One of the most important ways you and your family can support your child is to acknowledge that their symptoms are real and have a real impact on your child and your family. If your child has somatic symptoms, understand that they cannot control them and are not faking them or putting them on for attention.
Involving your child in their treatment
Understand symptoms
- Work with your child to understand their symptoms, including any physical, psychological and social factors that might be contributing to them.
Encourage your child to follow their physical symptom management plan
One important part of treatment is to develop a physical symptom management plan. Your role is to encourage your child to follow the plan. Typical actions might include:
- detecting triggers for their symptoms as early as possible
- identifying and talking about their feelings
- identifying stressful situations and applying techniques to cope with them
- using coping skills to handle physical symptoms and prevent them from getting worse
- pacing activities or workload throughout the day or week (see below).
While working with your child to identify and address any stressors, recognize that those who experience somatic symptoms might find it difficult to pinpoint their stressors and express their emotions.
Offer day-to-day support
- Switch from focusing on your child’s physical symptoms to focusing on improvements in your child’s functioning.
- Find ways to help your child talk about their emotions.
- Try to understand what it’s like to be your child.
- Listen to your child and validate their distress while also encouraging them to make steps towards doing what is important and meaningful to them.
- Praise your child’s effort to do activities despite their symptoms.
- Celebrate small successes.
- Be patient.
- Be hopeful about their recovery.
Supporting your child’s long-term recovery
- Set expectations for your child’s behaviour and offer them age-appropriate choices about their routine.
- Focus on ways to improve communication between family members.
- Talk to your child’s school about developing an individual education plan (IEP) and any accommodations to support your child with their learning (see below).
- Keep in contact with your child’s health-care team for advice and follow-up.
- Arrange regular follow-up visits with your child’s health-care provider to monitor symptoms and progress towards treatment goals.
Pacing everyday activities for your child when they have somatic symptoms
When a child has somatic symptoms, the most effective treatment involves re-engaging in meaningful activities. This can begin with restarting regular daily routines, getting restful sleep, physical activity and returning to school.
You can help your child find fun ways to return to their daily routine by, for instance, finding and taking up a new hobby, playing a game with friends or taking walks as a family.
If your child’s physical symptoms make an activity difficult, your child can use activity pacing to return to their routine. This means starting with an activity that your child knows they can do safely for a short time, and balancing activity with rest breaks. Over time, your child increases the type of activity and the duration until they reach their treatment goal—a safe return to their usual routine.
Example of activity pacing: Return to walking
| Time | Goal: Walking 25 minutes every day |
|---|---|
| Week 1 | Walking three minutes every day |
| Week 2 | Walking five minutes every day |
| Week 3 | Walking seven minutes every day |
| ... | ... |
| Week 9 | Walking 23 minutes every day |
| Week 10 | Walking 25 minutes every day |
Everyone progresses at their own pace. Encourage your child to choose an activity that is important to them and re-assess their goals as they improve.
Working with your child’s school
It is important to meet with and work with your child’s school to:
- develop a school-based symptom management plan to help your child attend school
- address concerns about your child’s learning and discuss any appropriate tailored supports.
Good communication between members of your child’s health-care team and the school can help support your child’s school participation. It can also be helpful to have your child’s health-care provider write a letter to the school to explain your child’s diagnoses and somatization and outline possible accommodations and coping strategies.
Encourage your child to play their part by identifying and sharing any challenges as well as any strategies that would help them.
School-based symptom management plan
A school-based symptom management plan often includes:
- typical triggers (such as workload, upcoming deadlines, being called upon by the teacher, giving class presentations, and crowded, noisy environments)
- warning signs that symptoms are getting worse
- techniques to manage symptoms (e.g., using fidget toys in class, breathing techniques, going for a walk, being in a quiet space, wearing sunglasses, wearing earplugs, using noise-cancelling headphones, having a plan for transitioning between classes)
- skills to manage stress, including identifying stressful situations and expressing emotions
- strategies to pace activities and workload
- accommodations (such as extra time for assignments and tests, a quiet space, reduced workload, class notes, modified physical education class)
- a list of support team members at school (such as a guidance counsellor, resource teacher and the vice principal or principal).
Example of activity pacing: Return to school
A return to school after a prolonged absence is most likely to be successful when it takes place gradually, with the right supports in place (for example, extra time for tests and assignments).
| Time | Goal: Return to school fulltime |
|---|---|
| Week 1 | Attending one half day |
| Week 2 | Attending three half days |
| Week 3 | Attending five half days |
| Week 4 | Attending one full day and four half days |
| ... | ... |
| Week 8 | Taking part fully in school and homework |
Supporting yourself while your child is treated for somatization
Caring for a child with significant somatization can take a toll on caregivers as they see their child not doing well and in distress. This can lead to a sense of helplessness, guilt and worry.
- Recognize that it is essential for you to manage your own worries and distress.
- Develop a support system to help with practical tasks.
- Engage in basic self-care, for example, by eating a balanced diet, making time for regular exercise and getting enough sleep.
- Remember it is common to feel this way, and you are not alone.
- Be good to yourself.
- There is reason to be hopeful.
Resources
Self-help
- AboutKidsHealth Teens — Being with all of your experiences
- Anxiety Canada Youth — How to do progressive muscle relaxation
Therapy in the community
Rehabilitation
- Canadian Association of Occupational Therapists
- Ontario Society of Occupational Therapists
- Empowered Kids Ontario
- College of Physiotherapists Ontario
- Physiotherapy Clinics (Government-Funded)
Kids Help Phone – kidshelpphone.ca
Kids Help Phone is a 24/7 e-mental health service offering free, confidential support to young people.
References
American Academy of Child and Adolescent Psychiatry (2017). Physical symptoms of emotional distress: Somatic symptoms and related disorders. Retrieved from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Physical_Symptoms_of_Emotional_Distress-Somatic_Symptoms_and_Related_Disorders.aspx
BC Children's Hospital (n.d.). Somatization. Kelty Mental Health Resource Centre. Retrieved from https://keltymentalhealth.ca/somatization
BC Children's Hospital (2015). Body talk: Stories of somatization. Kelty Mental Health Resource Centre. Retrieved from https://www.youtube.com/playlist?list=PLERqxY_UqhB5EvdiLrLKAs_DnAYnjJnm7
