Children can encounter stress at any phase in their lives. However, kids with chronic gastrointestinal (GI) disorders have additional stressors on top of the ordinary pressures of childhood.
They have many more doctors’ visits, medical procedures, injections, and exams. And on a personal level, they have to navigate their illness with their peers. They’re constantly balancing things like explaining why they missed school to their friends while also maintaining their privacy.
My role as a child psychologist who works with kids with GI disorders is to help them figure out how to live the life they choose to live, despite having an illness. One of the most important ways we do this is by learning how to manage stress so that they can return to school and their favorite activities. Here are some techniques I utilize with my patients:
How to Help Kids with GI Disorders Cope and Return to School
1. Utilize Relaxation Techniques
It’s important for kids to learn how to get their bodies to relax when their minds are telling them something scary is happening. We will often utilize something called diaphragmatic breathing, which is deep breathing, as well as progressive muscle relaxation. This is where we teach them to tense a muscle and then release it.
2. Use Metaphors
Metaphors can be utilized to help kids to be more psychologically flexible to do the things that work in their lives, rather than getting trapped by their mental rules. I like to use a metaphor about tug of war, when related to fear or anger. We all have these internal tug of war experiences that we can’t seem to let go of. Kids are angry that they have a chronic illness like IBD. And they can feel themselves physically fighting an angry feeling. I teach them that rather than constantly tugging back, to let go of the rope.
3. Teach the difference between BUT and AND
Many kids think that because they have IBD they can’t live their lives. They’ll say, I want to be on the baseball team, but I have IBD. I want to do things with my friends, but I have IBD. I often teach kids the difference between “but” and “and”. The word “but” makes things feel small and unsatisfying. “And” makes the world feel bigger. I have IBD and I’m going to try out for the baseball team. The way we use words can enhance our lives or compress it.
4. Practice Mindfulness
Becoming more aware of what’s going on in their minds, rather than struggling with it, can prevent kids from getting trapped by their negative thoughts. When we’re feeling sad, angry, or scared, our bodies react to that, making us stressed. We help kids become passive observers and to separate their thoughts from their sensory experiences. One way to practice this by helping them scan their bodies. To notice every sensation, from their toes to their heads. Notice what it feels like to have your feet flat on the floor. Do you notice where your body is touching and not touching the chair? At the same time, ask them what their mind is doing. Are they wondering what’s for lunch today? Or are they focused on the sensation of just sitting there?
5. Build the Motivation to Go Back
Kids with GI disorders miss a lot of school and activities. To help them mentally prepare to return, we must first build their motivation. I’ll do this by helping them realize what they’ve missed. Most often it’s their friends, recess, and their favorite teachers. By keeping these factors at the forefront of their minds, it justifies all of the hard work they have to put into returning.
6. Deal with the Illogical Thinking
When kids have missed a lot of school or practices, it can feel insurmountable to catch up. It can also feel overwhelming to think about all of the questions they’re going to receive from their peers. I coach them to think about both of these things in manageable pieces. They don’t have to return to school right where they left off. It can be a gradual process and should be individualized based upon their illness, symptoms and grade level. We’ll also try to find a balance between what information they want to share with their peers and what they want to keep private.
7. Develop a 504 Plan
Kids with chronic illnesses may qualify for a 504 plan, which is an agreement between the school and child to provide reasonable accommodations based on their condition. I can help them think through what they might need, like a place to practice their mindfulness, a readily accessible bathroom, and extra time for assignments when they miss school.
These coping techniques can help any child who is having trouble dealing with an illness. If you notice that your child is more emotionally reactive than before, such as having more anger and fear, or if she is withdrawing from things that she used to enjoy, it’s time to see a psychologist. We can help your child sort through his feelings and come up with strategies to deal with it.
Gastrointestinal disorders can affect every aspect of life – school, friends, family time and much more. To learn how our multidisciplinary team can help, call 513-636-4415 or email gastro@cchmc.org.
