Supporting A Distressed Caretaker

By:  Lindsey Golomb, M.A, LPC., Dominique Charlot-Swilley, Ph.D. , Stacy Hodgkinson, Ph.D.

“Calm down and just sit!” A mom yells, as she picks her child off the exam room floor and plops him into the seat, only to have him jump out of the seat, scream louder and stomp harder. Despite mom’s best efforts, she becomes increasingly distressed and dysregulated as she attempts to calm her child down.

In that moment you may be torn between ignoring the behavior, or stopping the visit to intervene. If you decided to intervene, you may worry about overstepping your boundaries as the pediatrician or making the caretaker feel like a bad parent. If you’ve felt this way, you’re not alone.

So how do we support caretakers who appear agitated and distressed by their child’s behavior

8 Tips to Effectively & Empathetically Support a Distressed Caretaker

Take a moment to develop Empathy. This caretaker is really stressed out. There may be other things going on at home that add to her stress that you don’t know about. All parents are trying to do their best and want the best for their children.

Acknowledge feelings. Acknowledging how stressful the child’s behavior can be, initiates a nonjudgmental dialogue with the caretaker. Acknowledge parents’ feelings such as frustration, stress, and exhaustion towards parenting. “Tantrums are really frustrating for all parents.”

Distract and Redirect. Offering the child a book, snack or simple activity can diffuse the situation. “We have extra books, is it okay if I give your child one to read?”

Normalize. Normalizing the child’s behavior based on his or her developmental stage helps the caretaker to feel less embarrassed or at fault. “This behavior is pretty normal for this age, although really hard for the parent.”

Breath. Focusing on breath can help reduce stress. Caretakers often need to focus on their own stress management skills in order to help their child develop his or hers. Introduce the strategy of a mindful breath. With the patient, take two deep breaths together and reflect on how it made them feel. “It takes a lot of patients to be a parent. Taking a minute to breath can help refocus your energy. Let’s take two deep breaths together. How did that make you feel?”

Reframe & Notice Together. Identifying children’s behaviors is important since children have really BIG emotions and limited language skills. “Let’s think together about what his behavior may be telling us? Are there patterns to the behavior?”

Praise. Helping the caretaker identify the unique strengths he or she possess as a parent and the unique strengths of the child instills hope. “I can see you care about your child a lot and you are really proud that he is doing well in school.”

Make a plan. Identify with caretakers where additional support would be helpful and create a plan based on the shared understanding of the caretakers’ needs. Questions like “what about this situation is most challenging for you?”,How stressful is this for you?” and, “Would you like some support around this?” can facilitate conversation. This also enables providers to identify potential parenting skills to practice at home or identify additional supports in the community.

Did you know?

of women are affected by
Perinatal Mood and Anxiety Disorders

Use this Path to Wellness and Planning Guide to help talk to women about their emotional well-being.

Upcoming Events 

The Child and Adolescent Psychiatric Society of Greater Washington is offering a conference focused on the intersection of child psychiatry and pediatrics and will include discussion about migraine, head injuries, POTS, functional abdominal pain, and other issues. If anyone is interested in registering, contact CAPSGW administrator, Ms. Dulcea Arden, at to gen an Eventbrite invitation.

For more information on the event, please see flyer

Resources and Information 
CFPS (Certified Family Peer Specialist)

DC MAP is partnering with a community partner, Total Family Care Coalition (TFCC), to provide enhanced support to families seeking mental health resources for their children from families who have navigated the system themselves. A pilot study is underway through which participating families will be randomized into one of two groups: Treatment as Usual (TAU) through DC MAP, or CFPS (where they will be assigned a Family Peer Specialist through TFCC). Over the span of 3 months, we are collecting data to learn more about the feasibility and utility of these approaches to connecting families to services. If interested in learning more about the study, please contact Renee Williams at
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