For a parent, few things are more difficult than seeing their baby in the neonatal intensive care unit (NICU). But coping with the fear and anxiety of having an infant in NICU care has become even more challenging due to COVID-19-related visitation restrictions.
"They're already overwhelmed with having to navigate the medical setting—to have to do that alone without the support of people who can provide a safe space for them is even harder," says Dailyn Acosta, Ph.D., pediatric psychologist, NICU division of neonatal-perinatal medicine, Children's Health in Dallas. "For babies, their safe space is their parents—but who is supporting these parents during that time?"
Parental support one of many roles for NICU psychologist
Acosta's role in supporting the families of NICU patients is prominent and visible. She's part of a growing trend where children's hospitals are embedding a dedicated psychologist in the NICU—and she wears many hats.
Her primary responsibilities include supporting families in individualized and group settings, but she also conducts clinical research and co-chairs the hospital's NICU developmental care steering committee.
NICU psychologists play a key role in providing expertise and support to enhance neuroprotective, family-centered and trauma-informed neonatal care and practices in a NICU. Under ordinary circumstances, Acosta would regularly walk the NICU's halls to check in on parents and introduce herself to newly admitted families. Today, those introductions typically come over the phone.
"It can be challenging to establish a rapport right off the bat when they're not seeing me face to face," Acosta says. "It's also a challenge to know when it's a good time for them; if I was there in person, I could see if they were busy talking to a medical provider or if it was just not the right time."
No substitute for support from peers
But the biggest roadblock to providing optimal family-centered support, according to Acosta, is the discontinuation of the weekly support groups she facilitates for NICU parents.
"Psychologists are there to support parents and the family, but nothing replaces being able to talk to other parents who are going through similar situations," Acosta says. "That can be so therapeutic for parents—they often feel so isolated and guilty about the situation—and it can be hard to verbalize to an outsider, even if it's someone who's there to provide support."
Children's Health launched virtual support groups last summer but paused them due to low parent turnout amid some technical issues. But the hospital plans to restart them this summer when schedules open up for parents and kids, and the sessions will feature a new user interface that's easier for families to navigate.
Virtual communications could have lasting impact
Overall, Acosta says feedback on virtual interactions has been positive, and she hopes to continue offering them in addition to reinstating the in-person consultation and peer support groups once COVID-19 restrictions are lifted.
She says some parents are more comfortable in a virtual setting and leveraging the technology makes it possible for others to attend meetings who otherwise couldn't due to work or family obligations.
"Being able to provide virtual support is a silver lining of COVID-19—hopefully, we can continue to offer a hybrid model," Acosta says. "Whenever you're able to offer parents more options that's always nice, because you're able to cater to their needs and provide individualized care."