OCWO ParentalBurnout 3674200 Report FINAL
OCWO ParentalBurnout 3674200 Report FINAL
OCWO ParentalBurnout 3674200 Report FINAL
Pandemic Parenting:
Of course, it didn’t. The pandemic lasted for two years, stretching the limits of parents’ physical, mental,
emotional, fnancial and professional well-being. Many parents, especially working parents whose
children were sheltered at home with them for more than a year, feel the experience has taxed or broken
them in some way.
We have felt these challenges as well. Our families faced the realities that millions of others did: struggles
to fnd balance between work and home responsibilities, virtual schooling for young children while
dealing with a lack of viable and safe daycare, and/or the feeling that every day felt like a week, every week
like a month, every month like a year.
It is this shared experience that inspired us to develop a survey that contained a valid and reliable tool
to assess and quantify working parent burnout and the conditions that seemed to exacerbate it. We then
took the survey a critical step further and examined how working parent burnout might be associated
with certain types of parenting practices, as well as concerning emotions and behaviors in their children.
Our survey provided parents an opportunity to refect on their own mental and emotional well-being
and how it might be afecting their children while potentially providing motivation to do something
constructive about it to help the challenging situation. We know that all parents do the very best that they
can, but when current stressors outweigh their coping skills and resources available to deal with them, it is
understandable to experience burnout and the emotional toll that it takes on mental health and well-being.
The fndings of our survey are described within the pages of this report. Our easy-to-use working parent
burnout scale is also contained in this document so that you can assess your own level of burnout. In
addition, strategies and resources to lessen burnout are included so that you can start using them right
now to feel emotionally better and engage more efectively with your children.
This survey captures a snapshot in time, at the height of the pandemic, but we all know that the adverse
efects will linger for some time well into the future. Please know that you are not alone. It is a strength to
recognize when we need help, not a weakness. It is also natural to feel like COVID-19 changed something
within you and your families. Millions upon millions of parents feel the same way. It will take time to heal,
so be patient with and kind to yourself.
Within this report, we ofer you helpful strategies to start feeling emotionally better about yourself and the
way you deal with your children. We want to encourage you and cheer you on, every step of the way.
This report highlights the results of a study that assessed parental burnout along with other important
measures, such as parent depression/anxiety and child behavior problems, conducted with working parents
who voluntarily and transparently answered our questions.
There are clear and strong relationships among working parent burnout and potential adverse efects on
both parents and children. It is critical to quantify, spotlight and acknowledge the presence of working
parent burnout as it ofen co-occurs with a mental health disorder, such as anxiety or depression.
This report will go more in-depth with the survey’s fndings. It includes tips, tools and resources that allow
working parents to assess their level of burnout, develop a better understanding about how to prevent and
deal with their burnout and guide their children through potential issues with anxiety, behavior problems,
depression, ADHD and stressful situations. Information is also included about an opportunity to participate
in a study that helps children/teens and their parents to learn mental resiliency/stress reduction techniques.
There is cause for optimism and hope: Recognizing and intervening for parental burnout have been
shown to improve both parent and child outcomes. Most importantly, steps must be taken to prevent it.
Bringing increased awareness to the issue of working parent burnout as a major public health issue will
help clinicians, parents, communities, institutions and companies recognize the condition and provide
preventive and targeted interventions to help parents and children to thrive and reach their optimal state of
mental health and well-being.
3
This is what burnout sounds like from
working parents during the pandemic:
If you have felt little interest or pleasure in doing things and/or have been feeling down, depressed or
hopeless several or more than half the days in the past two weeks, please reach out to your primary
care nurse practitioner/physician or employee assistance program at work as you may be sufering
from depression. Someone at the National Suicide Prevention Lifeline (800-273-8255) is always
available 24/7 if you ever need to talk 4with someone when feeling depressed.
Key Finding #1
Study Approach
Sixty-six percent of parents reported being burnout.
An online survey was conducted.
Key Finding #2 Participants were parents with children
under the age of 18 living with them.
Our study found that being female, the number of children Results were collected between
living in the home, anxiety in the parent, having child(ren) January 19, 2021 and April 28, 2021.
The survey was anonymous and
with the diagnosis of either anxiety or Attention Defcit
voluntary. 1285 parents self-selected
Hyperactivity Disorder (ADHD), and parental concern that
to participate.
their child(ren) may have an undiagnosed mental health
disorder are strongly associated with parental burnout.
5
Seventy-seven percent (77%) of parents
who had a history of personal anxiety
reported burnout.
Parental concern that their child may have an undiagnosed mental health disorder
carries a strong association with burnout in working parents.
6
Key Finding #3
Parental burnout is strongly associated with depression, anxiety and increased alcohol consumption in the
parent. Burnout is also associated with dramatic increases in the likelihood that parents may insult, criticize,
scream at, curse at and/or physically harm their children (i.e. spanking).
Insult
Scream
Criticize
Spank
7
Key Finding #4
The presence of working parental burnout is associated with parents’ reports of their children’s
internalizing, externalizing, and attention behaviors.
As part of the study, parents were asked to complete the Pediatric Symptom Checklist-17 (found in additional
resources section). This checklist assesses parents’ report of their children’s attention, internalizing and
externalizing behaviors. It is commonly used to help clinicians assess children for mental health disorders.
inability to sit still feels sad or unhappy fghts with other children
has trouble concentrating is down on themselves does not listen to rules
is easily distracted worries a lot teases others
The presence of working parental burnout is associated with all three of these behaviors in children. Parents
who identifed positive for burnout reported more attention, internalizing and externalizing behaviors in their
children than parents who did not report having burnout.
Caution must be used in interpreting this fnding as parents were reporting what they were perceiving in their children.
Further research is necessary to determine if what parents perceive is how the children are actually behaving by
observation; however, the Pediatric Symptom Checklist completed by parents reliably identifes children’s attention,
internalizing and externalizing behaviors.
Reference
1. Stoppelbein L, Greening L, Moll G, Jordan S, Suozzi A. Factor analyses of the Pediatric Symptom Checklist-17 with African-American
and Caucasian pediatric populations. J Pediatr Psychol. 2012;37(3):348-357. doi:10.1093/jpepsy/jsr103
8
Check Yourself for Working Parent Burnout
The 10-item Working Parent Burnout Scale is a tool that can be used to help both parents and clinicians
determine whether a parent is experiencing burnout. This scale is free for use and should be employed more
readily in the clinical setting as part of routine visits, but especially if a child or parent is being seen for a
mental health condition. This scale has demonstrated validity and reliability to detect parental burnout in the
working parent population.
Questions 4 and 10 use reverse scoring. Use these point values for questions 4 and 10.
Not at all = 4 points
A little = 3 points
Somewhat = 2 points
Moderately so = 1 point
Very much so = 0 points
10
Step 5: Take the next steps
Score 31+: Severe burnout – Ask for help from your healthcare
provider or mental health professional; connect with family
members and friends. Utilize available resources.
Overall, based on your defnition of burnout, how would you rate your level of burnout regarding being a
working parent?
☐ Occasionally I am under stress, and I don’t always have as much energy as I once did, but I don’t feel
burned out. (1 point)
☐ I am defnitely burning out from being a working parent and have one or more symptoms of burnout,
such as physical and emotional exhaustion. (2 points)
☐ The symptoms of burnout from being a working parent that I’m experiencing won’t go away. I think
about my frustration with being a working parent a lot. (3 points)
☐ I feel completely burned out from being a working parent and ofen wonder if I can go on. I am at the
point where I may need some changes or may need to seek some sort of help. (4 points)
Stopping to catch, check and change the negative automatic thoughts that ofen happen with parental
burnout can result in feeling emotionally better and can open the door to strategies and solutions that work
for you and your family. Perhaps you have children in half-day preschool who are home in the afernoons
while you work, or you’re shuttling older kids to multiple afer-school activities. Perhaps you stay up afer
your children go to sleep to do work for your job as you watch laundry pile up on the foor. Striking your right
balance may mean utilizing untapped resources and leveraging the village around you.
Here are fve other evidence-based strategies that can help you every day:
Children’s emotions and behaviors are ofen a source of stress for parents. This survey found that parents who
were very worried about their children’s mental health had a higher level of burnout than parents who were
less worried. The Pediatric Symptom Checklist-17 (located in the additional resources section) is a 17-item
screen designed to help identify possible cognitive, emotional and behavioral problems so that appropriate
interventions can be started as early as possible. “Never” is 0 points, “sometimes” is 1 and “ofen” is 2. Items
that are lef blank are given a 0. A score of at least 15 suggests possible signifcant behavioral or emotional
issues. If your child scores a 15 or above, please talk to your child’s healthcare provider.
12
Research study opportunity for parents and children to test online
stress reduction modules for children and teens
The authors of this report are conducting a research study with parents of children between 9 and
14 years old to determine the efectiveness of online stress reduction modules on child and parent
mental health and well-being.
13
Additional
resources for
parents
14
Pediatric Symptom Checklist (PSC-17) for Parents
Please mark under the heading that best describes your child:
NEVER SOMETIMES OFTEN
(0) (1) (2)
Does your child have any emotional or behavioral problems for which they need help? __No __Yes
and-services/pediatric-symptom-checklist
Total___________________
¿Tiene su hijo(a) algún problema emocional o del comportamiento para el cual
necesita ayuda?....................................................................................................................__□ No __□ Sí
treatments-and-services/pediatric-symptom-checklist
See Table 3.4 for common signs of anxiety in children and teens.
CHAPTER 3 • Patient Handout: Information for Parents About Anxiety in Children and Teens • 117
MEDICAL PROBLEMS THAT MIMIC ANXIETY SYMPTOMS
• low blood sugar,
• thyroid problems,
• seizures,
• irregular heartbeat,
• migraine headaches, and
• breathing problems.
MANAGEMENT
• Talk to your primary care provider if you have concerns; describe what you are noticing
about your child.
• Ask your primary care provider for things to read or websites to visit to learn more about
your child’s symptoms.
• Therapy might be recommended to help treat your child’s symptoms. It could involve
individual, group, or family work (cognitive behavioral therapy or skills building is the type
of therapy that is supported by research to be effective for children and teens experiencing
anxiety and/or depression).
• Help your child to practice mindfulness (staying in the present moment).
• Consider what could be changed at home or in school to help your child deal with their
worries (e.g., set a regular bedtime routine or think about which activities are stressful for
your child and think about ways to handle them differently).
• Medication is often recommended as an alternative treatment if symptoms are interfering
with your child’s day-to-day activities. Your provider may recommend a class of medicines
called SSRIs, short for selective serotonin reuptake inhibitors.
118 • CHAPTER 3 • Patient Handout: Information for Parents About Anxiety in Children and Teens
❍ Be sure to ask:
– What symptoms will the medication treat?
– How long will my child have to take this medication?
– How much medication will my child have to take, and how many times a day will
they have to take it?
– How often will we see and/or talk to you about how my child is doing on the
medication?
– What happens if my child misses a dose of medication?
– How do we stop the medication?
❍ SSRIs sometime take weeks to see the positive benefit; it is important for your child to
take the medication as prescribed. The most common side effects when starting an SSRI
is stomach upset/nausea, which tends to subside in a few days.
❍ Watch your child for any suicidal behaviors when being started on an SSRI.
❍ Never have your child abruptly stop the medication if placed on an SSRI.
• Your level of anxiety and stress will affect your child so seek help if you also are experiencing
anxiety to the point where it is interfering with your concentration, judgment, or functioning.
• Teach, practice, and reinforce coping skills, such as breathing exercises, mindfulness
meditation, visualization, positive self-talk, distraction with music or stories, and exercise.
CHAPTER 3 • Patient Handout: Information for Parents About Anxiety in Children and Teens • 119
Information for Parents About Behavior
Problems in Children and Teens
• Pediatric providers recognize how diffcult your role as parent is with this challenging child.
You still may want to remind us about how exhausting it is to have a child with behavior
issues.
• Please write down and tell us about every positive step that is being made as you parent
your child.
• Always build on your child’s particular positives; give your child praise and positive
reinforcement when he or she shows fexibility or cooperation.
• Your child’s problems are “loud” problems—they stand out for all to notice (as opposed to
anxiety, which is more of a private child problem). You may be bombarded by others in your
community telling you about your child’s behaviors.
• The journey of working with a child who has problem or disruptive behaviors can be
frustrating, draining, and isolating. This website connects you to a vast array of resources
and links that can help you better understand challenging children: www.livesinthebalance.
org/
• We want you to be well informed so you can teach others what you know. Your child’s
behaviors get “louder” and more obvious to others when they don’t have the skills to deal
with the demands being placed on them.
• Your child’s diffculties are complicated, and may have come with the child. Maybe it is in
their hard wiring—their brain anatomy and connections. Maybe it is in subtle temperament
qualities; maybe it is compounded with traumatic experience. Maybe your style of parenting
is perfect for one type of child but not such a “good ft” with this child’s strong personality
traits. Another signifcant factor is family stress, and family distress, including socioeconomic
status.
• Whatever the combination of factors, there is no blame; rather, there is assurance that your
child can learn to be more fexible, and can learn problem-solving skills, and can get better at
tolerating frustration.
• Recognize that, as Dr. Greene writes in the Explosive Child—children do well if they can.
• Your child longs for your approval, so provide it when your child does something positive.
• Because your child has some very real challenges with their “wiring” and temperament,
possibly genetics and early developmental stress, it is very likely that your child has trouble
with (a) fexibility, (b) frustration tolerance, and (c) problem-solving (from The Explosive Child
by Ross W. Greene, 2014), just as other children lag behind in acquiring academic or athletic
skills).
CHAPTER 7 • Patient Handout: Information for Parents About Behavior Problems in Children and Teens • 243
• Some of the skills children similar to yours (with problem behaviors) have trouble with
include:
❍ Diffculty handling transitions—shifting from one mind-set task to another,
❍ Diffculty refecting on multiple thoughts or ideas simultaneously (disorganized),
❍ Diffculty considering a range of solutions to a problem,
❍ Diffculty considering the likely outcomes or consequences of actions (impulsive),
❍ Diffculty expressing concerns, needs, or thoughts in words,
❍ Diffculty managing emotional response to frustration in order to think rationally, and
❍ Chronic irritability and/or anxiety signifcantly impede capacity for problem-solving.
• One of the biggest favors you can do for an explosive child is to identify the lagging
skills that are setting the stage for his or her challenging behavior so that you and others
understand what is getting in his or her way. Also, identify what problems may be causing
explosive episodes and what helps to calm your child down. You and the teacher can keep a
journal of these observations.
• Build in some extra minutes for the child to comply with your request. Your child may have
trouble “switching gears” and moving to the new activity. Don’t add time for their time out
for every minute they stall on the way. That is the way they are wired; that is, they are slower
to process a change in activity.
• Take a break or time out if you are about to make the confict with your child worse. This is
good modeling for the child of using self-control strategies.
• The best parenting style is a warm and involved guiding approach—providing discipline.
Being consistent and frm, yet loving, is the best approach.
• Build on the positives of your individual child (an example would be the COPE exercise in
the Child Handout—where you and your child list three positive things particular to your
child, and you display those prominently and bring those up regularly and add to them).
• Dr. Greene writes, “Good parenting means being responsive to the hand you were dealt.”
• Your child likely had developmental “lags” or challenges in these areas:
❍ Diffculty seeing the “grays”: concrete, literal, black and white thinking,
❍ Diffculty deviating from rules or routine,
❍ Diffculty handling unpredictability, ambiguity, uncertainty, or novelty,
❍ Diffculty shifting from original idea or solution, or
❍ Diffculty taking into account situational factors that would suggest the need to adjust a
plan.
• Pick your battles. Prioritize the tasks you want the child to do, or habits you want to develop.
• Avoid power struggles. The child with ODD has trouble avoiding power struggles so you
may have to go the “extra mile” to avoid getting into the battle of wills.
244 • CHAPTER 7 • Patient Handout: Information for Parents About Behavior Problems in Children and Teens
• Set up reasonable, age-appropriate limits with consequences that can be enforced
consistently. Review these with an expert you trust, such as your pediatrician or nurse
practitioner. Once these are set, feel confdent they are what are best for the child, and stick
consistently with your limits and consequences.
• All “adults” that are authorities in your child’s life should also know your rules and also
consistently enforce them. If the other parent disagrees, then there must be a plan made that
all of the important adults in that child’s life can consistently enforce.
• Your child has diffculty sorting out what to do if rules are not black and white.
Because of this diffculty—the adults caring for and parenting this child will have to be super
consistent in consistently enforcing the rules.
• Sticking to your expectations is very important. If you eventually give up your resolve and
give in, the child will learn to persist until you give in.
• Remember that the problem behaviors may escalate, get worse at frst, as the child “tests” the
new parenting approaches.
• Parents will need to make special efforts to care for themselves. The strong willed, explosive
child consumes so much of the parent’s time and energy, it is easy to become exhausted
physically and mentally. Maintain interests other than your child and ODD.
• Parents can seek out supports from other parents who are raising challenging children. When
you receive regular calls from the school or childcare setting with complaints about your
child’s behavior, you need sounding boards. You need people around you who support your
heroic efforts in parenting this child.
• Remember, much of the intense effort you are putting into your child is directly focused on
making sure that other people will want to be around them. You have a good parenting goal.
• Please know that your healthcare provider knows and applauds how much time and
energy you are investing—to make the tiny steps that seem undetectable but, in fact, are the
necessary steps for your child’s march toward success.
The Explosive Child book by Dr. Greene promotes a “collaborative problem-solving approach.” That
approach has been incorporated into this resource page for parents. There is an excellent website for
you to check out this approach to see if it fts with your family values/preferences.
www.livesinthebalance.org/
The research evidence to support “collaborative problem-solving” can be found on this website:
www.explosivechild.com
Fact sheet: Children with Oppositional Defant Disorder
https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-
With-Oppositional-Defant-Disorder-072.aspx
REFERENCE
Greene, R. W. (2014). The explosive child: A new approach for understanding and parenting easily frustrated, “chronically
infexible” children (Rev. 4th ed.). HarperCollins.
CHAPTER 7 • Patient Handout: Information for Parents About Behavior Problems in Children and Teens • 245
Information on Depression for Parents
WHAT IS DEPRESSION?
Depression is an unhappy mood that affects daily functioning, including thoughts, feelings, behavior,
and overall health. When depression is too severe or lasts too long, it is considered an illness that can
be treated. Left untreated, depression can take the joy out of life and even take away the desire to live.
Everyone experiences minor upsets, but this does not mean that everyone is depressed. To have true
depression, the symptoms must be present for at least 2 weeks.
The child with ADHD who is hyperactive/impulsive will have at least 6 of the following symptoms:
CHAPTER 5 • Patient Handout: Information for Parents About Attention Defcit Hyperactivity Disorder • 193
WHAT CAUSES ADHD?
Children with ADHD do not make enough chemicals in key areas in the brain that are responsible for
organizing thought. Without enough of these chemicals, the organizing centers of the brain don't work
well. This causes the symptoms in children with ADHD. Often there is a family history of ADHD.
Things that don't cause ADHD: poor parenting (although a disorganized home life and school envi-
ronment can make symptoms worse); too much or too little sugar, aspartame, food additives or color-
ings; lack of vitamins; food allergies or other allergies; fluorescent lights; video games; or too much TV.
• Make a schedule. Set specific times for waking up, eating, playing, doing homework, doing
chores, watching TV or playing video games, and going to bed. Post the schedule where
your child will always see it. Explain any changes to the routine in advance.
• Make simple house rules. It’s important to explain what will happen when the rules are
obeyed and when they are broken.
• Make sure your directions are understood. Get your child's attention and look directly into
his or her eyes. Then tell your child in a clear, calm voice specifically what you want. Keep
directions simple and short. Ask your child to repeat the directions back to you.
• Reward good behavior. Congratulate your child when he/she completes each step of a task.
• Make sure your child is well supervised. Because they are impulsive, children with ADHD
may need more adult supervision than other children their age.
• Watch your child around his or her friends. It’s sometimes hard for children with ADHD to
learn social skills. Reward good play behaviors.
194 • CHAPTER 5 • Patient Handout: Information for Parents About Attetion Defcit Hyperactivity Disorder
• Set a homework routine. Pick a regular place for homework, away from distractions such
as other people, TV, and video games. Break homework time into small parts and allocate
frequent breaks.
• Focus on effort, not grades. Reward your child when he or she tries to finish schoolwork,
not just for good grades. You can give extra rewards for earning better grades.
• Talk with your child's teachers. Find out how your child is doing at school—in class, at
playtime, at lunchtime. Ask for daily or weekly progress notes from the teacher.
CHAPTER 5 • Patient Handout: Information for Parents About Attention Defcit Hyperactivity Disorder • 195
Information for Parents on How to Help Your
Child/Teen Cope With Stressful Events or Uncertainty
The most important thing that you can do to help your child/teen cope with stressful events is to
remain as calm as possible when you are with them. Children pick up on their parents’ anxiety very
quickly. If they sense you are anxious, they will be anxious as well. Therefore, if you are having diffi-
culty coping with a stressful situation, it is a good idea to reach out to resources to help you, such as
friends, family members, support groups, clergy, or healthcare professionals. Taking care of your own
stress so that you are less anxious will help your child to stay calm.
CHAPTER 3 • Patient Handout: Information for Parents on How to Help Your Child/Teen Cope • 121
• Ask your child/teen, “What is the scariest or worst thing about this event for you?” or
“What is worrying you the most right now?” and take time to really listen to what they have
to say.
• Reassure children that they did nothing wrong to cause what happened. Toddlers and
preschool children especially feel guilty when stressful events happen.
• Tell children and teens that what they are feeling (e.g., anger, anxiety, helplessness) is normal
and that others feel the same way.
• Decrease anxiety in your child by reassuring them that you will get through this together.
Emphasize that adults are doing everything possible to take care of the stressful situation
and that they are not alone.
• Help your child/teen to release tension by encouraging daily physical exercise and activities.
• Continue to provide as much structure to your child’s schedules and days as possible.
• Recognize that added stress/anxiety usually increases psychological or physical symptoms
(e.g., headaches or abdominal pain) in children/teens that are already anxious or depressed.
• Young children who are depressed typically have different symptoms (e.g., restlessness and
excessive motor activity) from those experienced by older school-age children or teens who
are depressed (e.g., sad or withdrawn affect; anger/irritability, difficulty sleeping, or eating;
talking about feeling hopeless).
• Use this opportunity as a time to work with your child on their coping skills (e.g., relaxation
techniques, positive reappraisal, prayer). Children watch how their parents cope and often
take on the same coping strategies. Therefore, showing your child that you use positive
coping strategies to deal with stress will help them to develop healthy ways of coping.
• Be sure to have your child or teen seen by a healthcare provider or mental health professional
for signs or symptoms of persistent anxiety, depression, recurrent pain, persistent behavioral
changes, or if they have difficulty maintaining routine schedules or the symptoms are
interfering with functioning.
• Remember that stressful times can be an opportunity to build future coping and life skills as
well as to bring your family closer together.
122 • CHAPTER 3 • Patient Handout: Information for Parents on How to Help Your Child/Teen Cope