It is important for families to take good care of their bodies, but it is also important for families to take care of their mental well-being. If you are worried about your child’s mental health, it may be difficult for both you and your child to talk about it. However, doctors that work with young patients are trained to have discussions with children about their feelings, and your child’s pediatrician may be able to help. The Hazel team spoke with a special guest, Dr. Anoshiravani about his approach to talking to children in a clinical setting. Dr. Anoshiravani is a pediatrician and adolescent medicine specialist at Stanford School of Medicine and the Lucile Packard Children's Hospital Stanford.
Question: As a doctor working with young patients, what types of questions do you ask a child struggling with their feelings?
Answer: When I have these types of conversations with young people, I simply ask them how they are doing and allow them to share whatever they are comfortable sharing. Often by letting them talk freely, the conversation about their emotional health comes naturally. They may share that they feel down, or feel negative, or feel low on energy.
Question: How do you respond if a young person doesn’t want to talk about their feelings?
Answer: If it’s clear to me that something more is going on, I can share how other people are feeling, and check if they have that experience too. Or, I may say, “It’s great that things are good for you right now. I want to make sure you know that you can talk about those kinds of experiences if they ever come up.” Being matter-of-fact can help young people understand that I’m not looking for a specific answer, I just want to listen to what they have to say.
Often young people may not feel comfortable talking about their feelings because there are a lot of stigmas with mental health. They may think that nobody understands, or nobody is as sad as they are. When they have these sorts of conversations in their heads, it becomes very difficult to open up to others.
Some young people feel like they should handle it on their own and they should be strong or shouldn’t need anyone’s help. If you feel that way it’s less likely that you’re going to seek help. By explaining that a lot of people feel the same way, we can normalize the behavior and put them at ease. Sometimes knowing you aren’t alone can make it easier to open up.
Question: What happens if you try a few approaches, and the patient still isn’t willing to discuss things with you?
Answer: If I get the sense that the situation may be dangerous, it’s okay to push and explain why I’m concerned about the young person. If the situation isn’t dangerous, it’s best not to push the issue. This type of questioning tends to make young people uncomfortable and they may lose interest in talking about their feelings then or in the future.
If a child isn’t ready to talk about their feelings just yet, I can show I respect that and offer to be available if or when they do need to have a conversation. By respecting a young person’s autonomy, we can lay the groundwork for trust.
Question: What are some common challenges parents face when their child is struggling with hard feelings?
Answer: We know that it can be difficult for young people to talk to their parents about certain feelings. But, it can be equally hard for a parent to step back from all of their emotions and be objective when it comes to talking with their child about behavioral and mental health.
As a parent and as a doctor, I can share that this is okay. Even doctors, who are trained in this, have a hard time doing it with their own children. There are too many emotions involved. Parents shouldn’t feel like they need to fix everything by themselves. There are other trusting adult relationships, like a pediatrician or a nurse practitioner, or a school counselor, that can help talk to your child.
Questions: What can a parent expect after a doctor talks with their child about mental health?
Answer: Some parents may ask the doctor about what came up in conversation while a young person is in an appointment. However, a doctor may not be able to share that information with you. There are laws in most states that protect confidentiality for most young people. These laws are important because they allow young people to talk about their feelings with a trusted adult, even if the parent doesn’t know about it.
Question: What advice would you give to a parent trying to help a child manage feelings?
Answer: Parents may hope that their doctor will be able to fix whatever is going on emotionally with their child after one visit. While as a parent, I can understand the desire for a quick fix, it’s very rare that doctors are able to fix the problem or major issue with one conversation or one pill.
Often it takes time and dedication on the parent’s part and the child’s part and the doctor’s part. There needs to be an ongoing dialog and relationship overtime to make a difference in terms of behaviors and how a young person is feeling about themselves or about the world.
If your child is emotionally struggling, please reach out to your child’s doctor. If Hazel is available in your schools, our doctors may be able to guide your family to the right resources.