key: cord-268042-qhrhymle
authors: Skokauskas, Norbert; Leventhal, Bennett; Cardeli, Emma Leventhal; Belfer, Myron; Kaasbøll, Jannike; Cohen, Judith
title: Supporting children of healthcare workers during the COVID-19 pandemic
date: 2020-07-18
journal: Eur Child Adolesc Psychiatry
DOI: 10.1007/s00787-020-01604-6
sha: 
doc_id: 268042
cord_uid: qhrhymle

nan

Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The WHO 2019 "Novel Coronavirus Global Research and Innovation Forum: Towards a Research Roadmap" highlights several knowledge needs, including what are the relevant, acceptable and feasible approaches for supporting the physical health and psychosocial needs of those providing care for COVID-19 patients [1] . The roadmap is broad and detailed; however, we believe more attention should be given to the psychosocial well-being of the children of healthcare workers.

During the COVID-19 pandemic, extraordinary measures are being taken to protect the general population and, in particular, healthcare workers. The general population control measures (i.e., the closure of businesses and educational institutions, travel restrictions, and social distancing) are stressful for families, especially children. When social distancing and quarantine constitute everyday life experiences, the effects of well-known and critical protective factors for resilience and mental health (i.e., social and community support) are substantially disrupted.

Social distancing strategies disrupt healthy routines needed by children and increased exposure to trauma in childhood poses risks for later development of many forms of psychopathology, including anxiety, depression, posttraumatic stress disorder (PTSD), disruptive behavior, and substance abuse [2] . When there are adverse outcomes for their children, there is an inevitable, negative impact on their parents. If their parents happen to be healthcare workers and first responders, it will surely impair their ability and willingness to work during any crisis, including the COVID-19 pandemic [3] .

Children of healthcare workers are at greater risk for a stress response, because they have at least some, if not full, awareness of the risks that their parents are facing at work. As a result, these youth are more vulnerable to stress and trauma due to the fear that their parents may be infected and/ or even die from COVID-19-or even worse, face the dire consequences if it actually happens.

Healthcare workers and first responders are appropriately concerned about their children. If they can have more confidence that practical support is available to support their children during these challenging times, it will inevitably improve their ability and willingness to work effectively during the COVID-19 pandemic.

With careful planning and design, it is possible to provide help for children of healthcare workers and first responders. Using online strategies to provide interventions built on a foundation derived from the principles of evidence-based child trauma treatment, programs can reduce traumatic stress symptoms in children while building resilience and strengthening coping strategies. Trauma-focused cognitive behavioral therapy is an evidence-based child and parent intervention designed to help children recover from traumatic life events. It has a strong evidence base, having been evaluated for community settings use in many countries [4] . TF-CBT components have demonstrated efficacy in improving children's disaster-related PTSD symptoms when delivered in a web-based format [5] . Supports such as this are needed throughout the pandemic including the period in which lives gradually return to "normal."

WHO (2020) 2019 novel coronavirus global research and innovation forum: towards a research roadmap

Childhood adversities and first onset of psychiatric disorders in a national sample of US adolescents

Healthcare workers' willingness to work during an influenza pandemic: a systematic review and metaanalysis

A randomized effectiveness study comparing trauma-focused cognitive behavioral therapy with therapy as usual for youth

Web intervention for adolescents affected by disaster: population-based randomized ontrolled trial

Ethical approval Ethical approval for this letter was not applicable. All authors declare that the submitted work has not been published before (neither in English nor in any other language) and that the work is not under consideration for publication elsewhere.