Caregiver Responses to Child Posttraumatic Distress: A Qualitative Study in a High-Risk Context in South Africa.

Many low- and middle-income countries (LMIC) have high rates of child trauma exposure and limited access to psychological services. Caregivers are often a child's key source of support following trauma in such contexts. The aim of this study was to explore the experiences of primary caregivers in supporting their child posttrauma. Qualitative interviews were conducted with 20 female caregivers from a high-risk settlement in Cape Town following child trauma exposure. Children were exposed to significant traumatic events, including gang violence, assault, and fatalities of close relatives. The data were analyzed using thematic analysis; several key themes emerged. First, caregivers were typically aware of child distress posttrauma, based primarily on manifest behaviors. Second, caregivers identified varied ways of providing support, including being warm and responsive; seeking to ensure physical safety by encouraging the child's perceptions of the community as dangerous; and encouraging forgetting as a way of coping, with limited discussions of the event. Third, many barriers existed to accessing psychological treatment, and caregivers had low involvement in any interventions. Finally, caregivers also experienced significant distress that could impact their responses to their child. The results illustrate the challenges faced by caregivers in supporting children following trauma in LMIC contexts and the need for accessible psychological interventions.

Exploring transdiagnostic stress and trauma-related symptoms across the world: a latent class analysis.

Background: Although trauma exposure is universally prevalent, the ways in which individuals respond to potentially traumatic events vary. Between-country differences have been identified as affecting the development and manifestation of transdiagnostic psychological symptoms, but it remains unclear how stress and trauma-related transdiagnostic symptoms and risk patterns differ based on geographic region.Objective: To explore whether there are distinct classes of stress and trauma-related transdiagnostic symptoms and to determine predictors of class membership in a global sample.Method: Participants (N = 8675) from 115 different countries were recruited online between 2020-2022 and completed the Global Psychotrauma Screen, which assesses stress and trauma exposure, related symptoms, and risk factors. A latent class analysis (LCA) was used to identify classes of stress and trauma-related symptoms per world region (African States, Asia-Pacific States, Eastern European States, Latin American and Caribbean States, Western European and Other States, and North America) and the total sample. Likelihood of class membership was assessed based on demographics, characteristics of the potentially traumatic event, and potential risk factors across the world regions.Results: Similar class compositions were observed across regions. A joint latent class analysis identified three classes that differed by symptom severity (i.e. high, moderate, low). Multinomial logistic regression analyses revealed several factors that conferred greater risk for experiencing higher levels of symptoms, including geographic region, gender, and lack of social support, among others.Conclusions: Stress and trauma-related symptoms seem to be similarly transdiagnostic across the world, supporting the value of a transdiagnostic assessment.

A latent class analysis of transdiagnostic stress and trauma-related symptoms in a global sample showed high, medium, and low symptom classes.Class compositions were similar across global geographic regions.Several factors were associated with high symptom class membership globally, including gender, geographic region, and lack of social support.

Thinking about the next generation: The case for a mentalization-informed approach to perinatal and intergenerational mental health.

BACKGROUND: There has been substantial progress made across multiple disciplines to emphasize the importance of perinatal mental health both for parents and offspring. This focuses on what has been termed the 'First 1000 Days' from conception to the child's second birthday. We argue that our understanding of this issue can go further to create an intergenerational approach to mental health. Despite the existence of theoretical frameworks and practical approaches to implementation, there are gaps in the understanding of perinatal and intergenerational mental health including which psychological mechanisms are implicated in the transmission of risk and resilience within the perinatal period; and how to leverage these into treatment approaches. AIMS AND METHODS: In this paper, we explore the potential for mentalization as a candidate psychological approach to intergenerational mental health. RESULTS: We contextualize this issue in terms of the points of contact between mentalization and broader theoretical models such as the social determinants of health and the Developmental Origins of Health and Disease (DoHaD) model. Further, we provide an overview of the existing evidence base for the relevance of mentalization to perinatal mental health. DISCUSSION: Finally, we sketch out an outline model for integrating mentalization into perinatal and intergenerational mental health, highlighting several areas of opportunity to develop research and practice from diverse geographies and demographics. Here, we suggest that integration of mentalization with other conceptual frameworks such as DoHaD can mutually enrich the understanding of each model, pointing the way towards more effective early and preventative interventions.

Examining harmful impacts of the COVID-19 pandemic and school closures on parents and carers in the United Kingdom: A rapid review.

Background: As a result of the COVID-19 pandemic, school closures meant that for many households, home and school environments became intertwined. Parents and carers found themselves taking on the role as de-facto educators, as well as balancing working from home and caring for additional members of the household. Understanding the full extent of the effects incurred by parents and carers during school closures is vital to identifying and supporting vulnerable families. This rapid review aimed to appraise the available evidence on the potential effects of the COVID-19 pandemic on UK parents and carers. Methods: Searches for academic literature were conducted using Proquest Central, Scopus, and Google Scholar between 21st and 28th April 2021 using search terms describing "parents and carers", "COVID-19" and the "UK". Additional literature was identified on relevant parents and carers' organisations websites including charity reports. Results: Thirty-two articles were found relating to harms affecting parents and carers in the UK High levels of psychological distress, including anxiety and depression, were consistently identified in the general parent population, and especially in parents caring for a child with special educational needs and/or neurodevelopmental disorders (SEN/ND). Charity reports indicated that many parents, especially those from an ethnic minority background and kinship carers, were worse off financially and with food insecurities, whereas empirical evidence showed that mothers were more likely to initiate furlough for themselves compared with fathers or childless women. Domestic abuse support services also reported a sharp rise in demand during lockdown restrictions, and practitioners reported an increase in child and adolescent violence towards parents. Conclusions: Given the known impacts of parental stress, mental health problems, domestic violence and financial hardship on children's development, it is critical that these findings are taken into account in case of future pandemics to minimise harms both to parents and their families.

Psychological Interventions for Individuals Bereaved by Homicide: A Systematic Review.

Research has demonstrated that approximately 45-50% of individuals show healthy levels of psychological and physical functioning in the first 12 months post-loss. Homicidal bereavement (loss due to murder or manslaughter) does not appear to follow this pattern. Homicide-related mental health difficulties are a serious problem worldwide, displaying high rates of lifetime incidence, high chronicity, and role impairment. Individuals are at increased risk to develop symptoms of post-traumatic stress disorder (PTSD), complicated grief (CG), and depression. Nevertheless, a systematic review specifically on the efficacy of psychological interventions following homicidal loss has not yet been conducted. The current systematic review (registered via PROSPERO) aimed to review the psychological interventions available and report their effectiveness. Of 77 records, 7 met predefined inclusion criteria. Studies presented different methodologies, tested different clinical models, and treatment conditions. Thus, a narrative systematic review was conducted. Studies included manualized interventions to deliver 1:1 and group sessions. Cognitive behavioral therapy, restorative retelling, and eye movement desensitization and reprocessing were the main models used together with psychoeducational elements about trauma and grief responses. Overall, symptoms of PTSD, CG, and depression decreased significantly postintervention. Sustained improvements were reported for PTSD and depressive symptoms at the follow-up measurements. Mixed results were found regarding how individual (age, gender) and external factors (time since loss, relationship with the deceased) impact on symptom progression. As a result of differences in methodologies, categorization of therapies, methodological differences, and small sample sizes, important questions remain unanswered. Further randomized controlled trials and expert consensus could be considered.

Alcohol use during pregnancy in rural Lesotho: "There is nothing else except alcohol".

OBJECTIVE: Reducing alcohol use during pregnancy is a pressing public health priority in Sub-Saharan Africa, but insight into the factors that influence prenatal drinking practices is lacking. This study investigated perceptions of, and motivations for, alcohol consumption during pregnancy and associated practices in a rural district of Lesotho. METHODS: A combination of purposive and snowball sampling methods were used to identify pregnant women and mothers with young children from the general community, as well as from alcohol-serving venues. Between September 2016 and March 2017, a trained data collector conducted in-depth interviews with 40 women on reasons why pregnant women drink, what they know about the risk of drinking alcohol during pregnancy, and perceptions of women who drink during pregnancy. RESULTS: Sixty-five percent of women (n = 26) reported that they consumed alcohol during pregnancy. Findings were clustered into four themes: 1) alcohol use in daily and cultural life; 2) alcohol as relief from stress and hunger; 3) alcohol's effect on the baby; and 4) access to information about alcohol consumption. Our data suggest that alcohol use was a prominent feature of daily life and a key part of traditional events and ceremonies. Other than potentially harming the baby through falling on their stomachs while inebriated, women did not mention other risks associated with prenatal alcohol use. Rather, there were prominent beliefs that drinking alcohol - home-brewed alcohol in particular - had cleansing or protective benefits for the baby. Experiences of food insecurity were prominent, and women reported that alcohol helped curb their hunger and allowed them to save food to give to their children. CONCLUSIONS: Within this context of chronic poverty and food insecurity, alcohol use during pregnancy will continue to represent a valid, though tragic choice if the structural conditions and current social arrangements that facilitate prenatal alcohol use remain unchanged.

COVID-19 Unmasked Global Collaboration Protocol: longitudinal cohort study examining mental health of young children and caregivers during the pandemic.

BACKGROUND: Early empirical data shows that school-aged children, adolescents and adults are experiencing elevated levels of anxiety and depression during the COVID-19 pandemic. Currently, there is very little research on mental health outcomes for young children. OBJECTIVES: To describe the formation of a global collaboration entitled, 'COVID-19 Unmasked'. The collaborating researchers aim to (1) describe and compare the COVID-19 related experiences within and across countries; (2) examine mental health outcomes for young children (1 to 5 years) and caregivers over a 12-month period during the COVID-19 pandemic; (3) explore the trajectories/time course of psychological outcomes of the children and parents over this period and (4) identify the risk and protective factors for different mental health trajectories. Data will be combined from all participating countries into one large open access cross-cultural dataset to facilitate further international collaborations and joint publications. METHODS: COVID-19 Unmasked is an online prospective longitudinal cohort study. An international steering committee was formed with the aim of starting a global collaboration. Currently, partnerships have been formed with 9 countries (Australia, Cyprus, Greece, the Netherlands, Poland, Spain, Turkey, the UK, and the United States of America). Research partners have started to start data collection with caregivers of young children aged 1-5 years old at baseline, 3-months, 6-months, and 12-months. Caregivers are invited to complete an online survey about COVID-19 related exposure and experiences, child's wellbeing, their own mental health, and parenting. DATA ANALYSIS: Primary study outcomes will be child mental health as assessed by scales from the Patient-Reported Outcomes Measurement Information System - Early Childhood (PROMIS-EC) and caregiver mental health as assessed by the Depression Anxiety Stress Scale (DASS-21). The trajectories/time course of mental health difficulties and the impact of risk and protective factors will be analysed using hierarchical linear models, accounting for nested effects (e.g. country) and repeated measures.

Antecedentes: Los primeros datos empíricos muestran que los niños en edad escolar, los adolescentes y los adultos están experimentando niveles elevados de ansiedad y depresión durante la pandemia de COVID-19. Actualmente, hay muy poca investigación sobre los resultados de salud mental de los niños pequeños. Objetivos: Describir la formación de una colaboración global titulada 'COVID-19 Desenmascarado'. Los investigadores colaboradores tienen como objetivos (1) describir y comparar las experiencias relacionadas con COVID-19 dentro y entre países; (2) examinar los resultados de salud mental de los niños pequeños (de 1 a 5 años) y los cuidadores durante un período de 12 meses durante la pandemia de COVID-19; (3) explorar las trayectorias/temporalidad de los resultados psicológicos de los niños y los padres durante este período e (4) identificar los factores de riesgo y de protección para las diferentes trayectorias de salud mental. Los datos de todos los países participantes se combinarán en un gran conjunto de datos transculturales de acceso abierto para facilitar más colaboraciones internacionales y publicaciones conjuntas. Métodos: COVID-19 Desenmascarado es un estudio de cohorte longitudinal prospectivo en línea. Se formó un comité directivo internacional con el objetivo de iniciar una colaboración global. Actualmente, se han formado asociaciones con 9 países (Australia, Chipre, Grecia, Países Bajos, Polonia, España, Turquía, Reino Unido y Estados Unidos de América). Los socios de investigación han comenzado la recopilación de datos con los cuidadores de niños pequeños de 1 a 5 años al inicio, a los 3 meses, a los 6 meses y a los 12 meses. Se invita a los cuidadores a completar una encuesta en línea sobre la exposición y las experiencias relacionadas con COVID-19, el bienestar del niño, su propia salud mental y parentalidad. Análisis de datos: Los resultados primarios del estudio serán la salud mental infantil según la evaluación de las escalas del Sistema De Información De medición de Resultados Informados Por El Paciente ­ Primera Infancia (PROMIS-EC) y la salud mental del cuidador según la evaluación de la Escala de estrés, ansiedad y depresión (DASS-21). Las trayectorias/temporalidad de las dificultades de salud mental y el impacto de los factores de riesgo y de protección se analizarán utilizando modelos lineales jerárquicos, teniendo en cuenta los efectos anidados (por ejemplo, el país) y las medidas repetidas.

Associations between parental trauma, mental health, and parenting: A qualitative study in a high-adversity South African community.

RATIONALE: Research suggests that parenting behaviours are negatively affected by parental trauma. However, thus far, the evidence base has provided limited insight into why this occurs. Further, the available evidence has focused largely on high income contexts (HICs), and we know much less about the experiences of parents in low- and middle-income countries (LMICs) who are frequently coping with multiple adversities. OBJECTIVE: The current qualitative study aimed to gain a more in-depth understanding from the parent's perspective about whether and how their trauma impacted themselves and their parenting behaviours. METHOD: We conducted interviews with 30 trauma-exposed, Xhosa speaking parents (28 mothers) from Khayelitsha, a township outside Cape Town in South Africa, 66% of whom reported experiencing moderate to severe posttraumatic stress symptoms. RESULTS: Five key themes were identified: consequences for parents as individuals (in terms of mental and physical health); the centrality of community and cultural context to parental experiences; consequences in terms of parenting capacity; trauma related effects on the child and how these may influence parental coping; and mechanisms of coping and achieving recovery. CONCLUSION: Findings highlight the difficult nature of parenting following trauma due to impacts on multiple areas of life, and suggest potential avenues for the development of parenting interventions in order to support parents and families more effectively following trauma.

The impact of parental posttraumatic stress disorder on parenting: a systematic review.

Background: Posttraumatic stress disorder (PTSD) is a serious and debilitating disorder that can develop following exposure to a traumatic event. Where parents develop PTSD, it may have an impact on their parenting role. Objective: The objective was to review the existing evidence base on parental PTSD, examining whether parental PTSD has an impact on key parenting domains. Method: A comprehensive web-based search identified 27 quantitative studies that examined parental PTSD in relation to parenting domains. Results: Several parenting domains were investigated including: parenting satisfaction, parenting stress, the parent-child relationship, and specific parenting practices. Sample sizes ranged from 19 to 3931 parents. A range of parental traumas were investigated, including traumatic birth experiences, military trauma, and intimate partner violence. Findings indicated associations between parental PTSD and several domains of parenting, but there were inconsistencies across studies. Conclusions: Findings suggested that parental PTSD is associated with impaired functioning across a number of parenting domains, including increased levels of parenting stress, lower parenting satisfaction, less optimal parent-child relationships, and more frequent use of negative parenting practices, such as overt hostility and controlling behaviours. However, methodological limitations across the literature as a whole limited the potential to infer causal impacts of PTSD on parenting. Further study is also needed to advance our current understanding around the impact of different trauma types on parenting domains.

Antecedentes: El trastorno de estrés postraumático (TEPT) es un trastorno grave y debilitante que puede desarrollarse después de la exposición a un evento traumático. El hecho que los padres desarrollen TEPT, puede tener un impacto en su rol parental de crianza.Objetivo: El objetivo de esta revisión fue revisar la base de evidencia existente sobre el TEPT de los padres, y analizar si el TEPT de los padres tiene un impacto en los dominios de crianza de los hijos.Método: una búsqueda exhaustiva a través de internet identificó 27 estudios cuantitativos que examinaron el TEPT de los padres en relación con los dominios de crianza.Resultados: se investigaron varios dominios de crianza de los hijos, incluidos: satisfacción parental, estrés parental, la relación padre-hijo y prácticas de crianza específicas. Los tamaños de muestra oscilaron entre 19 y 3931 padres. Se investigó una variedad de traumas parentales, que incluyeron experiencias traumáticas de nacimiento, traumas militares y violencia de pareja. Los hallazgos indicaron asociaciones entre el TEPT de los padres y varios dominios de crianza de los hijos, pero hubo inconsistencias entre los estudios.Conclusiones: los hallazgos sugirieron que el trastorno de estrés postraumático de los padres se asocia con un funcionamiento deficiente en varios dominios de crianza de los hijos, incluido un mayor nivel de estrés parental, menor satisfacción parental, relaciones menos óptimas entre padres e hijos, y un uso más frecuente de prácticas de crianza negativas, como la hostilidad manifiesta y conductas controladoras. Sin embargo, las limitaciones metodológicas en toda la literatura en su conjunto limitaron el potencial para inferir los impactos causales del TEPT en la crianza de los hijos. Aún se necesita más estudios para avanzar en nuestra comprensión actual sobre el impacto de los diferentes tipos de trauma en los dominios de crianza.

Parental Experiences of Supporting Children with Clinically Significant Post-Traumatic Distress: a Qualitative Study of Families Accessing Psychological Services.

The aim of this study was to investigate the experiences of parents in providing support to their child following trauma exposure in cases where children are experiencing clinically significant levels of post-traumatic distress. Qualitative interviews were conducted with parents whose child was exposed to a trauma and referred for psychological treatment. Parents reported considerable anxiety in coping with their child's post-traumatic distress. Avoidance of trauma-related discussions was encouraged due to concerns that non-avoidant approaches may worsen children's post-trauma difficulties. Nonetheless, parents were often sensitive to their child's distress and offered reassurance and other forms of support. Many barriers existed to accessing psychological treatment, and perceptions of inadequate guidance from therapists on supporting child adjustment contributed to parental distress. The results illustrate the strategies used by parents in supporting their child post-trauma and may assist mental health professionals in providing acceptable guidance to parents following child trauma.

Self-perception of adaptation among homicidally bereaved individuals following a psychoeducational intervention: a UK longitudinal qualitative study.

OBJECTIVE: Research on homicidal bereavement has focused on postloss impact and coping. Less is known about how individuals perceive their adjustment posthomicide. Adverse experiences are likely to leave individuals with an increased risk of developing severe psychological difficulties, such as depression, Post-traumatic stress (PTSD), anxiety and complicated grief. This study aimed to explore how individuals perceive their change and progression posthomicide and post-psychoeducational intervention. DESIGN: Semistructured qualitative interviews were conducted both as part of a prospective study and retrospectively to allow for a longer follow-up period. SETTING: Homicidally bereaved individuals who participated in a residential psychoeducational intervention offered by a national charity (Escaping Victimhood (EV)). PARTICIPANTS: Twenty-nine individuals (mainly females) took part: 14 as part of a 6-9-month follow-up (short-term trajectory group (STG) individuals-mean age 45.25) and 15 individuals (long-term trajectory group (LTG) individuals-mean age 48.50), retrospectively, 2 to 5 years postintervention. RESULTS: Interviews were analysed using an inductive Thematic Analysis method. Three main themes and nine subthemes emerged, and applied to both groups, as follows: (1) actual changes perceived by the participants (increased understanding, improved coping strategies and positive self-change), (2) barriers to recovery (severe psychological difficulties over time, need for further support, reminders and close relationships with both victim and perpetrator), and finally perceived future progression (living day by day, hope and hopelessness). The only significant differences between the two groups related to the reported self-growth among LTG individuals and the perceived increased informal support among STG individuals by keeping in touch in other EV participants. CONCLUSION: This unique study provides insight into how homicidally bereaved individuals perceive their bereavement paths and helped to identify elements that appear to contribute for their adjustment. Importantly, it has highlighted that positive changes can also be an outcome.

The transition to parenthood following a history of childhood maltreatment: a review of the literature on prospective and new parents' experiences.

Background: Becoming a parent is viewed as one of the most important transitions in one's life. However, a history of childhood maltreatment may affect the adjustment to parenthood. Objective: The objective of this review was to synthesize the current evidence base to further our understanding of prospective and new parents' experiences in the transition to parenthood (pregnancy to 2 years post-birth), in the context of having a childhood maltreatment history. Method: A scoping review of the literature was conducted using the following online databases: PubMed, PsycINFO, PsycNET, and Published International Literature of Traumatic Stress. Results: The findings were synthesized into a four-component theoretical framework, which included mental health of the parent, physical changes, parental view of the child, and view of the self as a parent. A total of 69 papers, including 181,537 participants (of whom 30,482 mothers and 235 fathers had maltreatment histories), investigated the transition to parenthood. The majority of the studies showed that parents with a maltreatment history may suffer from a range of mental health problems during the transition to parenthood, experience more negative physical changes, and have more negative views of their child (or children). However, they reported both positive and negative experiences regarding their identity as a parent. Conclusions: The findings suggest that maltreatment is a risk factor for a more challenging transition to parenthood. Experiences of fathers with maltreatment histories merit more attention, as do those of parents in low- and middle-income countries. Future directions should include predictors of positive experiences and the development of early interventions to improve outcomes for this population.

Antecedentes: Convertirse en padre es visto como una de las transiciones más importantes en la vida. Sin embargo, un historial de abuso infantil puede afectar la adaptación a la paternidad.Objetivo: El objetivo de esta revisión fue sintetizar la evidencia actual para ampliar nuestra comprensión de las experiencias de los nuevos y futuros padres en la transición a la paternidad (desde el embarazo a dos años después del nacimiento), en el contexto de tener un historial de abuso infantil.Método: se realizó una revisión de la literatura utilizando las siguientes bases de datos en línea: PubMed, PsycINFO, PsycNET y Literatura Internacional Publicada de Estrés Traumático.Resultados: los hallazgos se sintetizaron en un encuadre teórico de cuatro componentes, que incluyó la salud mental de los padres, los cambios físicos, la visión del niño por parte de los padres y la visión de uno mismo como padre. Un total de 69 artículos, que incluían 181,537 participantes (30,482 madres y 235 padres con antecedentes de abuso), investigaron la transición a la paternidad. La mayoría de los estudios mostraron que los padres con antecedentes de abuso pueden experimentar una variedad de problemas de salud mental durante la transición a la paternidad, experimentan más cambios físicos negativos y tener una opinión más negativa de su(s) hijo(s). Sin embargo, informaron experiencias tanto positivas y negativas con respecto a su identidad como padre.Conclusiones: los hallazgos sugieren que el abuso es un factor de riesgo para una transición más compleja a la paternidad. Las experiencias de los padres con historias de abuso merecen mayor atención, al igual que los padres en países de bajos y medianos ingresos. Las direcciones futuras debieran incluir predictores de experiencias positivas y desarrollo de intervenciones tempranas para mejorar los resultados para esta población.

Post-trauma coping in the context of significant adversity: a qualitative study of young people living in an urban township in South Africa.

OBJECTIVE: Compared with knowledge of the post-trauma needs of young people living in developed countries, little is known about the needs of those in low-middle-income countries. Such information is crucial, particularly as young people in these environments can be at increased risk of experiencing trauma, coupled with less available resources for formal support. The aim of this study was to explore post-trauma coping and support-seeking of young people living in a high-adversity settlement in South Africa. DESIGN: Semistructured qualitative interviews analysed using thematic analysis. SETTING: An urban settlement ('township') in Cape Town, South Africa. PARTICIPANTS: 25 young people, aged 13-17 years, who had experienced trauma. Events included serious car accidents, hearing of a friend's violent death, and rape, and all reported having experienced multiple traumatic events. All participants identified as black South African and spoke Xhosa as their first language. RESULTS: Social support was considered key to coping after trauma, although the focus of the support differed depending on the source. Parents would most commonly provide practical support, particularly around safety. Peers often provided an avenue to discuss the event and young person's emotional well-being more openly. Outside of social support another key theme was that there were numerous community-level barriers to participants receiving support following trauma. Many young people continued to be exposed to the perpetrator of the event, while there was also the realistic concern around future traumas and safety, community stigma and a perceived lack of justice. CONCLUSION: This study provides insight into how young people cope and seek support following trauma when they are living in a context of significant adversity and risk. Overall, most young people identified helpful sources of support and thought talking about the event was a useful strategy, but concerns around safety and trust could impede this process.

Parental responses to child experiences of trauma following presentation at emergency departments: a qualitative study.

OBJECTIVE: Parents are often children's main source of support following fear-inducing traumatic events, yet little is known about how parents provide that support. The aim of this study was to examine parents' experiences of supporting their child following child trauma exposure and presentation at an emergency department (ED). DESIGN: Semistructured qualitative interviews analysed using thematic analysis. SETTING: The setting for this study was two National Health Service EDs in England. PARTICIPANTS: 20 parents whose child experienced a traumatic event and attended an ED between August 2014 and October 2015. RESULTS: Parents were sensitive to their child's distress and offered reassurance and support for their child to resume normal activities. However, parental beliefs often inhibited children's reinstatement of pretrauma routines. Support often focused on preventing future illness or injury, reflective of parents' concerns for their child's physical well-being. In a minority of parents, appraisals of problematic care from EDs contributed to parents' anxiety and perceptions of their child as vulnerable post-trauma. Forgetting the trauma and avoidance of discussion were encouraged as coping strategies to prevent further distress. Parents highlighted their need for further guidance and support regarding their child's physical and emotional recovery. CONCLUSIONS: This study provides insight into the experiences of and challenges faced by parents in supporting their child following trauma exposure. Perceptions of their child's physical vulnerability and treatment influenced parents' responses and the supportive strategies employed. These findings may enable clinicians to generate meaningful advice for parents following child attendance at EDs post-trauma.