Identifying and responding to trauma in children, young people and families in a hospital setting

Abstract

Children and young people may enter a hospital system for a number of reasons including for a diagnosis of a long term, lifelimiting or life-threatening condition, a change in health status or a hospital admission for medical management of a mental health condition. All of which can be conceived of as potential traumatic stressors. For parents and families the subsequent medical investigations and treatments themselves can be traumatic to witness in a loved-one, often accompanied with a high sense of threat, and a low sense of self-efficacy and control, with outcomes often uncertain. Children, young people and families who come to the hospital come with a full range of histories and experiences, from all walks of life and all kinds of cultural backgrounds, that can impact on their ability to trust healthcare staff or to cope with the feelings evoked in this setting. Similarly, hospital staff come to their chosen careers with a range of experiences that can lead to intense emotional responses, are impacted by repeated exposure to traumatic events, and by vicarious trauma from witnessing the trauma of children, young people and families. As well as working directly with children, young people and families, a key role of the psychologist in the paediatric setting is to help contain this anxiety by helping them and staff make sense of and respond to the challenges they face, through sharing a psychological formulation, collaboration, teaching and contributing to the development of policies and procedures that enable the system to prevent, identify and respond effectively to trauma.