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

Background Many low and middle income countries (LMIC) have high-rates of child trauma exposure and limited access to psychological services. Caregivers are often children’s key source of support following trauma in such contexts.
Aims To explore the experiences of primary caregivers in supporting their child post-trauma.
Method Qualitative interviews were conducted with twenty 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 analysed using thematic analysis.
Results Key themes were as follows. First, caregivers were typically aware of child distress post-trauma, based primarily on manifest behaviours. Second, caregivers identified varied ways of providing support, including: being warm and responsive; seeking to ensure physical safety through encouraging child perceptions of the community as dangerous; 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. Fourth, caregivers also experienced significant distress that could impact their responses to their child.
Conclusions The results illustrate the challenges faced by caregivers in supporting children following trauma in LMIC contexts and the need for accessible psychological interventions.