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 or teen 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 or teen in their treatment
Understand symptoms
- Work with your child or teen to understand their symptoms, including any physical, psychological and social factors that might be contributing to them.
Encourage your child to follow their somatic symptom action plan
One important part of treatment is to develop a somatic symptom action plan. Your role is to encourage your child or teen to follow the plan. Typical actions might include:
- detecting, as early as possible, any triggers for their symptoms
- 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 somatization might find it difficult to pinpoint their stressors and express their emotions.
Offer day-to-day support
- Switch the focus from your child’s physical symptoms and their impact to improvements in your child’s functioning.
- Find ways to help your child or teen talk about their emotions.
- Try to understand what it’s like to be your child or teen.
- Listen to your child or teen and validate their distress while also encouraging their ability.
- Praise your child’s or teen’s effort to do activities despite their symptoms.
- Celebrate small successes.
- Be patient.
- Be hopeful about their recovery.
Supporting your child’s or teen’s long-term recovery
- Set expectations for your child’s or teen’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 doctor to monitor symptoms and progress towards treatment goals.
Pacing everyday activities for your child when they have somatic symptoms
When a child or teen has somatic symptoms, the most effective treatment involves an early return to regular activities. This can begin with restarting regular daily routines, getting restful sleep, exercising 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 ‘graded activity’ to return to their routine. This means starting with an activity that your child knows they can do safely for a short time. 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 a graded return to walking
| Time | Goal |
|---|---|
| Week 1 | General exercises for standing |
| Week 2 | Walking three minutes every day |
| Week 3 | Walking five minutes every day |
| ... | ... |
| Week 10 | Walking 30 minutes three times a week |
| Week 11 | Walking 40 minutes four times a week |
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 any social issues.
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 doctor write a letter to the school to explain your child’s diagnoses and somatization and outline possible accommodations and coping strategies.
Encourage your child or teen to play their part too 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, falling behind, getting low marks, being called upon by the teacher, giving class presentations, too much noise)
- warning signs that symptoms are getting worse
- techniques to manage symptoms (for instance using a fidget spinner in class, calm breathing, going for a walk, being in a quiet space, wearing sunglasses, wearing earplugs, using noise cancelling headphones, having a plan for moving 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, being excused from oral presentations)
- a list of support team members at school (such as a guidance counsellor, resource teacher and the vice principal or principal).
Example of graded 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 |
|---|---|
| Week 1 | Attending 1 half day |
| Week 2 | Attending 3 half days |
| Week 3 | Attending 5 half days |
| Week 4 | Attending 1 full day and 4 half days |
| ... | ... |
| Week 8 | Taking part fully in school and homework |
Supporting yourself while your child is treated for somatization
Caring for a child or teen with significant somatization can take a toll on parents and 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 and you are not alone.
- Be good to yourself.
- There is reason to be hopeful.
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
- Ontario Ministry of Health and Long-Term Care
- LHIN Home and Community Care
Kids Help Phone – kidshelpphone.ca
Kids Help Phone is a 24/7 e-mental health service offering free, confidential support to young people.
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
