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THE AFTERMATH OF HURRICANE IVAN:

HELPING CHILDREN COPE

FRANK J. ZENERE, Ed.SFLORIDA CRISIS RESPONSE TEAM

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WHAT HAPPENS

Crisis and trauma throw people so far out of their range of balance that it is difficult to quickly restore equilibrium

Crisis reactions may be precipitated by either “acute or chronic” stress

Acute stress caused by sudden, arbitrary and often random event

Chronic stress occurs repeatedly over time with each recurrence further challenging a person’s adaptive resources

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THE CRISIS RESPONSE:THE SHORT-TERM CRISIS REACTION

The normal human response to trauma follows a similar pattern called the crisis reaction; It occurs across gender, ethnicity, age and culture

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THE PHYSICAL RESPONSE

The physical response to trauma is based on the human’s more primitive instincts; It includes:

Physical shock, disorientation and numbnessFrozen Fright

“Fight-or Flight” responseAdrenaline and hormone increaseBody may relieve itself of excess materialsPhysical senses heightened (sight, sound, feeling, taste, smell)Heart and respiratory rates increaseVascular dilation and muscle engorgement

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THE PHYSICAL RESPONSE cont.

ExhaustionPhysical arousal associated with the “fight or flight” syndrome cannot be prolonged indefinitely and results in physical exhaustion

Caregiver ReactionProduction of chemical “oxytocin”, primarily in women, may produce “Tend and Befriend” reaction as effort to protect children or loved ones

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THE EMOTIONAL REACTION

Our emotional reactions are heightened by our physical response

Stage 1: Shock, disbelief and denial

Stage 2: Cataclysm of emotions including anger/rage, fear/terror, sorrow/grief, confusion/frustration, self blame/guilt

Stage 3: Reconstruction of equilibrium – the emotional roller coaster that seeks balance

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TRAUMA AND LOSS

Trauma is accompanied by a multitude of losses

Loss of control over one’s lifeLoss of faith in one’s religious/spiritual belief systemLoss of trust in other peopleLoss of worldview – of fairness and justice

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TRAUMA AND LOSS cont.

Trauma is accompanied by a multitude of losses

Loss of significant persons

Loss of meaningful and sentimental property

Loss of a sense of immortality and invulnerability

Loss of future and expected rights of passage

Trauma losses result in bereavement and the need for integration

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TRAUMA AND REGRESSION

Trauma is often associated with regression to an earlier stage of development – mentally and physically

Individuals may do things that later seem childish

Examples include loose humor, diminished impulse control, free floating irritation, assuming a fetal position, referring to authority figures such as parents, law enforcement or administrators as “mommy or daddy”

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TRAUMA AND REGRESSION cont.

Individuals may feel childish; Examples include:

Feeling small

Wanting someone to take care of them

Feeling weak

Feeling as if things are out of control as if one were a child again

Using language that is highly simplified

Withdrawing and seeking nurture

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TRAUMA REACTIONS:PRESCHOOL-AGE CHILDREN

Play hurricane games

Fear of storm

Withdrawal

Anxiety

General behavioral problems

Thumb sucking

Bedwetting

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TRAUMA REACTIONS:PRESCHOOL-AGE CHILDREN

Clinging to parents

Sleep disturbances

Fear of dark

Regressive behavior

Loss of appetite

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TRAUMA REACTIONS:ELEMENTARY-AGE CHILDREN

Extreme withdrawal

Disruptive behavior

Difficulty paying attention

Outburst of anger

Stomach aches

Headaches

Depression

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TRAUMA REACTIONS:ELEMENTARY-AGE CHILDREN

Anxiety

Emotional numbing

FearsOf dark

Of being left alone

Of being separated from family

That something bad will happen to family

That they caused some part of the disaster

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TRAUMA REACTIONS:ELEMENTARY-AGE CHILDREN

Irritability

Aggressiveness

Nightmares

School avoidance

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TRAUMA REACTIONS:MIDDLE AND HIGH SCHOOL-AGE

CHILDREN

Sleeping and eating disturbances

Agitation

Irritability

Delinquency

Physical complaints

Poor concentration

Depression

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LONG-TERM CRISIS REACTIONS

Not all victims of trauma/crisis suffer significantly from long-term stress reactions

Many victims may continue to be reminded or re-experience some degree of crisis reactions over a longer period of time

These crisis reactions are often associated with “trigger or kindling events”, environmental cues, that remind the person of the trauma. These cues can bring back the intense emotion and physical reactions of the original trauma

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LONG-TERM CRISIS REACTIONS cont.

Trigger Events vary with different victims/survivors but may include:

Sensing (seeing, hearing, touching, smelling, tasting) something similar to what one was acutely aware of in the original incident

Anniversaries of the event

Proximity of holidays or significant “life events” to the trauma/crisis

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LONG-TERM CRISIS REACTIONS cont.

SUMMARY:

Survivors of trauma/crisis may experience stress reactions for years.Long-Term Stress Reactions are natural responses to terrible events.Unresolved stress reactions may result in several forms of post traumatic behavior.

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LONG-TERM STRESS REACTIONS

Persistent symptoms of increased physical arousal (not present in pre-crisis state) such as:

Difficulty falling or staying asleep

Irritability or outbursts of anger

Difficulty with concentration

Hyper-vigilance & heightened startle response

Physiologic reactivity at exposure (anxiety, fear, panic attack) that symbolizes incident

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RECOVERY FROM TRAUMA

Many people live through trauma and are able to reconstruct their lives without additional help

20/60/20 Rule: About 20% of those experiencing trauma will adapt and return to normal function within a short period of time; About 60% will experience some type of stress reaction that will, for a period of time, impair function; About 20% will suffer extensive impairment in one or more of their life functions

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RECOVERY FROM TRAUMA cont.

Recovery from immediate trauma is often affected by the following factors:

The severity of the incident and level of crisis reaction

The ability to understand what happened

The person’s pre-crisis stability

The nature and breadth of one’s support system

Access to help

The degree to which one’s experience is validated by culture and others

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RECOVERY FROM TRAUMA cont.

Recovery issues for survivors include:

The victim gaining some meaningful perception of control over the event

Working out an understanding of the incident and, as needed, a redefinition of worldview and values

Re-establishing a sense of future and personal goals

Re-establishing a sense of meaning, integration of the event into a personal narrative

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HELPING CHILDREN AFTER DISASTER: RECOMMENDATIONS

Meet and greet studentsRemain calm and reassuringAcknowledge and normalize feelings/reactionsEncourage expression about disaster-related eventsPromote positive coping and problem-solving skillsEmphasize children’s resiliency

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HELPING CHILDREN AFTER DISASTER: RECOMMENDATIONS

Establish/reinforce routines and expectations

Provide opportunities for children to share their concerns

Involve children in activities that allow them to make choices and resume a sense of control over their environment.

Incorporate information about the disaster into related subject areas, as appropriate.

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HELPING CHILDREN AFTER DISASTER: RECOMMENDATIONS

Listen to and observe children’s behavior.

Be sensitive to the disruption that relocation may cause.

Consider the developmental level and unique experiences of each child.

Involve students in recovery-related activities/projects.

Identify children at risk and make a referral to the appropriate school or community-based resource.

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STUDENTS WHO ARE AT HIGH RISK

Had a high level of exposure

Felt like they might die during the disaster

Were physically injured

Witnessed a grotesque destruction

Suffered significant loss

Are grieving for victims

Relocated following the disaster

Had preexisting anxiety disorders or mental health problems

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STUDENTS WHO ARE AT HIGH RISK

Had inadequate parental support

Are separated from their family

Used inadequate coping mechanisms

Experienced previous trauma

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POST-DISASTER ACTIVITIES: CLASSROOM DISCUSSION

Where were you during the hurricane?

Who was with you during the hurricane?

What do you remember about the hurricane?

What was the worst part of your hurricane experience?

How did you feel before, during, and after the hurricane?

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POST-DISASTER ACTIVITIES: CLASSROOM DISCUSSION

Do you know anyone who was injured during or after the hurricane?

What did you learn from this experience?

What would you do differently if another hurricane was to strike?

What can you do to help others affected by the hurricane?

How will this hurricane change you, your family, and your community?

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HELPING CHILDREN AFTER DISASTER: RESPONSES TO QUESTIONS

How do I respond to students when they ask, “Why did this happen?”

How can I help students with their lessons?

How do I assist students in understanding why some families experienced losses while others did not?

How do I help students deal with anxieties about the future?

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HELPING CHILDREN AFTER DISASTER: SUGGESTIONS FOR PARENTS

Listen to your child’s concerns, anxieties and fears – validate their feelings.

Offer realistic reassurances of safety and comfort.

Provide structure and routine in the home environment.

Encourage involvement in family and community recovery efforts.

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HELPING CHILDREN AFTER DISASTER: SUGGESTIONS FOR PARENTS

Be aware of abrupt changes in your child’s behavior; make appropriate professional contacts.

Provide factual information and talk in hopeful terms regarding the future.

Be prepared to tolerate regressive and acting out behaviors during the early post disaster phase.

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AFTER FRANCES: TAKING CARE OF ME

Be with other people.

Express your feelings/reactions.

Seek information and advice.

Reassure yourself.

Maintain healthy lifestyle/routines.

Seek professional help.