Emily Kutner, PhD is a pediatric psychologist on Connecticut Children’s psychology and hematology/oncology teams. She specializes in treatment of conditions that frequently affect children with chronic medical conditions, including anxiety, depression or chronic pain. We sat down with Dr. Kutner to learn more about how she works with families and their care teams to assist in managing these conditions during treatment.
What brought you to Connecticut Children’s and what is your role?
I am a pediatric psychologist specializing in hematology/oncology and the general intersection of medicine and psychology in a hospital setting. I completed a specialized fellowship, training as a psychologist in multiple subspecialties of medicine before moving to Connecticut two-and-a-half years ago. I am grateful for Connecticut Children’s, as I am truly able to come to my “dream job” each day, helping children and families ease distress when faced with medical illness or injury.
What are some the warning signs for depression, anxiety, and other conditions you look for in patients who are coping with illness or a chronic medical condition?
Research shows that nearly 80% of pediatric patients and their families report experiencing some traumatic stress following illness, injury, hospitalization, or painful medical procedures. When ignored, these stress reactions can negatively impact healing and recovery. It’s important for patients and families to assess for when these reactions begin to impair aspects of functioning. When your child is experiencing disruptions in sleeping or eating patterns, persistent change in mood (increased irritability, anxious, or sad mood), difficulties with replaying events repeatedly, or unable to complete activities of daily living (attending school, engaging with peers, etc) psychological intervention may be warranted. Children and adolescents with a health condition are more likely to be successful at managing their illness and staying active in meaningful activities if they are provided with care that addresses both psychological and medical needs.
How do you help children and their families cope with difficult diagnoses, treatments, or long hospital stays?
We know that unpredictable medical events can lead to challenging a child’s belief that the world is a safe place, which can increase symptoms of distress. I frequently work with families to improve health behaviors, such as sleep, diet, adherence, and physical activity, which can secondarily improve mood and functioning. I take an evidenced-based approach for treatment of psychological distress secondary to medical conditions, which may include cognitive-behavioral therapy, mindfulness, or biofeedback techniques. I often assist families in following complicated treatment plans and medication regimens, as well as create plans to assist in prevention of preventable future illness and injury.
How can parents best help their child when in the emergency room or in the hospital?
The most important thing to remember as a parent, is you are the best person to help your child’s anxiety and distress. Children often look to their parents to be calm and reassuring, and will model their parents’ affect. A good expectation is that it’s often best to provide honest information to decrease uncertainty in developmentally appropriate language. For example, if there is a procedure or IV involved, you should let your child know the reason for the intervention and that it may hurt. Instead of saying “this won’t hurt” or “you won’t feel a thing,” it can be more helpful to utilize distraction techniques, diaphragmatic breathing, and honesty regarding the intervention. This will help build trust within the medical team and hospital for your child, letting them know hospital staff is here to help them feel better. Be present with your child, if possible, and allow your child to talk about worries or feelings about being in the hospital. Let them know that whatever they are feeling, the feelings are normal, and reassure your child that he or she has not done anything wrong. Last but certainly not least, make sure as a parent that you take care of yourself! If you are worried, lacking sleep, or notably upset, it will be harder to help your child. Don’t be afraid to ask for help from family, friends, a counselor, or your own doctor. More information medical traumatic stress tips for parents can be found on The National Child Traumatic Stress Network.
What is the most rewarding part of your job?
This is the easiest question to answer- definitely the children and their families! I learn every day from the resiliency fostered by youth I engage with. Working in pediatric oncology, I am privileged to witness the importance of hope in a medical plan, and am so grateful families allow us to be a part of their treatment teams during such a vulnerable time.