The Importance of Empathy and Containment When Working with Families in Crisis

Introduction

Working in a paediatric hospital setting has exposed me to the immense emotional toll that hospitalisation can have on families, particularly parents of critically ill children. In such high-stress environments, core counselling skills such as empathy and containment are not just helpful – they are essential. This article examines the significance of these two foundational skills and their practical application in working with families in crisis.

Understanding Empathy in the Paediatric Context

Empathy, at its core, involves the ability to step into another person’s emotional world (Cherry, 2024) and communicate understanding without judgment. In the paediatric ward, I have often encountered parents who are overwhelmed by fear, helplessness, and anticipatory grief. Many have expressed feeling invisible or unheard amidst the fast-paced medical environment. By offering empathetic presence – through reflective listening, nonverbal attunement, and validating their emotions – I have witnessed how parents begin to feel seen and supported. Research indicates that empathetic engagement not only builds trust but also reduces distress (Opland & Torrico, 2024), promotes emotional support and understanding in caregivers (Family Resource, 2023).

The Role of Containment During Medical Crises

Containment refers to the counsellor’s ability to “hold” the client’s intense emotions (Team, 2017) without becoming overwhelmed or reactive. In practice, this means creating a safe, calm, and structured space where parents can express fear, anger, or grief without fear of judgment or collapse (Creativelyllc, 2024). For instance, during a recent case where a premature baby required emergency surgery, the parents fluctuated between panic and numbness. By calmly sitting with them, acknowledging their pain, and helping them regulate their breathing and thoughts, I provided a form of emotional containment that allowed them to regain composure. Diem-Wille (2021) emphasised the transformative power of this process, where one person “digests” the client’s raw emotions and returns them in a more manageable form.

Combining Empathy and Containment

When empathy and containment are combined, they create a powerful therapeutic environment that promotes psychological safety (Podolan & Carlo, 2023) and emotional regulation (Brennan, 2023). This is especially crucial in medical crises, where families often feel disempowered. As a counselling intern, I have also learned that self-awareness and supervision are critical in maintaining these skills. Empathising too deeply or failing to manage my own emotional responses can lead to burnout or countertransference.

Cultural Sensitivity in Counselling Practice

In the diverse context of South Africa, empathy must also be culturally sensitive (EAPA-SA, 2019). Each family carries its own belief systems, coping mechanisms, and ways of expressing emotion. What may appear as emotional detachment in one culture might be a form of strength and dignity in another (Amore, 2023). Acknowledging this requires the counsellor to suspend assumptions and approach each family with curiosity and humility. During one interaction, a mother maintained a stoic expression throughout her child’s deteriorating condition. Rather than interpreting this as denial, I gently explored her inner experience and discovered that her culture viewed outward distress as dishonouring to the strength of herself and the child. Respecting this allowed me to hold space for her in a way that honoured both her pain and her cultural identity.

Nonverbal Containment and Co-regulation

While verbal support plays a critical role, nonverbal containment is equally important (Petty, 2025) in high-intensity hospital settings. Gentle eye contact, an open posture, and consistent physical presence can communicate safety and regulation (Pollack, 2024) when words fail. Sometimes, the most meaningful intervention has not been advice or a technique, but simply sitting silently beside a parent whose child is in the theatre, or even just offering a bottle of water. These seemingly small acts often carry significant emotional weight. Our nervous systems are wired for co-regulation, and the presence of a calm, regulated other can help de-escalate panic and despair in trauma moments (Trauma Therapist Institute, 2025).

Conclusion

In conclusion, empathy and containment are not just abstract concepts but living, breathing skills that shape how we show up for others in moments of crisis. In paediatric hospital settings, these tools serve as emotional anchors for families navigating the unthinkable. Whether through verbal validation, silent presence, or culturally attuned support, these responses communicate safety and human connection. They remind us that even when we cannot change the outcome, we can still offer something deeply valuable: a steady, compassionate presence in the midst of the storm…

Author: Melissa Anri Thomas

References

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