Pediatric Coping Skills

Healthy coping and self-soothing strategies are often effective tools that help us manage the effects of stress and intense emotions. These strategies have also been shown to help moderate the relationship between stress and the development of more severe health problems such as depressive symptoms and physical health concerns. Tactics for healthy coping may, therefore, be considered an important preventive exercise for children and teens. Care providers can educate children, adolescents, parents and caregivers about the use of healthy coping skills for children.

Stress is normal

Children, adolescents, parents and caregivers face a multitude of acute and chronic life stressors, which can include:

• Pressures related to academics
• Peer relationships
• Social media
• Life transitions
• Political climate
• Separation or loss of caregivers
• Poverty
• Familial conflict
• Exposure to violence
• Physical illness

Children certainly aren't immune to experiencing stressful and adverse life events. Without appropriate intervention, stress in childhood has been linked problems in adulthood. That's why it's important for pediatric patients to develop coping skills.

What is coping?

Coping commonly refers to an individual's effort to regulate emotions, cognitions, physiology, behavior and situations in reaction to stressful events or challenging circumstances. In other words, coping is anything that one does in an attempt to manage stress. During stressful situations, coping skills can help to diffuse or "turn down the volume" of intense emotion, allowing for increased control over an individual's response to the situation.

Coping skills for children generally serve a variety of purposes:

• Self-soothing: engages the body's natural calming system
• Distraction: redirects to more pleasurable activities to decrease intensity of emotion
• Opposite action: activities that generate an emotion or experience counter to the distressing one
• Emotional awareness: activities that promote emotional exploration and increase clarity
• Mindfulness: focuses on being grounded in the present

Unhealthy coping mechanisms

Unfortunately, some individuals develop unhealthy methods to deal with stress and difficult emotional experiences. Misguided attempts to manage stress may result in:

• Self-harm behavior
• Substance abuse
• Unhealthy eating
• Social withdrawal
• Aggression
• Maladaptive behaviors

While these coping mechanisms may provide momentary relief, they do not promote long-term health. Learning how to teach coping skills to a child can create life-long habits for better health.

Building coping skills in children

Children first learn how to manage stress by watching their parents and caregivers manage stress.

Caregivers may benefit from examining their own typical coping strategies and how they are or are not modeling healthy coping for their children. Families with younger children may consider developing a "family coping plan" to practice healthy coping skills for kids together. Using movie or book characters for examples on healthy and unhealthy coping can also be helpful in teaching younger children about coping in an age-appropriate way.

Talking to teens about coping

The first tip is that you don't have to call it "coping." Teens might not use that word, or any word, to identify what they are doing to handle stress. Inquire broadly about anything the teen currently does to manage emotions. Make them feel calm and "turn it around" when the patient seems to be struggling.

Encourage teens to consider what strategies have helped them in the past, even if these strategies were not conceptualized as "coping" (e.g., "I usually feel better after soccer practice" suggests that exercise may be a coping skill even if soccer practice is not needed to manage stress or cope). Use the teen's own language to help increase the likelihood of engagement. Instead of a "coping plan," teens may respond better to the idea of a "stress management plan," a "list of calming activities," or some other label of their choosing. Building teen coping skills is often about recognizing what they are already doing, meeting them on their terms and making incremental adjustments.

Sample pediatric coping strategies:

Self-Soothing	Deep breathing Tensing and relaxing major muscle groups (Progressive Muscle Relaxation) Meditation or guided imagery
Distraction	Calming activities (listening to music, painting/drawing) Mind-occupying activities (puzzles, baking, playing a game) Talking to someone
Opposite Action	Enjoyable activities Exercise
Emotional Awareness	Cognitive strategies: coping thoughts (e.g., "This situation is really rough, but it's only temporary," "I can ride this out") Self-affirmations Journaling
Mindfulness	Grounding exercises (counting your breaths, counting or subtracting by sevens, counting the colors you see) Five senses grounding activities (5 things you see, 4 things you hear, 3 things you feel, 2 things you smell, 1 thing you taste)

Additional resources

If you think a child or teen is being negatively impacted by stress and is having a hard time coping, professionals at Children's Hospital Colorado's Pediatric Mental Health Institute can help. Our professionals are trained to help children and their families identify and create healthy coping habits together.

For more information, call 720-777-6200.