Homesickness prevention and treatment

A new report urges parents and children's doctors to change their thinking about homesickness among children, to see it as a nearly universal but highly preventable and treatable phenomenon -- rather than an unavoidable part of childhood.

The report, published in the journal Pediatrics, gives parents and physicians specific guidance to help anticipate and lessen the distress that homesickness can cause among kids and teens at summer camps, hospitals, boarding schools and colleges.

The paper's authors are a clinical psychologist at one of the nation's leading boarding schools, Phillips Exeter Academy in New Hampshire, and a University of Michigan physician who specializes in camp health issues. They're also old friends who first met at summer camp more than 25 years ago.

It's the first time that the evidence about homesickness prevention and treatment, which has been gathered through years of psychological studies, has been presented for pediatricians and family doctors to use.

The authors, and the American Academy of Pediatrics Council on School Health that sponsored the report, hope that those physicians will add homesickness counseling to children's camp and school physicals, and to the care of hospitalized children. They also point out special issues for children who have attention deficit disorder or developmental issues -- for example, the importance of continuing the use of medications for those conditions while at camp and not taking a "drug holiday."

"For over 100 years camps and schools have patted homesick kids on the back, tried to keep them busy and hoped it will go away," says lead author Christopher Thurber, Ph.D., the staff psychologist at Exeter, research consultant to the American Camp Association and author of a camp handbook for parents. "But research shows that it's healthier, and more effective to think about prevention. This report aims to get the message to parents and those who are taking care of kids before they go to camp."

One of the basic tips for parents and doctors is to talk to kids ahead of any separation, whether it's for camp, college, or a hospital stay of even a few days.

"What parents say ? and what pediatricians say -- beforehand matters, and is very important for the intensity of homesickness," says Edward Walton, M.D., a U-M Health System assistant professor of emergency medicine and pediatrics who serves on the board of the American Camp Association and was lead author of a 2005 AAP guideline on summer camp health that was produced in conjunction with the ACA.

One of the most important things for parents and doctors to recognize, and to say to kids before any separation, is that it's normal, not strange, to feel homesick. In fact, research has shown that 90 percent of children attending summer camp feel some levels of homesickness and that 20 percent face a serious level of distress that -- if untreated -- worsens over time and interferes with their ability to benefit from a camp experience.

Thurber's recent research compared the effectiveness of key preparation tools to camps' standard preparation. The results showed that a combination of coaching parents and educating children about effective coping actually lowered the intensity of first-year campers' homesickness by 50 percent, on average.

The ACA now publishes a DVD-CD set, "The Secret Ingredients of Summer Camp Success," that makes these evidence-based homesickness prevention strategies publicly available for the first time. It also makes information available to parents online, as part of its effort to preserve, promote, and enhance the camp experience for children and adults. ACA is also the only national organization that accredits camps, which must meet up to 300 health and safety standards to gain accreditation.

In children whose separation from their parents is sudden and unplanned, such as hospitalization, as many as half experience moderate to severe homesickness that can interfere with their functioning. In fact, says Thurber, special care needs to be taken with children who are hospitalized for an indefinite amount of time, because even a casual remark by a physician or nurse about when the child might be able to go home can cause severe distress and even interfere with care if that date arrives and the child is still in the hospital.

For more routine separations, such as the million children who go away to school or the 12 million who attend residential (overnight) camp each year, homesickness can get in the way of the important character-building lessons that these experiences bring.

All in all, summer camp and other separations from home can be great "life training" experiences for children, building their independence and teaching self-reliance and social skills that they'll use throughout life, say Walton and Thurber, who met when they were boys at the YMCA's Camp Belknap on Lake Winnipesaukee in New Hampshire, and worked there together this past summer.

Ultimately, they say, parents and pediatricians must work together to help children prepare for and cope with separations, while camp directors, boarding school staff, hospital Child Life specialists, and others can help treat homesickness once it arises.