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There is an issue in health care that is not being discussed: medical trauma. Parents of children with medical trauma are struggling. They not only have to deal with their child’s illness, whether it be short-term or chronic, but are left to find ways to address and ease the trauma largely on their own. I have seen it repeatedly as a pediatric psychologist. I have also felt the challenge and stress as a parent when a doctor asked me to do something my child was resisting.
There are methods and strategies to help parents and children face medical trauma. One is the COACH framework that offers ways to deal with difficult behaviors, such as refusal to have a port-a-cath accessed. For some children, it can be traumatic to constantly be poked and prodded. And it can get worse over time if not addressed. The COACH framework works by:
• Collecting information (Why is the situation tense? What has worked in the past to overcome fears?)
• Observing (Watching responses to medical intervention, the medical team and parents, as well as progress.)
• Asking questions (Asking the medical team what is required, ask to have the same nurse each week, etc.)
• Choosing strategies (Music as a distraction, creating a reward chart.)
• Helping (Getting help from multiple medical team members including the child life specialist, nurses, doctors and psychologists.)
This method can help both parents and children feel like they have more control over the situation. The COACH framework is just one option for families experiencing medical trauma. It can help families navigate both serious illness and disease as well as simple fears of shots or resistance to going to the doctor for a check-up.
Meghan L. Marsac, Ph.D., is a pediatric psychologist at Kentucky Children’s Hospital and co-author of “Afraid of the Doctor: Every Parent’s Guide to Preventing and Managing Medical Trauma.”
