Cook Children’s psychiatrists and psychologists are sharing some advice for parents.

How do I talk to my children?

• Ask them how they’re feeling and attempt to validate their feelings. Feelings of anxiety and sadness are normal. Reflect on what you hear and give them space to share. – Cook Children's family therapist Chris J. Gilbert, M.Ed, LPC, CCLS
• It’s OK if children ask questions that we don’t have an answer to. If you don’t have an answer, it’s OK to be honest and do what you can to help find an answer. You can follow up with “What makes you ask that?” – Kristen Pyrc, M.D., co-medical director of Psychiatry at Cook Children’s
•  If children feel sad or uneasy, validate what they are saying. Allow them to vent and share their own frustrations and reflect that back. – Family therapist Chris J. Gilbert, M.Ed, LPC, CCLS

Should I bring it up if my children haven’t mentioned it?

• For young children, you can ask them how their day went and if they heard anything unsettling at school. – Dr. Pyrc
• For children 10 and older, parents should consider starting the conversation because they will likely hear about it from a classmate.
• It’s also OK if they are not interested or don’t show interest. – Family therapist Chris J. Gilbert, M.Ed, LPC, CCLS

How can I comfort my children?

It’s important to talk with your child about things that frighten them because it helps reduce and manage fear. It lets them know that their parents empathize and care about their feelings and thoughts. – Cook Children's Neuropsychologist Lisa Elliott, Ph.D.

The best thing you can do for yourself and your family is to connect with them, tell them you love them, and hold them a little tighter because we are grateful they were able to come home. – Kia Carter, M.D., medical director of Inpatient Psychiatry at Cook Children’s Medical Center

Some tangible items to help your child feel more comforted:

• Create a small photo frame keychain with a family picture. They can attach it to their backpack or keep in their bag.
• Create matching bracelets to remind them of the connection to you and your family. – Dr. Elliott

You and your children can also:

• Donate to a charity.
• Write a letter to the family of a victim.
• Use your faith and pray for the needs of others.

These actions allow for some sense of a healthy outlet. - Family therapist Chris Gilbert

What if children do not want to go to school after hearing the news?

Let your child have one mental health day and do a lot of pouring into them and making memories together. Talk with them about how to handle problems and let them know we can still find joy. Do not let it be more than one day or it will only exacerbate the fear. – Dr. Elliott

“Kid’s worries about gun violence are valid,” said Kristen Pyrc, M.D., co-medical director of Psychiatry at Cook Children’s. “I have the same anxiety when I leave my house or send my kids to school. When you can, it is important to limit kids’ exposure to the news or information that is beyond their comprehension level. I hate having to have this conversation with increasing frequency because as adults we have not taken steps to adequately protect our children.”

Look for signs of anxiety

Keep an eye out for an increase in physical complaints. If these persist for more than a few weeks, seek professional help. - Dr. Elliott

• Stomach aches
• Headaches
• Change in appetite
• Nightmares
• Sleep disruptions
• Separation issues
• Panic symptoms
• Not wanting to participate in social activities

Parents, remember to take care of yourself

Model healthy coping skills as children take their cues from you. Children need to see that it’s OK to express emotion.

"It is vital for parents to take time to reflect on their own feelings before addressing their child’s fear centering around gun violence," Dr. Carter said. "We as parents have to remember to take care of ourselves first so that we can be the best parent for our children.  We encourage parents to find effective ways for themselves to cope by practicing in self-care whether it be exercising, meditation, seeking support in their religious faith. It can also be helpful for parents to consider joining parent support/community groups that can also serve as a platform to process these fears with other parents likely experiencing the same feelings. As parents, we are always modeling healthy behaviors for our children and this is a good time where we can model healthy coping skills and self-care for our children."

Effective ways to cope include speaking with other parents at school, forming/joining a parent support group, leaning on family members for support, eating nutritious meals, exercising, meditating, praying and speaking with your child’s school counselor for advice on resources or books on supporting yourself and your family through a school-related tragedy.

It's important that parents also process their feelings with other adults, support/communicate with their child's school staff and open up about their feelings and concerns.

Ways to help and ways to find support:

National Parent Helpline run by Parents Anonymous to get emotional support from a trained advocate: 1-855-427-2736

Tragedies such as these highlight the importance of donating blood. Giving blood supports nearby hospitals and rebuilds their supply for patients. Click here to sign up to donate blood at your local Carter BloodCare. Cook Children's Medical Center-Prosper is hosting its first blood drive. The drive is scheduled for 10 a.m. to 4 p.m. on May 12 on a Carter BloodCare bus. Register here.

Information from the National Association of School Psychologists about tips for administrators and how parents can talk to children about violence.

The National Child Traumatic Stress Network shares information for parents, including how to restore a sense of safety after a shooting.

For a great resource on how to speak up, visit sandyhookpromise.org.

For more on this topic:

• Sandy Hook Promise
• Cook Children's Behavioral Health
• Cook Children's Psychology
• Individual and family therapy
• Parent Education and Support
• Diagnostic Testing

Raising Joy Podcast

You can also listen to the recent Raising Joy Podcast with Dr. Jillian Peterson, founder of The Violence Project, as she informs listeners about her research findings related to mass shooters and what parents can do to help prevent the next school shooting.

Aim for Safety program at Cook Children’s

Safe storage. Safe children. Safe play.

When we have firearms in our homes, we must take certain steps to protect our children from unintentional shootings. Cook Children's Aim for Safety® initiative is designed to help reduce the number of injuries we see every year among children through gun safety education. This is not about whether guns are right or wrong. It's about taking the necessary steps to protect our children.

Safe storage: 

Parents and caretakers should always ensure safe storage in your own home and the homes you visit. Store firearms unloaded and in locked locations, out of reach of children.

• Use trigger locks and gun boxes.
• Secure ammunition separately.
• Hide gun safe and trigger lock keys.
• Keep unlocked guns in your possession.
• Make sure all guns are equipped with effective, child-resistant gun locks.

If a visitor has a gun in a backpack, briefcase, handbag, or unlocked car, provide them with a locked place to keep it when in your home.

Since the school shooting in Nashville last week, Lisa Elliott, Ph.D., psychologist at Cook Children’s, has seen an increase in conversation about school shootings with her patients and their parents who need help as well.

“It’s on everyone’s minds,” said Dr. Elliott, who has been a psychologist for 29 years. “Many of the moms have brought in their kids and asked for help themselves in navigating this.”

Dr. Elliott relates to these moms. School shootings now hit differently as her son is a middle school principal.

“Prayer gets me through,” she said.

We asked Dr. Elliott how to help children process this tragedy, along with tips for parents themselves. 

You can also listen to the recent Raising Joy Podcast with Dr. Jillian Peterson, founder of The Violence Project, as she informs listeners about her research findings related to mass shooters and what parents can do to help prevent the next school shooting.

What advice do you have for parents who are struggling with how to share the news of the school shooting with their children? How do they know when it is appropriate to talk with them?

The most critical part of reacting to this in front of children is to stay calm and always be honest with your responses.

To begin with, it all depends on how the kids process and handle emotions. You can wait to see if they say anything about it, and if they do, address it right away. I can tell you that late elementary, middle and high school students are talking about it. Do not minimize their concerns and immediately correct any inaccurate information. Let them talk first and lead the conversation, finding out what issues they want to talk through

Walk through the worst-case scenarios and talk to the school if needed, letting your child know all the safety measures in place. For some children, this kind of information empowers them.

Also, help them to know how to be observant – to be the helpers. We have to instill hope – Fred Rogers from Mister Rogers shared that his mother told him to “Always look for the helpers” in times of sorrow, tragedy, fear and anxiety, because if you also see the helpers you know there is hope.

At home, reinforce ideas of security and safety and maintain routines, with frequent check-ins.

How can parents reassure their children if they are struggling themselves to feel that everything will be OK?

Remember that to be the best parent to your child, you have to take care of yourself first – just like the airplane scenario with oxygen masks when parents are told to put their mask on before their child. It is important to model healthy coping as children take their cues from you. They need to see we care, and it is OK for them to see you express emotion, however, you do not want to overwhelm them. 

Effective ways to cope include speaking with other parents at school, forming/joining a parent support group, leaning on family members for support, eating nutritious meals, exercising, meditating, praying and speaking with your child’s school counselor for advice on resources or books on supporting yourself and your family through a school-related tragedy.

How do parents know when their child’s anxiety is beyond what they are able to help with and they need to pursue professional counseling?

Watch for these symptoms – an increase in physical complaints such as stomachaches or headaches, change in appetite, nightmares, sleep disruptions, separation issues, panic symptoms, not wanting to participate in social activities, and increased anger.

If any of these persist for more than a few weeks, seek professional help.

How do we shield our children from too much information with social media, TV, etc.?

Do all you can to limit your child’s exposure to the news, and even adult conversations, as children are always listening. We know from trauma research that violent images can cause secondary trauma. And parents need to model that as well by limiting exposure.

What if children do not want to go back to school after hearing the news?

Let your child have one mental health day and do a lot of pouring into them and making memories together. Talk with them about how to handle problems and let them know we can still find joy. Do not let it be more than one day or it will only exacerbate the fear.

What are some tangible ways parents can provide comfort to children?

Keychains with a small photo frame where you can place a family photo have helped many of the parents I see comfort their children. Attach it to your child’s backpack or lunchbox so they feel close to family while at school. Matching bracelets they can wear also help – anything that makes them feel connected to you and your family.

On this episode of Raising Joy, we meet Dr. Jillian Peterson, founder of The Violence Project, a nonpartisan nonprofit that created the largest and most comprehensive database on the life histories of mass shooters. She is a forensic psychologist, professor of criminology and author of “The Violence Project – How to Stop a Mass Shooting Epidemic.”

Her work has helped school leaders, police departments and universities across the nation adopt realistic tools for violence prevention. Listen in to hear what Dr. Peterson learned about mass shooters in her research and what parents and caregivers can do to help prevent the next school shooting.

Raising Joy is part of Cook Children’s Health Care System’s Joy Campaign, a communications initiative aimed at preventing youth suicides. For more information about the Joy Campaign, visit cookchildrens.org/joy.

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify and Google Podcasts.

Sadly, these heartbreaking occurrences no longer shock us. But that doesn’t make these events any easier to talk about with our children, especially as they occur more and more often.

So, where do we go from here and how do we make sense of any of this?

Lena Zettler, director of Psychology at Cook Children’s, says parents should spend time listening and watching their kids after tragedies such as what took place over the weekend. When talking to your children, Zettler encourages parents to focus on what makes their kids safe.

“I know it seems more difficult to do, especially when something like a shooting is close to home or in our same state, but our job as parents is to reassure our kids about the ways they are safe,” Zettler said. “Sadly in this day and age, that means talking about the drills our children perform in school to protect themselves. Maybe, as a family, you have your own safety plan. Remind your children of the safe people in the world who are looking out for them, such as their parents, grandparents, teachers, police or other relatives or close family friends. A good idea, may be to sit with your child and make a list of all the safe people they know in the world.”

When talking to your children, Zettler encourages parents to focus on what makes them safe, based on their child’s specific fears. She suggest parents ask opened ended questions before providing information. For instance, with the El Paso shooting, we are hearing that racism and targeting immigrants played a role. However, don’t assume that kids have made the connection between race and this incident. Find out what they know and what scares them and address those specific issues.

“Focus on what things make your children safe, based on their fears,” Zettler said. “Respond with your eyes, body language and words when kids express their fears. Anytime we are scared, our brains read body language and facial expressions more than words. Kids may express these fears verbally or behaviorally. Pay attention and provide reassurance when you see they need it.”

Lisa Elliott, a licensed psychologist and clinic manager of Cook Children’s Psychology Clinic, said the events of the weekend came up during most of her sessions on Monday. She reminded the children to focus what Mr. Rogers’ mother taught him, “To this day, especially in times of 'disaster,' I remember my mother's words and I am always comforted by realizing that there are still so many helpers ― so many caring people in this world.”

“There are always helpers in crisis and there are more helpers than there are people who do hurtful things,” Elliott said. “Today, this was once again helpful for each one of the kiddos who brought this up. We actually did an exercise where the kids looked up all the stories of those who helped people.”

Joy Crabtree, Psy.D, a licensed psychologist for Cook Children’s Behavioral Health in Southlake, said parents must set the example for their children to follow. Crabtree encourages a discussion of the events, but only if your youngest children have learned about the incident elsewhere. If they haven’t heard about it, don’t share information with them. If they already know about it, answer their questions and most importantly, reassure them as best you can.

For example, talk about the good people like the first responders who took care of the people who were hurt and everyone who worked together to make sure people were safe.

“Parents have to stay calm and cannot be glued to the TV,” Crabtree said. “If you have an elementary-aged child, and they haven’t learned the news, there’s certainly no reason to sit down with them and show them the story. There’s no need to cause fear in your children. By the time children are 7 or 8 years old, they can distinguish fact from fiction and will understand the consequences of what they are watching. If they have heard about it, take as much time as needed to sit down with them and have a discussion/answer session, providing reassurance and support. Answer their questions, but only their questions. There’s no need to add more information that may scare them even more.”

For older children, such as those in middle school and high school, Crabtree encourages parents to again determine if their child is mature enough to handle the information. If parents feel they can handle it, use the DVR as your friend during the news. Watch it with your child and pause the TV to answer questions. Gauge your child’s emotions and turn the TV off if your child becomes too emotional or the news is too intense.

The psychologists we talked to agree the recent tragedies may also be a good time to promote speaking up when your kids see a peer who is in distress. “They are not tattling. If they see a peer who is acting out things or talking about violence, speak up to a trusted adult,” Zettler said.

“It is definitely important for children and teens to speak up and say something if they have a concern, or feel someone may be making a threat, either toward themselves or someone else,” Crabtree added. “And sadly in the times we live in now, it’s also important to have general situational awareness, no matter where you are.”

For a great resource on how to speak up, visit sandyhookpromise.org.

Kids, even teens, look to parents for reassurance. Parents can express their feelings about these events, but do not make this about your feelings. Model resiliency and good coping (calming, grounded practices that could include praying, meditating, deep breathing, laughing, yoga, and exercise for instance).

After listening, ask the child what they need: it may just be a hug for now. Reach out to professionals for help if fears persist more than a few weeks.

Crabtree advises parents to watch and see if their children restrict activity. For instance, they may not want to go to school or to the playground because it is too far away from home, or simply because they are afraid. Also, notice if your child becomes withdrawn or more clingy than usual, and constantly wants to sleep in your bed. For older kids, if you see them avoiding social events or larger gatherings, that might be something to discuss.

“It is common for children to have a mild fear, but if you see an overwhelming fear, it’s important to start by talking to their pediatrician,” Crabtree said. “If it continues to be a concern, then it may be time to get professional help.”

For more on this topic:

• Sandy Hook Promise
• Cook Children's Behavioral Health
• Cook Children's Psychology
• Individual and family therapy
• Parent Education and Support
• Diagnostic Testing

It was the nation's deadliest school shooting since a gunman attacked an elementary school in Newtown, Conn., more than five years ago.

What makes the news more tragic is that these were students, and children, who were killed by a fellow student. By the time your child returns home from school today, he or she may have questions about this tragic event.

So how do you talk to your child about the shooting?

Joy Crabtree, Psy.D, a licensed psychologist for Cook Children’s Behavioral Health in Southlake, said parents must set the example for their children to follow. Crabtree encourages a discussion of the events, but only if your youngest children have learned about the incident elsewhere. If they haven’t heard about it, don’t share information with them. If they already know about it, answer their questions and most importantly, reassure them.

Crabtree said that in the cases such as what’s currently in the news, parents need to think through whether their child can handle any news about it at all. Depending on their age and maturity level, it might be best to shield children from the news entirely.

“Parents have to stay calm and cannot be glued to the TV,” Crabtree said. “If you have an elementary-aged child, and they haven’t learned the news, there’s certainly no reason to sit down with them and show them the story. There’s no need to cause fear in your children. By the time children are 7 or 8 years old, they can distinguish fact from fiction and will understand the consequences of what they are watching. If they have heard about it, take as much time as needed to sit down with them and have a discussion/answer session, providing reassurance and support. Answer their questions, but only their questions. There’s no need to add more information that may scare them even more.”

For older children, such as middle school and high school, Crabtree encourages parents to again determine if their child is mature enough to handle the information. If parents feel they can handle it, use the DVR as your friend during the news. Watch it with your child and pause the TV to answer questions. Gauge your child’s emotions and turn the TV off if your child becomes too emotional or the news is too intense.

Children may not understand the distance of the events on TV, make sure to calm their fears and let them know they are safe. If they continue to be fearful of their own safety, it may be helpful to get out a map and show them how far away they are from the incident that happened today. You can reassure them that the police have the situation under control.

“This news can be very scary to many children,” said Crabtree. “Parents need to realize this can really raise anxiety levels. They may feel that if it can happen there, it can happen anywhere. I can’t stress enough the importance of just being there for your child right now to support them, listen to them, and reassure them. Again, for younger children, only discuss it if they are already aware of the situation.”

Teens may have more questions and concerns because they can find information on the Web and discuss it with their friends at school. The event may hit even closer to home because they may be fans of the artists who were performing at the festival. They may have been to some of their concerts themselves and think, “that could have been me.” They may wonder why something like this happens. Share with your child your own fears and anxieties about the events. Let them know it’s Ok to feel scared or frustrated, but it cannot overtake them. Also, share with them ways that they may help by donating monetarily or giving blood in some instances. Sometimes when tragedy happens it helps them to work through their anxiety by becoming active and helping others.

Listen to your teen, or older child, regarding their fears and concerns. How an adult manages their own feelings can also provide a positive example for them.

Crabtree advises parents to watch to see if their children restrict activity, for instance if they don’t want to go to school or to the playground because it is too far away from home, or simply because they are afraid. Also notice if your child becomes withdrawn or more clingy than usual, and constantly wants to sleep in your bed. For older kids, if you see them avoiding social events, or larger gatherings, that might be something to discuss.

“It is common for children to have a mild fear, but if you see an overwhelming fear, it’s important to start by talking to their pediatrician,” Crabtree said. “If it continues to be a concern, then it may be time to get professional help.”