Psychologist working on app to help parents of injured children

February 28, 2022
portrait of a woman in a white lab coat in front of acute care inpatient unit entrance
Leigh Ridings, Ph.D., works with families whose children have undergone a traumatic injury. Photos by Sarah Pack

Between 20% and 40% of trauma patients will develop significant mental health problems, like post-traumatic stress disorder or depression, in the year after the incident that brought them to the hospital.

The Trauma Resilience and Recovery Program, based out of the College of Nursing at MUSC, helps those patients struggling with the mental aftereffects of traumatic injury. Last year, 161 of its patients were under the age of 18.

Now, Leigh Ridings, Ph.D., associate director of child and family services at the TRRP and an assistant professor in the College of Nursing, is developing an app to meet the needs of parents or other caregivers whose children under age 12 have been injured. Some 20% of caregivers also experience PTSD or depression after their children are injured, she said.

a woman holds a cell phone up to the camera to show what's on the screen, an app that shows how emotions can lead to actions 
A sample screen from the app under development.

She’s received a grant from the National Institute of Child Health and Human Development to undertake this project, which builds on the existing work of the TRRP. While the TRRP has an existing text messaging service that checks in on patients after they’re discharged, that system doesn’t meet the needs of the youngest patients, Ridings said.

Ridings has been working with Bernard Jansen in MUSC Digital Health Solutions on the technological aspects of the app, which is now at the point of usability testing – determining if it’s easy to navigate and provides information where the user expects to find it. The app will be dual-pronged. It will include a check-in for the child’s emotional recovery and provide information about the recovery process, as well as a check-in for the adult’s emotional recovery.

It’s common for parents to berate themselves or ruminate over the “if onlys” after a child is injured. The app normalizes such feelings, Ridings said. “It’s normal to feel guilty, to feel relief, to feel anger – all of these things,” she said.

The app will also include some “what to expect”-type information. For example, after a car crash, a young child may become distressed whenever the parent attempts to buckle her into a car seat. Ridings had a patient who became distressed whenever attorney commercials featuring loud car crashes came on TV. A child may not want to return to a home where he was injured. Young children may become extra clingy or may start throwing temper tantrums after a trauma.

“How do they know what's normal? What's a normal acute stress response? And then, when does it cross that line into really problematic? And what do you do if it does cross that line?” Ridings said.

The app will include resources to connect with mental health providers. It will also include resources for parents, like tips on mindfulness, deep breathing and progressive muscle relaxation – skills that will help caregivers to address their own needs so they can be there for their children.

“The majority of people after traumatic injury do get better, and they do OK in terms of mental health. But we want to make sure that no one's slipping through the cracks.”

Leigh Ridings, Ph.D.

Ridings said this work to address mental health is gaining recognition as an important part of recovery. The TRRP was established in 2015, and grants from The Duke Endowment have allowed the team to replicate the model at Trident Medical Center, Prisma Health Greenville Memorial Hospital and Prisma Health Richland Medical Center.

Nationally, however, follow-up with trauma patients is spotty. Ridings said she just completed a project looking into this and found that about half of pediatric trauma centers do some sort of work on mental health. Even fewer adult trauma centers do.

“I think, on the pediatric side, they're doing a better job across the country, in terms of addressing mental health, than they are on the adult side. But everybody is doing it completely differently,” she said.

That may change, as she has heard that the American College of Surgeons will strengthen a recommendation that trauma centers assess for acute stress.

“The majority of people after traumatic injury do get better, and they do OK in terms of mental health,” Ridings said. “But we want to make sure that no one's slipping through the cracks.”