Parent-child separation causes significant stress and emotional distress in children, as any parent who has left their child with an unfamiliar caregiver can attest. During these separations, children may exhibit inconsolable crying, refusal to eat or drink, and a desperate longing to be reunited with their parents, highlighting the profound impact of separation on their well-being.
Evolutionarily, children are wired to perceive separation from their parents as a matter of life and death. Behind the visible distress lies a surge of stress hormones in their bodies, preparing them to fight or flee from the perceived danger.
The Horror of Prolonged, Parent-Child Separation
Prolonged separation, unlike brief separations at nursery or pre-school, takes a toll on children’s physical and cognitive development. Prolonged separation depletes their bodies and impairs their brain function, leading to long-term detrimental effects on their mental and physical health. Such separation threatens crucial attachments, increases the risk of negative outcomes and disrupts children’s developmental trajectories.
The impact is particularly significant in the early years of life, when the brain is developing rapidly but lacks the cognitive capacity to understand the reasons for separation. As a result, children may form false beliefs about themselves, their parents and the world. They may internalise the ideas that their needs and desires are unimportant, that their parents cannot be relied upon to care for them, and that the world is a dangerous place full of untrustworthy people.
While it is easy to see why this can be damaging without extensive knowledge of trauma or child development, there is ample evidence to support the notion that the current administration’s zero-tolerance immigration policy, which has led to the separation of over 2,000 children from their parents, is likely to have serious consequences. The early parent-child relationship plays a critical role in emotional regulation and the development of a sense of security and trust. Therefore, sudden, unexpected and prolonged separation from parents, as experienced by these children, can be deeply traumatic.
Trauma, Recovery and PTSD
In the field of mental disorders, a traumatic event is defined as an encounter involving death, threatened death, serious injury or sexual violence. In the case of parent-child separation, these circumstances easily fit into these categories. Even when protocols are strictly followed and there is no violence, the act of separation can be perceived as a threat to the life or well-being of a young child who is torn away from a sobbing and frightened parent.
While resilience is usually the norm following exposure to trauma, the experiences that detained children have following separation can interfere with the natural recovery process. Research suggests that both the severity of the trauma and ongoing life stress contribute to the development of mental health problems in those exposed to traumatic events. Consequently, the duration and timing of separation play a crucial role in determining the likelihood of resilience.
Reactions to prolonged separation vary among children, but can manifest as chronic symptoms of PTSD. Common symptoms include recurrent intrusive thoughts or memories related to the separation, nightmares related to the event, avoidance of reminders, negative changes in thoughts about the world and self, persistent blaming, detachment or withdrawal, hypervigilance, irritability or aggression, exaggerated startle responses, difficulty concentrating, sleep disturbances, and developmental regression.
Institutional care: shortcomings and long-term consequences
Even in the most controlled and apparently peaceful of circumstances, the effects of parent-child separation are far-reaching. Children thrive on predictability, which is often lacking in institutional care, where staff rotate throughout the day and care for large numbers of children at the same time. While basic needs such as shelter, food, water and medical care may be met, they cannot compensate for the nurturing attention that young children desperately need.
This need for love and care is especially critical for immigrant children who have experienced war and violence in their home countries or during their journey to America. Lack of social support is consistently found to be the strongest predictor of PTSD in trauma-exposed individuals. As a result, the natural process of recovery may be hindered in immigrant children who are separated from their parents overnight and deprived of their support networks.
Furthermore, the actual conditions in these detention centres remain largely unknown. It is unlikely that children will be given the space to adequately express and process their emotions while in the care of overwhelmed strangers who may not even speak their language. Sadly, institutional care is often harsh and debilitating to the vulnerable children who are trying to cope with circumstances that no child should ever have to face.
Sadly, it is not surprising that orders to suppress crying and emotions are commonplace, as they provide short-term compliance from the staff perspective. However, rejecting children’s expression of their inner experiences has significant long-term consequences. It can result in children lacking effective tools for managing intense emotions, as young children rely on caregivers to teach and model coping strategies. As a result, it may lead to the development of psychopathology and impairments in overall functioning, as difficulties in emotion regulation are implicated in a wide range of mental health problems.
Supporting children after separation and traumatic events 4 key actions
- Allow children to have comfort items such as their favourite food, music or stuffed animals.
- Offer activities such as playing, hugging, reading or singing, but respect their boundaries and don’t force any of these interactions.
- Speak calmly and use language that children can easily understand.
Inform and reassure
- Reassure children of their safety and set clear, warm boundaries that create a safe environment.
- For example, gently intervene if a child tries to harm others and explain that hurting people is not acceptable.
- Tell children who have been separated from their parents that the separation was not their fault or their parents’ fault.
- If possible, provide updates on the parents’ whereabouts, well-being and expected time of reunification.
Listen and validate
- Encourage children to share their traumatic experiences if they feel comfortable doing so, but respect their need for space if they are not ready.
- Let children know that it is normal to feel scared, angry, confused or any other emotion.
- Validate their feelings without judgement and allow them to express themselves as long as it is safe to do so.
- Understand that overwhelming emotions can lead to acting out or aggressive behaviour, which doesn’t make them “bad” children.
- Avoid pressuring children to talk about their feelings or telling them how they “should” feel.
- Ask how you can support children in their healing process.
- If necessary, provide access to evidence-based, developmentally appropriate and culturally sensitive mental health services, such as cognitive behavioural therapy (CBT) for PTSD, depression or anxiety.
- For children separated from their parents, assist in expediting and facilitating the reunification process whenever possible.
Support for reunited families: Support after reunification
Reuniting separated families is of paramount importance, but it’s important to recognise that reunification alone may not fully reverse the effects of separation outlined above. Symptoms of PTSD, anxiety, depression and other disorders may persist after reunification. As a result, ongoing monitoring of previously separated children is necessary, along with efforts to reintegrate them into normal daily activities such as school, play and sports. Regular assessment of parents is also crucial, as parental psychopathology negatively affects both parenting behaviour and child outcomes.
Parents should consider seeking mental health treatment for children who struggle to regain a sense of normalcy or experience PTSD symptoms for three or more months after reunification. Early, developmentally appropriate intervention is recommended to minimise distress and guide children towards healthy functioning and development.
Effective evidence-based treatments for childhood PTSD include trauma-focused cognitive behavioural therapy (TF-CBT) and prolonged exposure therapy for adolescents (PE-A). These short-term interventions (10-20 sessions) help children process traumatic memories and reengage in meaningful activities, improve coping skills, and foster more adaptive beliefs about themselves, others, and the world.
Children struggling with other disorders, such as depression, anxiety or substance use, may benefit from alternative forms of CBT, such as behavioural activation for depression, exposure-based treatment for anxiety, or dialectical behaviour therapy (DBT).
Importantly, there is strong evidence to support the effectiveness of these treatments, even in complex cases. In addition, they are often available at low cost through local clinical psychology training programmes. As a result, parents and children can take comfort in knowing that emotional healing from separation and other trauma is possible and can be achieved in a relatively short period of time.
- National Child Traumatic Stress Network – https://www.nctsn.org
- Cohen, J.A. (2006). Treating Trauma and Traumatic Grief in Children and Adolescents. New York, NY: Guilford Press.
- Trauma-Focused Cognitive Behavioral Therapy – https://tfcbt.org
- Zoellner, L.A., & Feeny, N.C. (2014). Facilitating Resilience and Recovery Following Trauma. New York, NY: Guilford Press.
- Bowlby, J. (1988). A secure base: Parent–child attachment and healthy human development. New York: Basic Books.
- Laurent, H. K., Ablow, J. C., & Measelle, J. (2012). Taking stress response out of the box: Stability, discontinuity, and temperament effects on HPA and SNS across social stressors in mother–infant dyads. Developmental Psychology, 48, 35-45. doi:10.1037/a0025518
- Koss, K. J., Hostinar, C. E., Donzella, B., & Gunnar, M. R. (2014). Social deprivation and the HPA axis in early development. Psychoneuroendocrinology, 50, 1-13. doi: 10.1016/j.psyneuen.2014.07.028
- Hodel, A. S., Hunt, R. H., Cowell, R. A., Van Den Heuvel, S. E., Gunnar, M. R., & Thomas, K. M. (2015). Duration of early adversity and structural brain development in post-institutionalized adolescents. NeuroImage, 112-119. doi: 10.1016/j.neuroimage.2014.10.020
- Gunnar, M.R. (2017). Social buffering of stress in development: a career perspective. Perspectives on Psychological Science, 12, 355-373. doi: 10.1177/1745691616680612
- Zimmer-Gembeck, M.J., Webb, H,J., Pepping, C.A., Swan, K., Merlo, O., . . . Dunbar, M. (2017). Review: Is parent–child attachment a correlate of children’s emotion regulation and coping? International Journal of Behavioral Development, 41, 74-93. doi: 10.1177/0165025415618276
- Sroufe, L.A., Carlson, E.A., Levy, A.K., & Egeland, B. (1999). Implications of attachment theory for developmental psychopathology. Development and Psychopathology, 11, 1-13. Doi: 10.1017/S0954579499001923
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- Kessler, R.C., Sonnega, A., Bromet, E.J., Hughes, M., & Nelson, C.B. (1995). Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry, 52, 1048-1060. doi: 10.1001/archpsyc.1995.03950240066012
- Brewin, C.R., Andrews, B., & Valentine, J.D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68, 748-766. doi: 10.1037//0022-006X.68.5.748
- Ozer, E.J., Best, S.R., Lipsey, T.L., & Weiss, D.S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychological Bulletin, 129, 52-73. doi: 10.1037/0033-2909.129.1.52
- Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 541–565. doi:10.1097/ 00004583-199505000-00008
- Rojas-Flores, L., Clements, M., Koo, J., & London, J. (2017). Trauma and Psychological Distress in Latino Citizen Children Following Parental Detention and Deportation. Psychological Trauma: Theory, Research, Practice, and Policy, 9 (352-361). doi: 10.1037/tra0000177
- Bridley, A., & Jordan, S.S. (2012). Child routines moderate daily hassles and children’s psychological adjustment. Children’s Health Care, 41, 129-144. DOI:10.1080/02739615.2012.657040
- Smyke, A.T., Koga, S.F., Johnson, D.E., Fox, N.A., Marshall, P.J., . . . the BEIP Core Group. (2007). The caregiving context in institution-reared and family-reared infants and toddlers in Romania. The Journal of Child Psychology and Psychiatry, 48, 210-218. doi: 10.1111/j.1469-7610.2006.01694.x
- Linehan, M.M. (2015). DBT skills training manual (2nd ed.). New York: Guilford Press.
- Sroufe, L.A. (1996). Emotional development: The organization of emotional life in the early years. New York: Cambridge University Press.
- van der Kolk, B. A. (2003). The neurobiology of childhood trauma and abuse. Child and Adolescent Psychiatric Clinics of North America, 12, 293–317. doi:10.1016/S1056-4993(03)00003-8
- Fernandez, K.C., Jazaieri, H., & Gross, J.J. (2016). Emotion regulation: a transdiagnostic perspective on a new RDoC domain. Cognitive Therapy and Research, 40, 426-440. doi: 10.1007/s10608-016-9772-2
- Creech, S.K., & Misca, G. (2017). Parenting with PTSD: A Review of Research on the Influence of PTSD on Parent-Child Functioning in Military and Veteran Families. Frontiers in Psychology, 8, 1-8. doi: 10.3389/fpsyg.2017.01101
Alissa Jerud, Ph.D., is a licensed clinical psychologist and Clinical Assistant Professor at the University of Pennsylvania's Department of Psychiatry. In her Philadelphia private practice, she focuses on anxiety and related disorders, utilizing evidence-based cognitive-behavioral treatments (CBT), including exposure therapy. Dr. Jerud is also skilled in Dialectical Behavior Therapy (DBT), addressing emotion dysregulation with mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills.