HELPING
CHILDREN COPE WITH DISASTER AND TRAUMA
See
MHANYS Fact Sheet "Coping
With Disaster and Trauma" for adults.
When
a disaster strikes, or when a traumatic event occurs, it makes
as significant an impact on children as on adults. Children may
react to traumatic events differently than adults, but they too
must readjust in the wake of changes wrought by a traumatic event.
Depending on the nature of the traumatic event and severity of
the impact it has had on them, many children will be able to draw
on their natural resiliency and will be able to successfully work
through their reactions and move forward over time, particularly
if they are able to turn to the adults in their lives for guidance
and reassurance. Wondering what the future holds, some children
may find it more difficult to cope with troubling events, particularly
those whose lives have been more directly affected, or those who
have already experienced trauma and find these events evoking
the prior trauma.
Responding
to children's concerns:
Following a traumatic event or disaster
children need reassurance. They may be too young to fully grasp
what has happened, but they know something bad has happened. Often
they are very concerned for their own safety and the safety of
family members and friends.
Reassure
them. Offer them plenty of your time and physical closeness in
the form of hugs and other comforting gestures. Explain to them
what measures are in place, or what steps are being taken, to
ensure they are safe. Listen to them talk about their fears and
let them know you take them seriously. Dispel misconceptions respectfully,
and don't minimize their concerns even if they seem unrealistic.
For example, don't dismiss the fears of a child who has seen TV
footage of a volcanic explosion by saying, "That's stupid,
there are no volcanoes for hundreds of miles around here."
Instead, explain that there are no volcanoes in your area and
the chances of a volcanic explosion are very remote. If you do
live in a volcanically active area you may want to tell the child
about early-warning systems and other procedures in place to ensure
his/her safety. Offer to help the child educate himself/herself
on the topic by going to the library, for instance, and finding
age-appropriate, accurate information on the subject. If you live
in an area prone to natural disasters such as tornados, you may
want to review safety drills with children in a non-threatening
way before a crisis, to show them what they can do and get them
accustomed to the idea.
Following
such cases as a terrorist attack or a school shooting, it may
help to explain just how rare these events really are. Let children
discuss their concerns with you. Allay their fears as best you
can, while at the same time letting them know you take their concerns
seriously.
Respond
to children's questions with straightforward answers that are
appropriate for their age. Make sure they get the information
that they want and need, but don't let them get overloaded or
give them details that they can't fully understand. Not talking
about the situation, or refusing to talk about the situation,
will not make children's concerns go away. Rather, it may make
them feel that they cannot come to you with questions.
Children
look to the adults in their lives to get an idea of how to react.
If adults are reacting with fear, anxiety, depression, anger,
children may take those reactions on as well. Remaining calm yourself,
and sticking to customary routines as much as possible will help
children remain calm themselves.
During
the time following a traumatic event it is especially important
to be sensitive to children's needs. Be available for them to
talk to you. They may want a lot of physical contact and hugs,
or simply to be with you. They may become clingy or may behave
in other ways that you thought they had outgrown. Be patient and
set aside extra time to spend with them. Make sure, as much as
possible, that children have access to things and routines that
they are used to, as children often find familiar things comforting.
Control time that children spend watching news coverage of intense
or frightening scenes of disaster, and talk with them during or
afterwards to help them understand what they are seeing. For young
children you may want to consider not letting them watch such
images at all. Children who have already experienced trauma in
their lives may be especially sensitive to such footage.
Some
children find it difficult to express their feelings verbally.
Encourage them to draw or play, and use their drawings or the
games as a starting point for discussions. If, for example, a
child draws a picture of a house on fire, or a child pretends
to be a fireman, talk with him or her about what the drawing shows
and how it makes him or her feel. Offer your support without increasing
their fears.
When
talking with children always try to understand their concerns
on their own terms. Don't make assumptions based on what you think
they ought to be feeling.
Children
may be very eager to do something to help. Encourage them and
help them find appropriate activities. If something traumatic
has happened to someone close to them, they might want to write
a letter or card, draw a picture, or make something to give as
a present. In the case of a natural or man-made disaster activities
might include selecting food to donate to a food drive, or clothes
for a clothing drive, or contributing money to relief agencies
such as the Red Cross or the Salvation Army. They may want to
write a letter of support to community leaders or relief workers,
or letters of condolence to victims of disaster. They may also
wish to seek out other activities in support of relief efforts
that may be going on in local schools or youth groups.
The
mental health impact of trauma on children:
Like adults, children cope with traumatic events in different
ways. It takes adults and children time to readjust after an intense
or disastrous experience, and the time it takes differs from person
to person. There are signs to be alert for that may signal the
need for counseling or evaluation by a mental health professional.
Children
may react to intense feelings of sadness, helplessness, or fear
by entering a depressed state.
Symptoms
of depression in children vary depending on age and may include:
Infants
and toddlers
Decreased pleasure in activities that should interest
a child of this age and developmental level
Sad or deadpan facial expression
Little motor activity / listlessness
Withdrawing, or lack of interest in play or other social activities
Too little or too much crying
Excessive whining
Verbal expressions of sadness
Preschoolers
Loss of interest in previously-enjoyed activities
Frequent unexplainable stomachaches, headaches, and fatigue
Hyperactivity or excessive restlessness
Frequent sadness
Low tolerance for frustration
Irritability
Pessimism, or a tendency to view the world as sad or bleak
School-Aged
Children
Frequent and unexplainable physical complaints, such
as stomachaches or headaches
Significant changes in weight - loss or gain
Expressions of sadness or hopelessness
Low self-esteem
Excessive worrying
Changes in sleep patterns
Tearfulness
Unprovoked hostility or aggression
Refusal or reluctance in attending school
Drop in grades
Lack of interest in playing with others
Poor communication
Thoughts about, or efforts to run away
Morbid or suicidal thoughts
Adolescents
Drop in grades
Behavior problems in school or at home
Anti-social or delinquent behavior
Feelings of sadness or hopelessness
Low self-esteem
Extreme sensitivity to rejection or failure
Social isolation
Listlessness or restlessness
Fatigue
Changes in sleep patterns
Loss of enjoyment in previously-enjoyed activities
Difficulty with relationships
Eating-related problems
Inattention to appearance
Self-destructive behavior
Morbid or suicidal thoughts or actions
(taken from Help Me, I'm Sad by David G. Fassler, M.D. and Lynne
S. Dumas)
Other children may be unable to bring under control their feelings
of anxiety.
Symptoms
of serious anxiety in children and adolescents may include:
Constantly
worrying about the future - particularly about their own safety
or the safety of loved ones
Frequent nightmares
Restlessness
Difficulty concentrating or thinking clearly
Reluctance or refusal to go to school
Overly clingy or needy behavior
Extreme anxiety, panic attacks, or tantrums when separated from
parents or familiar surroundings
Withdrawing
Overall tension and uneasiness
(taken from Help Me, I'm Sad by David G. Fassler, M.D. and Lynne
S. Dumas)
Symptoms of anxiety in children
can closely resemble those of depression.
Stress
places a physical toll on the body as well. Stress may manifest
itself in psychosomatic illnesses such as otherwise unexplainable
stomachaches, headaches, or other aches and pains. The physical
symptoms of panic attack can be extremely frightening for children,
as well as adults. Physical symptoms may include shortness of
breath or feelings of choking, dizziness, trembling or nausea.
When severe symptoms of anxiety persist for longer than several
weeks, and anxiety continues to impair a child's ability to function,
it is important to seek professional evaluation for post-traumatic
stress disorder (PTSD). In some cases PTSD may emerge months after
the event.
These
changes in behavior do not have to be permanent responses to trauma.
Even short-term counseling following a traumatic event can have
a beneficial impact. Consulting a mental health professional and/or
participating in peer discussion groups with other kids can be
very effective in helping a child deal with emotionally painful
aftereffects of tragedy.
Helping
children cope with bereavement or loss:
Children who have experienced the death of a loved one
need the same thing adults do: the comfort and support of friends
and family, patience, understanding, and time to heal.
Children
do grieve in different ways than adults. They may want to run
around and play while the adults around them are mourning the
loss of the loved one. Accept that children need to come to terms
with loss at their own pace, and that they have ways of managing
stress and sadness that are different from those of adults. They
may have difficult questions and look to adults to give them clear,
straightforward, truthful answers presented in a compassionate
way. Younger children may be confused or frightened by what is
going on around them, and may not have reached a developmental
stage where they can fully understand what has happened. As they
confront loss, children may need lots of attention, affection
and reassurance, particularly reassurances that they will be safe
and that they will be taken care of.
Younger
children often believe they have the ability to influence events
by wishing. In a situation where a child might have had a fight
or disagreement with someone who was later injured or killed in
a disaster, the child may feel terrible guilt, as if he or she
had somehow 'caused' the tragedy. For example a child might have
lost a fight with his older sibling about what TV show to watch
and wished in passing that something bad would happen to the sibling
in retaliation for being so mean. If the sibling was later hurt
or killed the child might feel responsible.
If
you suspect a child may be carrying inappropriate feelings of
guilt or responsibility for a tragedy, make it very clear that
the full responsibility for a natural disaster lies with natural
conditions, or with the human perpetrators in the event of a crime
or terrorist act.
Other
Resources
Following
trauma or disaster your local Mental Health Association, county
mental health agency, or mental health helplines can refer you
to mental health resources in your area. Look in the yellow pages
of the phone book under 'Mental Health Services'. Disaster relief
agencies, such as your local Red Cross and Salvation Army can
also provide, or direct people to, mental health services and
counseling.
A
directory of County Mental Health Agencies is available on the
Internet at
http://www.clmhd.org/county_directory.html.
A directory of MHA affiliates in New York State is available at
http://www.mhanys.org/affiliates
on the Mental Health Association in New York State, Inc.'s website.
The
American Psychological Association operates a referral line at
1-800-964-2000 which connects callers with the state psychological
association referral network in their area. In New York State
the number is (518) 437-1050.
Further
information on anxiety and stress disorders are available through
a number of organizations, including:
National
Mental Health Association at http://www.nmha.org,
1-800-969-NMHA (1-800-969-6642)
National Alliance for the Mentally Ill at http://www.nami.org,
1-800-950-6264
Anxiety Disorders Association of America, Inc. http://www.adaa.org,
(301) 231-9350
The
following online resources were consulted in putting together
this factsheet:
"Helping
Children Handle Disaster-Related Anxiety" - LifeNet, part
of MHA of NYC
"Helping
Children Cope After a Terrorist Attack" - National Alliance
for the Mentally Ill
"Managing
Traumatic Stress: Tips for Recovering From Disasters and Other
Traumatic Events" - American Psychological Association
"Empowering
Children During a Crisis" - Anita Laffey
"FAQ:
Stress Response to Traumatic Events" - PsychWorks, Inc.
See
other Information Center Fact Sheets.
The
Mental Health Association in New York State, Inc. is a 501(c)(3)
not-for-profit organization, with 33 local affiliate MHAs serving
54 counties. MHANYS is working to ensure available and accessible
mental health services for all New Yorkers.