Families come in all different sizes and forms, and will be meeting the challenges of Covid-19 in their own unique ways. As some schools open this week, a new platform of challenge will be experienced in what emerging from lockdown looks like – as much as our entry into the pandemic. In my working role, in addition to medical education, I also work in counselling – this is primarily around relationships, but I have also started training in supporting families. I wanted to expand further here from general relational support to how families can best hold themselves together into and out of lockdown. This reflection forms off the back of supporting families during this time, but also includes a resource list at the end for further channels of reference. If you have time for further reading, other blogs that may be of interest include those I have written on relationship safety and support during Covid-19, and pregnancy and partnership during a pandemic. The former may be particularly helpful in considering how to build communication skills at home – relevant for all the family. In this post, I have taken a question and answer style to focus on ten areas that may be commonly queried by family members.

 

1. Why are families at risk during this time?

 

Covid-19 brings forward all forms of uncertainties and worries. Families are larger groups of personal relationships, and in its most basic answer, worries from Covid-19 are likely to be experienced as much more complex when there are more heads around a table, or more people to consider in making a decision. A larger group can also be challenged in group responses to stress.

The outbreak has also caused changes to people’s routines, now that children are not at school and parents are working at home, families are spending more time together. This, along with the disruption in routine they’re experiencing may mean families have a hard time coping.

Families also often include not only people with different roles, but a wide variety of ages and differing needs for support. Most families will include vulnerable members, and so there will be concerns around how to support these individuals – those isolated, those in ‘at risk groups’, or those in frontline occupations. 

 

2. I am a parent; I should know how to cope right?

 

My antennae go up when I hear ‘shoulds’, ‘oughts’, or ‘coulds’ in counselling. What I have found is that parents can also be the worst at holding these terms to themselves, before they direct them to children. Noticing the immense difficulty of this time is so important; many individuals are struggling in a general way with working at the same time as managing additional childcare and care giving necessities. It can be easy for workplaces to focus on the benefits of remote workers at home missing the commute and ‘gaining extra time’, when in reality many are struggling with juggling their time into an additional role. Those in frontline work may also struggle with increased guilt over not being able to provide care for their family at home, while they face the challenges of face to face work. Many families are raising concerns on how to maintain meaning for children and older generations. It’s all a huge juggle- we’ve not seen a pandemic before as a generation, and as a parent it is not expecting that you ‘should’ know how to cope. 

 

3. How do we manage as a family in allocating space?

 

As the practicalities of space affect a single relationship, less space for an even larger group can raise tensions further with conflict in a need for every individuals’ own independence and day to day working needs. There may also be concerns on the mixing of vulnerable and exposed groups- for example elderly relatives and healthcare workers in the same shared space. Considering these needs in depth, it is helpful to discuss how those who are vulnerable will be kept at distance/could space be divided? Can different areas be used at different times for different needs, e.g. a remote meeting/some quiet time to focus on a project? How is time as much as space allocated to ensure everyone has time for themselves and time allocated together? If conflict comes up, how can people use space to withdraw from an upset?

 

4. Our child does not seem to hear us, how can we communicate better?

 

Conflict and anxiety can lead to a fight-flight-freeze mechanism. The brain can shut down to the anxiety centre of the amygdala and the front parts of the brain become less engaged, which we need to process information. Children and young people – with estimates up to our mid twenties – are still forming the front part of the brain, and so are naturally on a further back foot for understanding. This means the basics of communication are even more important – however, one needs to expect to take this one step further in adaption. For this, there are 3 basic reminders:

  • Agree what is communicated with yourself/partner – Children can be confused by differing information, so when parenting, agree with yourself the key pointers prior/discuss clearly with a partner what your shared approach may look like.
  • Have patience and repeat often – Children will not remember; they sometimes can’t due to processing/if feeling anxious. Take time to explore something again and repeat things as needed.
  • Adapt language further- There is even more need to be specific and clear. Use short sentences and simplify language, holding age in mind.

 

5. What things might my child/family be worried about and how do we plan for the future?

 

The only way that you will know what another person is worrying about is to ask. There are deeper ways of thinking about this though, including the importance to connect into the emotional experience as and when another person feels able. Some areas may need to be put on hold at the moment to discuss as they feel overwhelming, but signposting them may be helpful.

Specific focus on what uncertainty means for all can be an important question. Setting time aside regularly to check in daily/weekly/monthly is really important with individuals and as a group. It can be helpful to consider the timeline of changes that have happened to give a sense of structure around changing events. Areas of focus for the pandemic may be giving space to clearly discuss with one another concerns around core anxieties we all have as humans:

  1. Illness – what are everyone’s health concerns around COVID and generally? What trusted information is available to keep up to date while not having this as one only focus? You may choose to look at current governmental advice together or trusted sources such as the World Health Organisation (WHO).
  2. Isolation- how is everyone feeling connected? What steps can be made to maintain contacts remote by new and old methods? Consider calls and video platforms such as Zoom and Houseparty.
  3. Identity- how may people feel roles may change? How can one support others with shifts around work and home?

Children may also find it particularly important to consider the effect of school closures and now openings, or effects of missing exams. Give space to consider what ways children can connect with learning currently to maintain engagement – and talk ahead of time around how to manage ‘what if’s’ as exam grading may effect next steps in life choices for college or university.

Coaching tools can be useful individually and together to consider next steps – a Wheel of Life tool can consider compartmentalising how different areas currently feel, and be used to appreciate things in the current. Discussing things that are unknown can be helpful in each area to think about how as a family you can support one another if different eventualities were to occur (click here for template to wheel).

 

6. Step parenting is a nightmare, how can the families organise separations and visits?

 

Added challenges may present for families that are ‘blended’. What is classed as a household may place restrictions on contact, and there may be longstanding or new tensions around parent separations and new family step-parenting. In a shared parenting arrangement, it is a child’s right to see both named parents, but one can anticipate there may be many cases where this does not occur through wider parental concern, conflict, and the new struggles of practical arrangements. This can be greatly upsetting for whole family contact. 

The communication approaches above remain key, especially in acknowledging that tensions in step parenting and separations may symbolise the wider anxiety of living in a very uncertain time. Children will often question their own role in causing a separation, or the difficult dynamics between family members. It is important that with conversations around difficulties of contact, or a new separation, a child understands– by repeated explanation- the role of difficulty is not because of them, that they are cared for, and that maintaining connection is important for all separate relationships with them.

If one parent cannot see a child it is helpful that the steps to ensure contact are discussed, including new world options of creating remote contact. Space given to hear and discuss feelings around visiting is important. Parents explaining that they will aim to have an ongoing process to check in with children, and to ask children to come to them to discuss if they feel upset, whenever it occurs, offers permission for children to raise their concerns. 

 

7. Grandpa has died, how do we support one another through the bereavement?

 

Many families may experience a bereavement because of Covid-19, or secondary to something else. Difficulties around this will not only be linked to the stages of grief, but also to the wider context – for example, being unable to say goodbye to a loved one because of social distancing measures, or, after a death, full funeral services being suspended. 

In supporting one another, acknowledging the range of emotions and unique responses to grief can be useful. Grief and loss are said to include stages of shock, denial, anger/anxiety, bargaining, and upset. Ultimately, we head towards an ‘acceptance’ – however none of us move through these emotions in the same way. We may jump , meander, and move in and out of different states at different times. 

There may be a need to slow down after a bereavement, and giving yourself and others time is also really important. It is not necessary to shy away from conversations around the bereaved person -approach this in a position of curiosity of whether yourself and another want to talk now. 

Whether funeral services are open fully or not, making opportunities to remember a loved one who has passed away may be helpful not only in the short but also in the longer term. Perhaps a memory box could be made, or different members of the family could reminisce on different recollections together aside from a funeral service. Making a note to check in with one another around birthdays, anniversaries, and the date a relative died can also be significant..

Lastly – be mindful of mental health, as particular bereavements may be traumatic and upset may turn to depression. If there is a consistent worsening in mood and an inability to manage day to day activity for a prolonged period for a family member (or yourself), signposting support and checking in with the GP is important.  

 

8. I’m concerned conflict has become unsafe in my immediate/wider family, what do I do?

 

There are basic measures for conflict management shared on my relationship post that may be helpful in general to having a family strategy for conflict. In naming conflict, a family friendly term could be made like ‘Hufflepuff’. A caution on safety is different, however. As there have been escalating risks of domestic violence during the pandemic, there can equally be expected concerns around child protection in environments where family members cannot easily remove themselves and other support networks may no longer be visiting. Safety of children is the most important thing, and if this feels in doubt in any way it is imperative to recognise the concern and get help. The relationship post also considers signs to look out for, a three-step action plan in case of an emergency, and some support contacts.

If you have a concern about wider family, cautions apply in making contact to consider that any perpetrator of violence is not nearby. Set a separate time to call and ask for a yes/no response of whether a perpetrator could overhear – only continue as safe to do so with the other family member alone and set a phrase/way to communicate if the situation changes/other agreement for later contact.

 

9. We have a new baby coming, how can we adapt?

 

I am one of the new families emerging in the pandemic as I am now 36 weeks pregnant. The post I created on Pregnancy and Partnership during a Pandemic considers some core concerns that may be coming up at this time for new families or those growing during Covid-19. 

Significantly, pregnancy and the year after are already known as a time of heightened stress, with mental health known to be most at risk for women than at any other point in their lives. Many will be concerned around unknowns for their new baby and the process of bringing that baby into the world in settings that are needing to be responsive to the pandemic. The post and video consider some of the wider considerations of pregnancy and perinatal well-being in more depth, together with a ten-point well-being list and a resource sheet that may be helpful to keep up to date with current known information.

 

 

10. How do we have fun as a family and build connection?

 

In my relationship post I consider 5 ‘love languages’ – these same areas can also be looked at as a family. Briefly, core questions would look at what closeness means for everyone. Can space be made to share appreciations with one another, delegation of tasks be set to help at home, and quality time be organised as a group?

Setting activities that one would like to do in the here and now, and planning for potential activities in the future can set hopes and goals for fun. With activities that may not be available in a pandemic, thinking creatively around how one could adapt things enjoyed that may offer a connection to meaning. For example, if one was going to go to a museum to learn about natural history, could the family have a natural history day – perhaps watching a film on dinosaurs or nature from David Attenborough, and then do some creative tasks around the theme- e.g. drawing activities or learning a craft?

 

With the ending focus on fun and connection, I finish this post acknowledging that while noting some core concerns in likely questions, I have also seen many families bond in new ways through the current pandemic. There are hopefully opportunities in the difficulty for new appreciations and developing connections that have greater depth. If you feel you were struggling before the pandemic and need wider support, please also see the resources below.

Maudsley Learning offers covid-19 advice and support, find out more today. Keep safe, keep well, and keep connected.

Family Support Resource List

Article written by Dr Camilla Tooley.