Helping Children Cope When a Loved One Is Injured: Experts Weigh In on Ways to Ease the Worry
By ADRIENNE MAND LEWIN, ABC News

Jan. 30, 2006 The families of ABC News' co-anchor Bob Woodruff and cameraman Doug Vogt are coping with a trauma that's all too familiar to those with loved ones serving in Iraq.

Woodruff, who has four school-aged children with his wife, Lee, and Vogt, who has three young daughters with his wife, Vivian, were seriously injured Sunday by an improvised explosive device while traveling with a convoy near Taji, Iraq. An Iraqi soldier also was injured in the blast.

As of Jan. 21, 9,282 of 16,548 injuries of military personnel were caused by IEDs, according to the Department of Defense, and at least 894 of the 2,242 deaths in Iraq have been from IEDs. In the last week, there were 221 IEDs reported, according to security personnel.

For the children of service members, receiving news of a parent's injury is a jarring experience, but experts tell ABC News there are ways to help them understand what is happening with less fear and stress.

Answering Tough Questions
"Any time where you have to deal with something difficult for yourself then how do I explain it to my children becomes a parent's worst nightmare because [they think,] 'I'm not even sure how I wrap my head around it,'" said Robin Gurwitch, a psychologist who is a member of the American Psychological Association's Disaster Response Network.

"When something has happened, children are going to look to their parents about what should I do," she said. "So if their parents are extremely upset, then I will probably be extremely upset. That doesn't mean if something happens moms and dads should pretend that everything is OK."

Gurwitch said it was important for parents to already have a rapport with their children about their loved one's participation in the war so they know that they can ask questions. "Say: 'Your dad or your mom has been working really hard to stay safe,'" she said. "They are very well-trained and they have their buddies there to take care of them and good doctors there to take care of them.'"

When someone is injured, the most important thing is to be truthful with children, said Robert R. Butterworth, a licensed clinical psychologist who specializes in trauma.

"You can't say things are all right when they're not because you can't hide that fact," he said. "Parents try, but kids pick up the emotions."

Kids will have different reactions upon hearing the news. "The older kids will get upset why are they there and all that," Butterworth said. "Little kids want to know what's going to happen. Are they going to die? Try to say something like, 'The doctors are working on it.' But hiding is not a good idea. Telling older children and not telling younger children is not a good idea. The details are depending on age."

It is also critical to help allay children's stress and worry about the situation, said Judith A. Myers-Walls, associate professor of child development and family studies at Purdue University.

"The most important things to tell the child are that the child is safe and that people are working to help the injured family member," Myers-Walls said, adding, "This may be a new situation for a child, and he or she may not know what is appropriate to do when expressing anger, sadness and frustration. Adults can model their own responses, and they can talk with the child about what might be helpful or appropriate."

Beth Ann Brooks, a professor working in child and adolescent psychiatry at Wayne State University in Michigan, said that all children needed information, though younger ones should receive more brief and less-detailed explanations.

"No matter the age," Brooks said, "the more serious the injured's condition, there should be care taken to ease into the subject gradually with a lead-in like: 'Remember when Mr. Smith, our neighbor, was in that car accident last year and was in the hospital? Well, today we learned that. '"

Butterworth and other experts said explaining as much as possible about what was definitely known was important so that kids know exactly what the injury means, as well as where the patient is being treated. "When you don't explain, kids can fantasize a more frightening scenario," he said.

Dealing With Changes
There are also things parents and other adults should never do when discussing the injured family member. They should never promise that the loved one will get well and come home because sometimes they don't, said Gregory K. Fritz, a professor of psychiatry at Brown University School of Medicine. But he also said parents should never lie or take away all hope.

Butterworth noted that older children might have strong reactions about the reason for the war or why their loved one was there in the first place, sparking a political discussion.

"It's important that you don't debate the war," Butterworth said. "If they have feelings, just let them have feelings. Family members may have different feelings about it. Get the anger out about their fear."

Gurwitch said going to school and staying in a routine could help. Adults also should talk to children about what kids at school are saying about the news so they can correct any misinformation.

Children may have a series of reactions to the event, she said, including nightmares, trouble falling asleep, and a harder time concentrating. "Extra patience, extra care are going to be so critical at this time," she said. "Recognize that their behavior may be more disruptive."

Children also may have the idea there's something they "could've or should've done" to protect their loved one, she said, and adults should make sure that kids can share those feelings and allay those fears and concerns.

The experts suggested that even very young children make a card or video or a collage of pictures for the patient so that they feel like they are doing something to help.

They also should be reassured that when their parent comes home even if they look different they still are the same parent who loves them, said David C. Schwebel, associate professor of psychology at the University of Alabama at Birmingham.

"The most important information to be relayed," he said, "is that the loved one is doing everything they can to return home quickly, that the doctors are very good and are taking care of the loved one as best they can, that [assuming it is true] you will see your daddy/mommy/whoever very soon, and that he/she will still love you just like he/she always did, even if his/her legs are missing or he/she uses a wheelchair or crutches."