Chapter 2: Strategies to assess and engage with families

Assessing and responding to psychosocial distress


“In the end, the most important things are comforting the family and meeting them where they are”. – ICU Nurse

Below are several strategies for responding to and supporting a family member in distress. Hover over each one for additional information. 

Make space for feelings.



Don’t rush in too quickly to stop emotional reactions by speaking up or offering tissues to a family member. Moments of silence are sometimes needed so that families can collect their thoughts and process information.


Validate the family's experience and recognize their suffering.



Point out areas where the family is doing well. Recognize their expertise as family members in understanding and caring for the patient. Normalize that what is happening in the ICU is extraordinarily difficult and demands a lot from them.



Extend support and encouragement.



If a family member is crying and no one in the family offers support, you can respectfully extend support and encouragement.  Observe which family members appear to be struggling the most. It may be the person who appears to be the most distressed or someone who is marginalized or silent. (For more information on use of touch, see A note about physical touch.) 












Clinician Tip

Conversation Prompts

“What is the hardest part of this for you”?

“Who are you worried about”?

“How are you doing”?