Volume 37 · Number 6
JUNE 2007

Parenting in Times of Crisis

By Daniel S. Schechter, MD; Beth Ellen Davis, MD, MPH

Most parents would do anything to protect their young children. Human evolution, compared with other species, has led to placing an enormous investment of energy and time in ensuring the safety of relatively few offspring. And yet, when both caregiver and the child sense a threat, the degree to which the caregiver is available to protect and help contain the stress and anxiety of the child is variable. Multiple factors affect the caregiver’s emotional and physical availability to help a child’s response to stress, trauma, and loss. The caregiver’s past experience, biological (ie, genetic and other constitutional) vulnerability, the nature of the specific threat, and the degree of exposure to the threat contribute to a parent’s response when a child is stressed. Above all, the pressing need to ensure survival of oneself and family determines a caregiver’s ability to participate in an essential developmental task of young children, namely, mutual regulation of emotion, arousal, and attention, leading to the development of self-regulation by age 5 to 6.

ABOUT THE AUTHORS

Daniel S. Schechter, MD, is with the Infant-Family Service, Department of Pediatric Psychiatry, Morgan Stanley Children’s Hospital of New York, New York-Presbyterian Hospital; and Assistant Professor of Clinical Psychiatry (in Pediatrics), College of Physicians and Surgeons, Columbia University, Division of Developmental Neuroscience. Beth Ellen Davis, MD, MPH, is a Colonel, U.S. Army, and is with Developmental Behavioral Pediatrics, Madigan Army Medical Center, Tacoma, Washington, and is Associate Professor of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Address correspondence to: Daniel S. Schechter, MD, Division of Developmental Neuroscience, 1051 Riverside Drive, Unit 40, New York, NY 10032; fax 212-543-5467; or e-mail dss11@columbia.edu.

Dr. Schechter and Dr. Davis have disclosed no relevant financial relationships.

The opinions and views expressed herein are those of the authors and do not reflect the official policy or position of the Department of the Army, the Department of Defense, or the United States government.

EDUCATIONAL OBJECTIVES

1. List at least three child mental health “first responder” strategies to help children after a disaster or crisis.
2. Define “reflective functioning” and know at least one question to ask to elicit reflective functioning in a parent.
3. Discuss how relationship-focused intervention is a part of any family-oriented treatment plan.