Supporting Parents and Caregivers with Trauma Histories during COVID-19

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Context

Parenting during the COVID-19 pandemic

The COVID-19 pandemic has impacted the lives of countless parents and caregivers, with unknown long-term consequences to their health and well-being. The unprecedented demands placed on parents and caregivers to shift their roles in caregiving—and in their other occupational, educational, and social responsibilities—have created a prolonged state of stress and uncertainty. Parents and caregivers may also experience increased financial hardship and unemployment, loss of consistent child care services, and challenges with virtual learning, all of which can negatively impact parent-child relationships and further increase parental stress.

Parents and caregivers play a critical role in helping children heal and adapt to changing environments. Modeling positive coping skills, instilling family structure and routines, and maintaining social connections are known to promote child well-being during stressful and unpredictable times. However, when parents and caregivers face significant, chronic stress and hardship, their capacity to provide adequate nurturance and support to their children may be diminished.

Parents and caregivers with trauma histories

For parents and caregivers with a history of trauma, the compounding effect of pandemic- and trauma-related stress may further impact parent-child relationships and families’ well-being. Research shows that parents and caregivers with unresolved trauma-related stress may have difficulty responding consistently to their children and using positive parenting practices. During the pandemic, parents and caregivers with trauma histories may experience increased trauma and loss reminders, which can affect their emotional regulation, particularly when social contact is limited or fears about contracting COVID-19 are heightened. Emerging research shows that elevated parental stress due to the COVID-19 pandemic is associated with increased violence at home, harsher parenting, and increased child abuse potential.

Parents and caregivers with trauma histories may also identify with groups that experience worse health and mental health consequences related to COVID-19. As a result of systemic inequities such as poverty, unemployment, lack of affordable housing, discrimination, and limited access to high-quality health care, Native American, Black, and Latinx people are more likely than White people to acquire, be hospitalized for, and die from COVID-19. These systemic inequities similarly increase risk for adversity, trauma, and disparate outcomes. Asian people have also experienced increased racism, anti-Asian xenophobia, and pandemic-fueled harassment and violence due to the origination of COVID-19 in China. The intersectionality of multiple parent/caregiver identities (e.g., race, ethnicity, income, trauma, and mental health history) and their associated values, norms, and risks plays a critical role in designing and implementing effective supports for parents and caregivers with trauma histories during the COVID-19 pandemic.

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Resiliency Factors for Parents and Caregivers with Trauma Histories

Decades of research on resilience suggest that protective factors may mitigate the impact of COVID-19 on parents and caregivers with trauma histories. Enhancing personal protective factors for these parents and caregivers can improve long-term outcomes for families. Protective factors include the following:

Positive coping skills

Positive coping skills, such as cognitive-behavioral approaches, encourage parents and caregivers to challenge cognitive distortions and replace them with more helpful thoughts. For example, negative thoughts like “things will never be back to normal, ever again,” could be replaced with “we do not know when the pandemic will end, but there are still many things I can enjoy in my life right now.” Additionally, mindfulness techniques can encourage non-judgmental acceptance of one’s thoughts, feelings, and experiences.

Family and social support networks

Family and/or social supports can be an important component of buffering the negative impacts of trauma. Finding creative ways to stay connected to social supports via text, phone calls, or videoconferencing can reduce isolation for parents and caregivers. Remember that physical distancing does not necessarily mean social distancing.

Family structure, predictability, and routines

Maintaining family structure, predictability, and routines—such as calendars/visual schedules, family meal times, and regular family activities like movie nights at home or board games—throughout the pandemic can be valuable for children and families.

Perceived control over life events

Parents and caregivers should be able to perceive control over life events. Although the COVID-19 pandemic is unpredictable and can change over time without notice (e.g., stay-at-home orders, virtual learning), research shows that focusing on situations that can be controlled in one’s life can improve stress and mood.

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Recommendations for Supporting Parents and Caregivers with Trauma Histories during COVID-19

Identifying needs early and promoting resiliency factors for parents and caregivers with trauma histories can significantly buffer families from the negative long-term impacts of the COVID-19 pandemic. Below, we provide recommendations for policymakers and providers and agencies to support parents and caregivers with trauma histories, and offer tangible strategies and tools for parents and caregivers to implement themselves.

Recommendations for policymakers

• Consider the unique needs of families with children when developing pandemic-related policies, particularly those related to economic relief and employment, child care, education, and health and mental health promotion.
• Prioritize financial, housing, rent/eviction, and meal assistance to parents with minor children through strategies like school-based meal programs, Supplemental Nutrition Assistance Program (SNAP), Women, Infants, and Children (WIC), and Emergency Benefit Transfer (EBT). Many parents lack the financial resources to meet their basic needs during the pandemic, which can increase parental burden and stress.
• Extend paid leave options and Family and Medical Leave Act (FMLA) benefits to parents to provide child care and virtual learning support during work hours.
• Invest in child care programs and providers to ensure robust access to child care, particularly for children with disabilities and families facing financial hardship.
• Create emergency COVID-19 response strategies to connect families with open child care options in their area, by ages served and program type, and enhance flexibility in nontraditional child care hours and voucher availability for families struggling financially.
• Connect child care providers with needed financial supports and assist them with implementing health and safety requirements.
• Enhance funding for mental health resources and supports tailored to parents and caregivers, including reimbursement for school mental health services, tele-service delivery, and family-focused interventions.
• Enhance access to behavioral health care for parents through strategies such as Medicaid expansion or increased use of prevention and intervention services. Increase informal or formal screening of parent and caregiver mental health in child-focused services.
• Invest in programs that expand access to the internet and other information/communication technology, particularly for families who do not have access to these resources at home or in the community due to closure of businesses and community buildings.

Recommendations for providers and human service agencies

• Form authentic partnerships and engage with parents and caregivers with trauma histories—especially those individuals who have been historically marginalized, discriminated against, and disproportionately affected by the pandemic. Parents and caregivers who struggle with their own trauma and who may have had previous negative experiences with service systems may be hesitant to engage in services again. Strengths-based, trauma-informed engagement strategies are important for building rapport with parents and caregivers with trauma histories.
• Implement trauma-informed, family-focused curricula agency-wide and with partnering community agencies to ensure a common language and coordinated response for addressing trauma in families (e.g., Psychological First Aid, Skills for Psychological Recovery, FITT Toolkit).
• Actively pursue trainings and shared learning opportunities to increase providers’ knowledge and skills in diversity, equity, and inclusion, with a focus on implications for supporting families during the pandemic.
• Coordinate services across systems (child protection, mental health, adult- and child-focused supports) to provide a family-centered approach to service and resource delivery. Provide opportunities for cross-training of adult- and child-serving systems in trauma-informed care principles.
• Enhance screening for food insecurity and housing stability and connect families to local resources and programs to meet their basic needs.
• Child-serving systems, in particular, should make concerted efforts to engage parents and caregivers in all aspects of service delivery, given the known benefits of integrating parents and caregivers into child trauma services.
• Initiate conversations with parents and caregivers about shifts in parenting roles, responsibilities, and work-life balance during the COVID-19 pandemic.
• Encourage positive coping skills for parents and caregivers, including cognitive-behavioral techniques, mindfulness, daily routines, positive activity scheduling, and safe virtual social interactions. Connect parents and caregivers with other community resources to broaden their social networks during the pandemic.

Recommendations for parents and caregivers

• Shift expectations to meet the reality of the current situation, focusing on what gives you and your family meaning, enjoyment, and purpose. Remember that children do not need a perfect parent or caregiver, but one who is responsive to their physical and emotional needs. Practice self-compassion and care and try replacing inaccurate, unhelpful thoughts with encouraging ones.
• Learn and practice strategies for talking to children and provide developmentally appropriate information about COVID-19 that addresses their fears about trauma and loss and other challenging topics.
• Minimize COVID-19-related disruptions to daily family activities and schedules. Maintain predictability and a sense of control or choice in small daily decisions, whenever possible, to buffer the negative impacts of trauma and stress.
  • Try to maintain consistent bedtimes, meals, and physical activity.
  • Identify creative ways to occupy children at home and engage in enjoyable activities that can be done safely or virtually (e.g., playing a family game, listening to music).
  • Families struggling with food insecurity or housing instability should locate their local 211 office for support or talk to a housing/shelter case manager or local food bank about ways to maintain family routines and meet basic needs.
• Take a few minutes each day to identify your feelings and experiences. Practice regular coping skills to reduce stress and trauma reactions that may be getting in the way of positive parent-child interactions or daily activities.
• Develop a plan for maintaining contact with friends and family members via phone, text, or videoconference, especially during times of quarantine or stay-at-home orders. Seek support and continued connections from friends, families, and faith-based communities. Daycares and schools may provide additional ways to stay in contact with educators and classmates, in-person or virtually.
• Stay informed during the pandemic but be careful to reduce overexposure to media outlets or social media that might increase fear, anxiety, or panic. Be particularly aware of limiting media/social media time for children, especially for young children.