This resource aims to help parents and carers to feel more prepared when supporting themselves and their child after a traumatic event. It helps to explain some of the reactions that might happen, some practical advice on how to cope with the symptoms, and where to get further support.
What is a trauma?
Trauma is what can happen to someone because of a sudden, unexpected event where the person experiences extreme stress. They may fear for their life, suffer an injury, witness a stressful event or hear about something that happened to a loved one. It could be a one-off single event, repeated or multiple events.
Examples include:
sudden or life-threatening illness or injury
medical procedures
invasive or frightening treatment experiences
being in the hospital or emergency department
domestic violence and assaults
Medical trauma
Children’s experiences of hospital and treatment can be very different. Some children are in hospital for a short time, while others may receive treatment throughout their childhood or even for their lifetime.
In the hospital, children are away from what is familiar to them, such as their homes, family and friends, school, and their routines.
Longer or repeated periods in hospital, and treatments that children may find scary, painful or anxiety-inducing can increase the risk of medical trauma.
Immediately after a traumatic event, most children will feel upset, worried, and confused. This is normal and most children do not continue to have trauma symptoms. It is important to let them know that they are not alone and how they are feeling is normal.
What are the symptoms of trauma?
After a traumatic event, it is normal and understandable to experience a variety of symptoms. These symptoms might come on straight away or later on, everyone is different. People often start to feel better after a few weeks. Symptoms may include:
Re-experiencing the traumatic event
nightmares, related or unrelated to the event
flashbacks, where a picture or sound from the event keeps replaying in your mind and it feels like you are there
repeatedly acting out the trauma through play
intrusive thoughts and images about the event
Avoidance
avoiding talking or thinking about the event
avoiding places or people that remind you of the event
keeping busy to distract from thinking about the event
Increase in negative thoughts or feelings
difficulty sleeping
difficulty concentrating or paying attention
irritability or outbursts of anger
feeling more tearful than usual
having strong waves of emotion when you think about what happened
startle more easily or feel more nervous ‘on edge’ than before
being very alert for danger
feeling disconnected from your thoughts, body and your surroundings
feeling detached and emotionally numb
not being interested in your usual activities
not being able to remember some parts of the traumatic event
dissociation — feeling like everyday things aren’t real or aren’t happening to you
Sometimes people can feel a mix of emotions. You might feel embarrassed, ashamed, guilty, or like you or someone else is to blame when this is not the case.
Physical reactions
New physical symptoms or complaints, such as headaches or tummy ache
Feeling in a daze
A change in behaviour, sometimes with more risky or destructive behaviour
How can I support my child?
Where to start
Reassure
Provide reassurance. Remind your child that whatever happened is over, that they are now safe. This will help your child re-orientate and slowly feel safe again. You might have to repeat this a number of times while they are processing the event, especially if they are experiencing flashbacks or nightmares.
Listen and give them space to process
Remember everybody will be different in how they deal with trauma. If your child wants to talk about what happened, express their feelings, or asks you questions, try to answer them as best as you can. Focus on listening rather than asking lots of questions. You can help your child to name their feelings and reassure them that all thoughts and feelings are OK. Some children choose not to talk and that’s okay too.
Try not to make any assumptions about what your child may be thinking or feeling and try not to put your concerns on them. They might not have understood the event the same way you have. There is no right way to process this experience, just allow them space to talk and follow their lead.
It’s important that your child has someone to talk to if they need to but can also engage in normal or fun activities to give them a break from thinking about the event.
Return to familiar routines
Try to go back to your daily routines as much as you can to give your child the feeling that things are going back to normal, and they are safe.
Help your child to get enough sleep, eat regularly, go back to school, and see friends as much as possible. At first, you may want to keep your child out of school if they are very distressed. This is understandable, but it is good for them to go back to their usual routines as soon as possible. They may want to practise what they can say to peers about what has happened or why they have been out of school. Remind them it is their story, and they can share as much or as little as they like.
Returning to a routine might be difficult if you or your child is in a hospital setting, but trying to make things more predictable, such as telling the child when you are around, what is happening and making a timetable poster, might help.
Be together more
Spending more time together as a family may help after a traumatic event can help you to connect you as a family and reduce any feelings of vulnerability and loneliness.
Include everyone
Do not forget that if siblings or other family members are around, they might be equally as affected by what has happened and will also need support.
How to help yourself
Be kind to yourself
It’s completely normal to have these feelings after experiencing something traumatic. There is no right or wrong way to process your experience. These feelings should start to feel easier after a few weeks
Self-care
Take time for yourself. Looking after yourself is important, you need strength to be able to support your child through this difficult time.
Sleep might be very disrupted for you and your child, try and get regular sleep if you can. Perhaps a family member or friend could come over to help with practical things so you can rest.
Receiving support in times of distress is very important. That can be practical support like helping out with childcare and food shopping or through more emotional support in the form of listening. Support might come from family, friends, neighbours, school, or hospital staff. Please ask for help. Most people really want to help in times of distress.
What can I do about my symptoms when they get too much?
Unwanted thoughts, memories, and emotions can pull you away from the present moment. When you practise these techniques they can bring your attention back to the present moment, help you feel safer and more able to cope. These can be helpful for anyone to try. You and your child could do these together.
Grounding exercise
What are 5 things you can see? Look for small details such as a pattern on the ceiling, the way light reflects off a surface, or an object you never noticed.
What are 4 things you can feel? Notice the sensation of clothing on your body, the sun on your skin, or the feeling of the chair you are sitting in. Pick up an object and examine its weight, texture, and other physical qualities.
What are 3 things you can hear? Pay special attention to the sounds your mind has tuned out, such as a ticking clock, distant traffic, or trees blowing in the wind.
What are 2 things you can smell? Try to notice smells in the air around you, like an air freshener or freshly mowed grass. You may also look around for something that has a scent, such as a flower or an unlit candle.
What is 1 thing you can taste? Carry gum, a mint, or small snacks for this step. Pop one in your mouth and focus your attention closely on the flavors.
Grounding phrases
Remind yourself you are safe
Come up with a phrase to say to yourself “I am safe now”, “this is just a memory”, “this will pass”, “I survived”.
Be kind to yourself
“It’s no wonder you are feeling frightened because you have just had an unwanted memory of the past. You are safe now”
What would you say to a friend who was feeling this way?
There is no right or wrong way to process a traumatic event, and processing what has happened to you might take some time. Though the symptoms mentioned in this leaflet are normal and understandable responses to a traumatic event, it is important to reach out for extra help if you need to. If your symptoms become significantly worse or persist for more than one month, then you could benefit from additional support for your mental health.
Remember that children and young people do recover from traumatic events. Give your child and yourself time, these symptoms can often reduce after a few weeks.
Further resources
Feeling Good app uses audio tracks to help relax your body and mind and build confidence.
Catch It app help you to learn to manage negative thoughts and look at problems differently.
Chill Panda app uses breathing techniques to help you relax more, worry less and feel better.
Although we have written this resource for you, others who support you may have also been impacted by what has happened and may find the information useful. Please feel free to share.
This resource was written in line with Post Traumatic Stress Disorder NICE guidelines ICD-11 and DSM-5.
Is something missing from this resource that you think should be included? Please let us know
Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.
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