The services are provided for free to the families of critically ill patients hospitalized in the ICU. Each session will be held between 08:00 to 19:00 from Monday to Friday and lasts between 30-60 minutes. Bearing in mind the different needs of each child/teenager, sessions may be continued even after the patient's discharge . All services will be accessible through the website of the psychological support service provided by the "Ariadne" project at ariadne.intensivecareforum.org.cy

Services are briefly described as follows:

1. Children and teenagers assessment

The first part of psychological support focuses on the evaluation of symptoms and present mental state. The assessment is conducted through the use of valid psychometric tests and a clinical interview. Furthermore, assessment focuses on the precise identification of problems arising due to patients' hospitalization and how they affect the child's and teen's psychological state. The entire process will be also implemented through telecommunication systems.

2. Psychologists are able to provide appropriate information to the underage family members of critically ill patients, related to the hospitalization of their loved ones

There are times when children struggle with difficult situations. As we have seen, the ICU hospitalization of their relative or the possibility of losing their parent or a close relative, may cause sadness, anger and anxiety. Most of the times, parents/legal guardians avoid to inform their children/teenagers about the patient's hospitalization, in order to protect them. As a consequence, children are emotionally isolated and this may cause stress, psychosomatic symptoms and fear of separation. If children are nearby and overhear adult conversations when they shouldn't, some negative outcomes could result. Without adult explanation on what they overheard, children might misinterpret the information, arrive to a wrong conclusion or exaggerate about the difficulties of a situation.

The psychologists' role is to inform those children and teenagers who want to know about their relative's condition (during their hospitalization in ICU), after of course discussing with the child's/teenager's parents/legal guardians. Psychologists are able to provide appropriate information to children by using simple explanatory phrases without difficult medical terms, in order to help them express their feelings, ask questions and reduce stress and confusion.

3. General information addressed to teenagers, related to Intensive Care Unit

This category offers the opportunity to teenagers to collect general information about the ICU. They will find written material in simple language about a) the structure and activities of the ICU, b) the most common diseases and disorders of the patients hospitalized in the ICU and c) explanations of medical terms. The ultimate goal is to bridge the communication gap between teen and Health Professionals.

4. Pictures of ICU area and equipment

It is important to note that only teenagers may have access in this category and psychologists' efforts focuses on information and preparation of teenagers, before visiting the ICU. Teenagers will have the opportunity to see pictures related to ICU equipment, for example ventilator, dialysis machine, vital signs monitor and other machines with short explanatory text. In this way, children will form their own first impressions related to ICU, before visiting this clinical area. So, according to what they had seen and read, they will be able to decide whether or not they want to visit the ICU.

5. Drawing

Drawing and painting are regarded as two of the most important ways through which children express themselves . They have been repeatedly associated with the opportunity to express their emotions. It should be also noted that their paintings reflect their inner world and transfer on paper various elements, related to their psychological status and interpersonal style.

As we have seen, a child's painting is useful in other levels of expression. As part of a therapeutic process, the painting may be a very helpful mean for children, in order to express their feelings, share experiences and solve various problems. The painting is an assessment mean for the emotional conflicts of children, but also a way of communication between the Psychologist and the child. Τhe aim of Psychologists is to help them communicate easily and express their feeling through the painting.

6. Teenagers' questions and immediate answers from Health Professionals

During this difficult period, teenagers need help and guidance. For this reason, they have the opportunity to discuss with the Health Professionals and express their personal concernsand ask questions about the patient's condition . For example, "why my father/mother needs a ventilator?", "What is traumatic brain injury?", "Will my father/mother live?" etc. Each Health Professional must answer honestly and carefully, in order to help teenagers reduce their stress and anxiety.

7. Instructions for parents associated with loss and mourning management

Preparing children for the death of a loved one is a very difficult and emotionally demanding process. Most parents are not willing to share with their children any information about an illness or death. Their efforts focus on preventing children from participating in painful discussions and cause unpleasant ups and downs of their psychological mood. It could also be said that parents don't encourage their children to express their thoughts related to this subject. Consequently, children often pretend that everything is under control because they don't want to make their parents/legal guardians feel uncomfortable.

It's worth mentioning that some parents/legal guardians may not allow their children's participation in this project. In this case, they can benefit themselves from the guidance of our professional Psychologists and also they may find important and useful information at ariadne.intensivecareforum.org.cy. For example, they can learn how to provide appropriate and correct information to their children and which are the consequences in a child's psychology when a relative is hospitalized in the ICU. By browsing the website, parents can have access to articles, publications and relevant research. Also, they may take advices from professional Psychologists or Psychiatrists on how they can approach their children, how they can start a discussion, which information they must provide to their children, ways to manage loss and mourning and which reactions are considered normal and expected.

Psychological support sessions for children and teenagers

During the first part of the project's implementation, psychological support services will be provided in vivo at the psychologist's office, close to the ICU, after discussing with the child's parent/legal guardian.

During the second part of project's implementation, sessions will be conducted in virtual rooms between the child and the Psychologist. Psychological support sessions are available through simple telecommunication systems, online from the child's/teen's house, without being necessary to visit the psychologist's office. Therefore, children don't need to visit the ICU. Also, it's important to note that psychological support services are provided in a warm environment under a climate of trust, respect and confidentiality.