O ne One of the most controversial – sometimes even vitriolic – public health debates of the COVID-19 era centered on the safety of opening schools for personal classes. For some politicians, the urge to open up seemed to be influenced by optics – a signal that states were "open to business". At the same time, parents have sought to help children and teens with their schoolwork and other aspects of distance learning, and have longed for a safe way to return to a less chaotic educational experience. Some parents have had to leave their jobs to take care of children and still cannot return to work. Teachers and other school staff have raised concerns about their own safety and the safety of their families and students.
Everyone agrees that online learning is not ideal for most students – and can be virtually inaccessible to marginalized populations – but in many areas it seemed like the safest option. However, psychiatrists, educators, parents, and community activists remain concerned about the negative impact the lack of personal instruction and peer interaction has on the mental, emotional, social, developmental, and academic well-being of children and adolescents
There has been a lot of confusion about how often children and teenagers get COVID-19 and how likely they are to spread the coronavirus. Recent guidelines from the Centers for Disease Control and Prevention (CDC) found that while fewer children than adults in the US had COVID-19, the number of cases in school-age children has increased. Not only can children and adolescents become infected and sick, but they can also pass the virus on to others. At the same time, in March the CDC revised its guidelines for physical distancing in schools, saying that 3 feet of spacing (as opposed to 6 feet) is sufficient in elementary, middle, and high schools, where masks are worn and transmission through the community is low
Teachers and other educational system personnel have received vaccinations in many countries. School districts are implementing physical distancing protocols, and the American Rescue Plan Act of 2021, passed by Congress in mid-March, includes money to improve building ventilation. With these developments, many schools that were not yet open planned a return to personal education, either full-time or on a hybrid basis.
In all the debates and planning, one group was noticeably silent: the students themselves. Many children and young people struggle with a feeling of powerlessness, says Adam W. Carter, a former school counselor who is currently the graduation coordinator for trauma-informed counseling at Northern Illinois University's Counseling and Higher Education Department. "We don't ask children if they want to go back to school, if they feel safe," he says. "We make decisions as adults with [the needs of] children almost after the fact."
Lack of agency in making decisions about personal schooling isn't the only area where many children and teens feel voiceless, say the sources Counseling Today spoke to for this article. Like adults, children and teenagers miss their friends; are frustrated with the inability to socialize with others without fear of infection; mourn the loss of celebrations and the marking of milestones; are afraid that they or a loved one will get sick; and are tired of spending so much time in front of a computer screen.
In other words, they have all the stress but not as much control as adults, notes Carter, a member of the American Counseling Association. Children and adolescents often do not know how to talk about or recognize how the pandemic is affecting them.
For example, "Children may not know how to talk about how they miss hanging out at school or with friends," says ACA member Barbara Mahaffey, a licensed professional clinical advisor and executive director of the Scioto Paint Valley Mental Health Center in Ohio. They often ask to visit others but don't realize they have abdominal pain and other psychosomatic effects because they are lonely, she adds. "Children may not ask for help and parents may not realize a child's plight," Mahaffey says.
Many parents have significant concerns and stresses about their finances or how to protect their families from COVID-19. You may also mourn friends or family members who have died from the coronavirus. Parents often believe that protecting their children from these worries is best, but the reality is that children are picking up on the underlying fear without understanding its source, Mahaffey and Carter say.
The burden for children and adolescents is evident. According to the November 13, 2020 edition of the CDC's weekly report on morbidity and mortality, visits to the child and adolescent emergency room related to mental health increased in April 2020 and remained increased until October 2020 (the latest date when for which statistics were available). . Compared to the same period in 2019, emergency rooms related to mental health increased by 24% in children ages 5-11 and increased 31% in children ages 12-17.
Missed connections
Children and young people want to be with one another, says Carter. Without personal instruction and social activities, they find it difficult to figure out how to interact with one another. This generation is used to socializing via social media platforms and chat apps, but after spending six to seven hours online for school every day, interest in electronic gatherings has waned during the pandemic, he says. Being virtual all day but rarely, if ever, in the company of others has created a special kind of loneliness for children and adolescents.
Consultants also find it difficult to get in touch with these customers online. When the pandemic started and advice shifted online, Sarah Zalewski, a licensed professional counselor (LPC) who specializes in child and youth counseling, knew she needed a new way to engage with customers. At the time, in addition to her private practice, Zalewski was working as a school counselor in a Connecticut middle school.
"When you come into my office, I always have toys," she says. "They love to play, [and] me too."
The toy acted as an ice breaker, and students and young customers found it easier to open while their hands were busy, explains Zalewski, an ACA member. But with that icebreaker gone thanks to the abrupt end of the face-to-face sessions, she had to think about alternative ways to connect. "I didn't mean to do the traditional adult thing like," How was your day? How was school? “Says Zalewski.
Zalewski thought about what she had done herself to cope with the stresses of the pandemic. One of her favorite coping mechanisms: playing video games. Given the popularity and ubiquity of video games, she decided they could be a great way to bridge the gap with young customers.
In the beginning, Zalewski mainly discussed the games with her customers, asking them which games they liked and why. Whenever roleplaying entered the discussion, she explored which characters her clients usually inhabit. Did you choose a warrior or a priest? How was the character like them? How was it different? How did the character reflect who the client wanted to be in real life? "Why do you want to be a druid?" Zalewski could ask. "What's really cool about druidism?"
Zalewski emphasizes that advisors trying this approach need to know or learn the language of the games. "Gaming is a culture," she says. “Use cultural humility. For example, if you don't know what a druid is – [because] he is different in different games – ask. They love to talk about it. "
Finally, Zalewski started playing the games with her customers. They start in Google Meet, where they handle all of their communication. They then use an online link or a gaming platform. Zalewski has multiple screens and customers often use tablets.
Sometimes the games are relatively simple. For example, Zalewski recently started playing Connect Four with a young client to practice frustration tolerance (because the client doesn't always win). When a customer expresses frustration over the course of a game, Zalewski looks for the source. Is it really about the outcome of the game itself or is it frustration with a person in the client's life who comes out during the game session? Sometimes the frustration really comes down to the situation that kids and teens are in with the pandemic, including feeling like they are no longer able to do the things they once enjoyed.
Game-based problem solving helps customers build coping skills while they play, Zalewski points out. In addition, she often instructs young clients to use relaxation techniques that she has taught them, such as: B. Square Breathing (inhale four counts, hold four counts, and then exhale four counts).
Zalewski also enjoys using Roblox, an online platform that offers a variety of games and allows users to create their own games (a feature she compares to sandbox therapy). By creating games or even leading Zalewski through a virtual obstacle course, young clients can develop a sense of leadership, she says.
Children and adolescents struggle with the lack of social contact during the pandemic, says Zalewski, and this often manifests itself in anxiety, depression, anger and withdrawal. Isolation is especially difficult for people with depression and attention deficit / hyperactivity disorder, she adds.
As physical activity improves mood levels and basic functions, Zalewski tries to get her young customers in through games like Just Dance and Ring Fit Adventure (a fantasy adventure world in which physical movement is used to control movement in play) Movement) and other virtual reality games.
To keep customers moving, Zalewski often gives customers “homework” (with parental permission) and asks them to play a certain number of games between sessions. Zalewski also encourages customers to engage in social interaction. As with any other skill, social skills wither if you don't use them, she says.
Many role-playing games allow users to communicate with one another in chat boxes. Zalewski says there are also "clans" and "guilds" that players can join. Another resource she likes is Discord, a platform where users can discuss games and other interests on secure, topic-based text channels.
Zalewski says her customers laugh at her for her continued love for Pokemon Go. Still, she thinks it's an encouraging way for kids and teens to go outside with their parents and interact with others in safe, physically distant ways while they collect Pokemon.
School vertigo
While some children and teens get along well with virtual learning, it is generally not geared towards the needs of children and teens, says ACA member Jennifer Betters-Bubon, LPC and former school counselor. "We know that young children have to move," she says. “They live from environments that offer sensory stimulation and movement. Even in traditional high school, kids can stand up and move down hallways and interact with friends. "
"We have kids who zoom in for hours and don't necessarily get up," continues Betters-Bubon, an assistant professor of counseling at the University of Wisconsin-Whitewater. "It is stressful on your brain and your body. [and] It is not suitable for building relationships."
When adults feel the fatigue from having too much screen time, they can usually disconnect for at least a short period of time. "When children get tired, adults are still responsible," Carter points out. And when a child asks for a break, parents or caregivers may think that the lack of structure is causing them to fall behind. "You may not understand that children have the same need to disconnect," says Carter.
Betters-Bubon notices a lack of motivation in the children and young people she sees in her practice. She believes this is partly because schoolwork is not as engaging without the connection to other people and the school itself. "It can feel like," What's the point of this work? "She says. Betters-Bubon points out that in addition to COVID-19, students are studying the effects of racial trauma and other significant stressors, all of which influence their view of whether their current math problem is truly relevant right now. [19459005"]
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Betters-Bubon says that some of her younger clients are so decoupled that she has shifted the focus of her work to her parents. She has tried to keep middle and high school students busy by asking them to create things between sessions, such as: B. a vision board on how to deal with your fear and then share your creation with her.
Now that many schools are opening at least on a hybrid basis, Betters-Bubon and other advisors say they are seeing excitement among students about reuniting with friends mixed with much fear. Many Betters-Bubon customers are scared of the possibility of catching COVID-19, catching up academically, or in some cases starting a new school without the normal transition. Betters-Bubon has performed a considerable amount of exposure therapy with clients of children and adolescents. To do this, they have to come up with a list of scary things they might encounter and work their way to do each one in ascending order. In some cases, she has been able to reach out to school officials to ask them to allow their clients to at least see the insides of their new surroundings before class begins.
Betters-Bubon recognizes that it is a strange new world for students returning to school. The type of break has also changed. Due to the need to maintain physical distance, her son's elementary school no longer allows balls in the playground. Students just stand around and focus on keeping each other apart, says Betters-Bubon. As a result, they do not interfere with the gross motor movements essential to healthy growth that they used to perform when running around, climbing equipment, and throwing balls. Betters-Bubon wonders what the impact could be if this scenario normalized.
Some schools have implemented sensory pathways in hallways with different obstacles for running and jumping, says Betters-Bubon. She would love to see more of it, especially outdoors. Non-contact games, which involve performing actions like moving students to different parts of a circle, can also be a great way to keep kids moving while staying physically far away, she says.
LPC Melissa Brown works with a behavioral health center in the Atlanta area as a mental health advisor in a local school district with a majority of black students, most of whom live in poverty. The community has been hard hit by both COVID-19 itself and the economic devastation from the pandemic-triggered recession.
The school district has had a hybrid schedule since January. Brown has tried to make students feel normal by providing one thing that is consistent. "When we meet, this will be your safe place," she tells the students. "We can talk about anything and do anything you want."
Many of the children still fear that they or their relatives will get sick. That's why Brown holds family meetings to help students and their families come up with a plan to stay safe. The children are used to having a plan of what happens if a fire breaks out at school. The idea of developing something similar for their home therefore seems natural to them, she says.
In sessions they talk about teaching children to wash their hands, show examples of what 6 feet physical distance looks like, and discuss why they cannot see their grandmother, uncle or friends today. They are also looking for alternatives, such as driving past a friend's or loved one's house or sending them a picture.
Brown also tells parents to be honest with their children. They cannot hide information they believe is harmful as it is likely to affect their children anyway through social media, messages, or friends. Instead, parents can be their children's first source of information, Brown says.
Mourning and trauma
Brown has experienced a significant amount of pandemic-related grief, particularly in elementary school. After attending a funeral every Friday for a month, a little girl asked Brown if it was wrong for her to stop crying.
Brown often uses play therapy and art therapy to help younger children explore their emotions. Eventually, the little girl was able to process her feelings and contextualize them, such as, "This person who died was a friend of my mother's and I didn't really know her" and "That was my grandfather, but he was sick with cancer and I know he is in a good place now. "
Zalewski has helped young customers come to terms with the loss of grandparents and pets. She notes that furry family members have become even more important companions during the pandemic.
One child particularly liked the idea of creating a memorial for a beloved dog. With Zalewski's help, the customer created a room on his island in Animal Crossing, a social simulation game that allows players to build and create things. Zalewski and the child found a virtual dog and gave him a red bowl to drink. The child's real dog had enjoyed being outside and sniffing flowers, so they also created a fenced-in area with flowers, the drinking bowl, a sofa (in case the dog wanted to curl up), and a radio for the dog to listen to. Players in Animal Crossing can choose the music on the radio, so the kid chose happy songs because they wanted the dog to be happy.
"To make it through was very powerful and then [the child was] able to visit [the memorial]," said Zalewski. She suggested that the child share the memorial with their mother and father, which ended up being an emotionally meaningful experience. They discussed how it felt for each of them to lose the dog and be able to grieve together, says Zalewski. She believes the process helped normalize grief for the child. Mom and Dad were sad too, but they got through, and so could the client.
"Now mom and dad and the child can talk more comfortably about the dog," says Zalewski. "It's okay to be sad. Sadness won't break you. It's okay to share the happy stuff too."
Zalewski also helped children and adolescents cope with the loss of loved ones such as grandparents. Many children are reluctant to share some of their feelings about loss because they fear it could be painful for those around them, says Zalewski. She helps young clients express their grief by inviting them to speak to her about the things they remember about their grandparents or other loved ones who have died. "Everyone has a loss," she says. "I will help you access the good memories."
These memories are often funny, like how the grandparent always made the customer a cup of coffee or tea and the customer always drank it even though he thought it tasted terrible. Or they remember a unique sweater that their grandmother made for them.
"Often children have never grieved and they don't know how to do it," says Zalewski. It provides a safe place to explore the feelings of being really sad and missing a loved one.
Go forward
"We have no room where children can be afraid of learning in person again, especially given the heightened safety protocols," says Carter. "Masks, no touch, no singing, playground closed – all of these things can be scary, but we expect kids to be able to turn that off and learn as usual."
As schools continue to open, Betters-Bubon believes that a trauma-informed approach with a school-wide focus on relationships is essential. “A trauma-informed approach integrates social-emotional learning that embeds sensory strategies in the classroom and enables voice and choice,” she says. “This also includes a focus on the well-being of employees. School counselors would focus on teaching all staff members and helping them understand the effects of trauma on the brain and student learning, including helping schools devise specific ways to build relationships. "
Betters-Bubon would also like to see closer collaboration between schools and external mental health counselors in order to focus on building resilience in children and adolescents. This could mean taking a broader systemic perspective and working with the critical adults in the students' lives, she says. "I noticed an increased need for family counseling to bring about systemic changes in families that ultimately help children and adolescents."
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Laurie Meyers is a senior writer for Counseling Today. Contact them at [email protected].
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Opinions and statements in articles appearing on CT Online should not be assumed to reflect the opinions of the editors or guidelines of the American Counseling Association.
