Crying

When tragedy strikes, school personnel should perform a range of tasks and roles to minimize harm to children and lay the groundwork for their recovery.

By Thomas Demaria and David J. Schonfeld

Despite our best prevention efforts, we can’t always protect students from the many stressful and often traumatic experiences they may encounter. In the event of a crisis, the school’s immediate goal is to minimize the negative effect, support coping, accelerate adjustment, and instill confidence in students that school staff members are available to address their needs.

Children will react differently to crises and potentially traumatic events depending on numerous factors, including their developmental stage, cognitive capacity, and skills at managing high levels of stress and anxiety. Some common reactions one might see immediately following a traumatic or crisis event include:

  • Sleep problems — difficulty falling or staying asleep, difficulty waking in the morning, nightmares;
  • Anxiety, worries, and fears due to limited knowledge or experience and the tendency toward misunderstanding and misattribution;
  • Separation anxiety or school avoidance;
  • Bereavement and grief if deaths resulted from the event;
  • Sadness or depression;
  • Avoidance of previously enjoyed activities, withdrawal, and isolation;
  • Difficulties with concentration and academic work and subsequent failures in school;
  • Irritability, which may result in outbursts of anger or be viewed as a conduct problem;
  • Developmental or social regression (more clingy, less cooperative, more demanding, more
    self-centered, or less tolerant of others);
  • Onset of or increase in alcohol, tobacco, or other substance abuse; and
  • Somatization — developing physical health symptoms as a result of stress.

While most students will experience one or more reactions to a traumatic event, some may show no reaction at all. They may not shed tears or show any indication that they have been affected. One cannot assume a student isn’t experiencing distress simply due to a lack of overt or obvious reactions. Similarly, the lack of an obvious reaction doesn’t imply some kind of impairment. In most cases, searching aggressively for reactions in students who appear to be coping well or are indicating that they’re having no difficulties can be counterproductive. For example, after the murder of a student, middle school students bullied a girl because she didn’t cry at the memorial service. The school staff encouraged her to let out her feelings like the other girls so she wouldn’t be picked on. The girl later reported that she was in fact sad about the loss, but didn’t feel comfortable showing her emotions to her peers. Similarly, cultural factors may affect how students display emotions. A group of children in Sri Lanka were reluctant to follow an art directive to draw the emotions they experienced about the tsunami that devastated their country. The children only drew happy faces until teachers asked them to turn over their papers and draw their “inside faces.” Their drawings then portrayed many different emotions.

Children will react differently to crises and traumatic events depending on their developmental stage, cognitive capacity, and skills at managing high levels of stress and anxiety.

Many students internalize their reactions rather than act out or show dramatic emotional displays. But the event may  corrupt their internal world, including their life goals, quality of life, and personal happiness. A school once requested consultation following a series of student suicides, but withdrew the request shortly thereafter because students appeared to be doing well and not causing the school noticeable problems. The school was also concerned that talking about a previous traumatic event might unnecessarily provoke students. Contrary to their thinking, talking can help students put painful experiences into words, thereby increasing their capacity to master an ugly memory.

Conversely, not all reactions after a traumatic event represent trauma symptoms or disorders. For example, trauma and bereavement or grief following the loss of a loved one may present with similar or overlapping reactions, including anxiety, sadness, difficulty with concentration, loss of appetite, and sleep problems. Bereavement can be present after a crisis in the absence of trauma symptoms and disorders. In one case, an adolescent showed strong emotional reactions following a major community shooting where people were killed on either side of him, including a very close friend seated at his side. He resisted multiple offers of counseling to help process the event but felt unable to return to school. During a home visit, a crisis counselor suggested his reactions might be related less to trauma and more to the grief associated with the death of his close friend — something that had not been suggested during the previous several weeks. At this point, he welcomed the opportunity for bereavement support.

Risk factors for difficulty with adjustment

Situations that existed before the crisis or as a result of the traumatic event have been found to increase the risk of developing subsequent adjustment difficulties. Knowing these risk factors can help schools identify who needs additional supports, especially given that these students may not show signs of distress or seek help. These risk factors include:

  • Injury of the student as a result of the event, or death or injury of those close to the student;
  • Student’s perception (at the time of the event) of danger;
  • Exposure to horrific scenes (including indirectly through the media);
  • Separation from parents or other important caregivers as the result of the event;
  • Loss of property or belongings;
  • Disruption in daily routine or environment;
  • Previous mental health problems;
  • History of significant losses or traumatic events;
  • Distress among caregivers;
  • Lack of supportive, open, and honest communication from adults; and
  • Lack of real or perceived community resources and social support.

Minimizing lifelong effect of trauma

Crises can have a lifelong effect. Most children, however, won’t develop lasting problems. In fact, some children will even report improvement in some aspect of their lives as a result of the negative experience, referred to as post-traumatic growth. These improvements can include a greater appreciation of life, closer relationships, awareness of new possibilities, increased personal strength, and spiritual growth. Support and assistance provided by school personnel can accelerate this natural recovery process and minimize a student’s distress.

Schools should create environments where students feel safe asking questions and sharing their concerns. Unfortunately, this isn’t always the case. For example, after dozens of students died when an earthquake caused the collapse of their school in China’s Sichuan Province, elementary school teachers were found yelling at students to stop crying and telling them that because they survived, they had no right to be upset. The teachers were probably feeling overwhelmed by witnessing the distress of students while confronting their own personal reactions to the tragedy. The teachers unfortunately didn’t realize that their unsupportive behaviors caused even more distress among students. Students won’t feel safe if they believe an adult does not understand them.

Children are unlikely to disclose their feelings if adults around them seem unaffected. Adults should share their (common) reactions to normalize such discussion with an emphasis on sharing coping strategies. For example, “I was worried yesterday after I heard what happened, but then I talked with my husband about my concerns and felt better. Who are some of the people you can talk to when you have such concerns?” As role models, school staff should be encouraged to share their own feelings with students when appropriate and model their positive coping responses. A teacher shouldn’t be ashamed to shed a tear during a class discussion. The teacher can explain to the class that sometimes feelings can leak out and that this is a natural reaction when sad events happen. By returning to teaching after this brief pause, a teacher can model how we can have emotions without being overwhelmed or ashamed by them.

How educators can support

Students and families look to schools for stability and security after their world has been turned upside down. Communities rely on schools to provide stability, shelter, and guidance during times of crisis. Everyone in the school is a potential point of contact for students and family. School staff can play a valuable role in correcting misinformation, gossip, and rumors.

School staff should be comfortable providing support and should not feel as if they’re being asked to provide counseling. Educators are frequently asked to identify students who appear to be having difficulties following a traumatic event. Teachers can perceive this as a burden if they interpret it as being asked to conduct a clinical assessment. The word “identify” might well be replaced by “notice” or “be aware” of students whose behavior changes after a traumatic event. Even without extensive clinical training, teachers can easily notice if a student is less social, more disruptive, or less focused. Drawings and artwork may appear different than artwork produced in the past. Writing assignments in older students may contain more of a negative and pessimistic tone.

Active listening will help a teacher increase awareness. Active listening involves listening not only with your ears but also with your eyes and other senses. Being available to listen to students requires adults to quiet the “noise” our own thoughts generate and to avoid trying to provide solutions. School staff should strive to strengthen their capacity to listen when students find the courage to share experiences that were scary, dangerous, or violent.

Students won’t feel safe if they believe an adult does not understand them.

Talking openly with children about the traumatic event will increase their belief that they’re safe and protected. Withholding information from children can lead them to develop fear and fantasies since they may assume they aren’t being told the truth because a danger still exists or because they can’t trust the caregiver. Limiting information shared can also result in a misunderstanding that can cause further distress. In one scenario, a family did not tell a child that his father died in their home, and he later developed a belief that his father was murdered by the hospital where he was allegedly taken. The child then refused to visit his pediatrician or tell his mother about medical problems he experienced.

Finally, children will often base their responses on what they see modeled by caregivers. Even subtle gestures can affect a child’s response. For example, providing a tissue at the first sign of tears, telling a student they should talk to the school counselor about their “bad” feelings, and encouraging a student to be a “big boy” or “big girl” when they appear upset are often perceived as dismissive. Letting a student know you’re available to listen to his or her concerns without trying to simply quiet them down or send them to someone else will assure the student that emotions are indeed permitted in the classroom.

Role of school mental health providers

After a crisis, school mental health professionals play an important role in screening and identifying students who may be at risk. These professionals can walk around the school property and surrounding community to find students who cluster in locations away from the attention of school staff and offer support in locations where they are found. While respecting confidentiality and privacy, students also may offer their assistance in identifying other students in distress, whether based on their discussion, observations, or from information gleaned from social media.

Outreach by school mental health professionals can include education provided to the school staff and parents about short- and long-term reactions following traumatic exposure; consultation with school staff about students whose behavior changed following the traumatic event; and guidance about school activities planned to foster healing after the traumatic event.

School mental health staff should also provide professional development for staff outside the context of major crisis events to better prepare them to support students dealing with personal crisis and loss. Consultation with educators about providing lessons on coping skills outside the context of a crisis can be very valuable. Creative teachers can be encouraged to adapt information about psychological trauma and “psychological first aid” for their class instruction. An English teacher used the story of Harry Potter to discuss the role of the hero in literature, which included Harry’s quest following the murder of his parents. She noted that the resilience Harry found on his epic journey was enhanced by his reliance on his peers Hermione and Ron and adult mentor Dumbledore. The teacher then asked students to search the literature they had read for peers and mentors that other protagonists or heroes had with them during times of crisis. In another school, a mathematics teacher discussed the difference between probability and possibility to help students better understand the actual risk they faced in an effort to reduce their fears when a traumatic event disrupted their assumptions about the world. Another teacher had students develop a narrative and timeline about a community crisis so students could learn about primary sources when conducting historical research.

Finally, school mental health staff can play a critical role with administration and the overall school community to ensure a smooth transition from the immediate response to a long-term plan for recovery. In this vein, they often play an important role on the school crisis response and recovery team. They also can help coordinate and collaborate outreach with community mental health partners as needed.

Role of school administrators

School staff and administrators must ensure that all of a school’s working parts turn in the same direction and that the school speaks with one consistent and calming voice. Coordination efforts can be challenging after a major event since too often energy is initially focused on revitalizing dormant school crisis plans while also adapting school operations to serve the community’s evolving needs. In such cases, having school-employed mental health professionals who are part of a schoolwide crisis response and recovery team becomes critical.

Educators and other school personnel may be reluctant to support students affected by a crisis because of perceptions that administrators don’t endorse such actions. Administrators therefore play an important role in setting the overall tone for the response. For example, at a staff meeting after a major school shooting, a school superintendent personally stressed the importance of understanding the emotional needs of individual students and gave permission for the staff to adjust academic expectations until recovery had advanced sufficiently. The superintendent stressed the importance of supporting students and staff and of open communication with everyone in the school community.

Administrators also set the tone through their communication regarding the details of the event. Descriptions should be honest, developmentally appropriate, and given in a setting where students feel comfortable asking questions and seeking support. In one middle school, following the death of a student on a Friday, the administrator decided to send a sealed letter home with each student at the end of the day so they could discuss the situation with their parents. It was later discovered that many students had opened the letter on the bus, leading to significant distress and an inability to provide needed supports for some students until the following Monday.

Community-based supports

Following a disaster, school administrators must multitask and stretch their existing resources when confronted by the emergent needs of students and staff. School administrators may also be burdened by the role their school plays in community crisis plans that call for school buildings to be temporary housing shelters, supply storage and distribution centers, and crisis counseling locations. Community crisis responders may be called on when school human resources are insufficient. Community crisis responders include emergency service workers, pediatricians, and other healthcare providers, mental health professionals, clergy members, and experts from professional organizations. They provide valuable support when schools, students, and their families may be temporarily overwhelmed. The community crisis responders can be viewed as a temporary bridge between the disaster and recovery. Their assistance is valuable because of their special expertise, and sometimes their personal distance from the event protects them from being personally affected by the local tragedy. The community crisis responders also symbolically represent larger society and reassure children that other people are available who care for them and can provide protection.

Students and families look to schools for stability and security after their world has been turned upside down.

Schools should try to establish relationships with community crisis responders before a crisis occurs. This gives the school time to learn about the expertise of the responders and for the responders to become more familiar with the school district. The authors have personally responded to hundreds of school crisis events and have found that the consultation is often most effective when there is a preexisting personal relationship, typically because of a prior training, collaboration, or response to an earlier event.

Role of school partnerships

The goal of recovery is to support children until their own personal capacity for self-determination can be reawakened. This often involves reconnecting the family with its own pre-existing support systems. Children and families should be empowered to resume control of and responsibility for their lives as soon as they’re ready. In school disasters, involving students in helping others who need assistance is often a helpful strategy. For example, following a bus crash that injured many students, the student government leadership in a middle school distributed paper and crayons so students could write get well cards. The principal and students who knew the injured students delivered the cards to individual families. This active involvement increases students’ belief that they can control their own future and reignites the peer support networks that existed before the traumatic event.

Schools can also provide families with information about how they can help their children recover from the traumatic stress and losses. Give families tools to support post-traumatic growth in their children following traumatic exposure. Direct families to web sites of reputable professional organizations such as the National Center for School Crisis and Bereavement (www.schoolcrisiscenter.org), the National Child Traumatic Stress Network (www.nctsn.org), and the National Association of School Psychologists (www.nasponline.org) where they can gain more information and access to resources.

Short-term response is a shared responsibility

Crises and traumatic events often cause confusion and fear followed by frantic attempts by those surrounding students to maintain normalcy and insulate them as much as possible. This becomes a Herculean challenge since such experiences transform a child’s world and the normal course of development. By working together and sharing a common response and eventual recovery plan, educators, school mental health professionals, school administrations, community-based supports, and family can provide consistency and facilitate personal growth and resiliency.

 

Post-traumatic stress vs. PTSD

Traumatic stress after a trauma (post-traumatic stress) is not the same as post-traumatic stress disorder (PTSD), which is a chronic disabling mental illness. Traumatic stress reactions can last several months but will generally abate if a child experiences no other traumas and can rely on his or her own pre-existing strategies for coping with stress. For example, a child who witnessed her sibling being killed as a result of gang violence may initially be preoccupied with her own safety and pending criminal justice processes. Once she is reassured that she is safe and will be protected, she may not show further signs of traumatic stress. She may, however, begin to express her grief about the loss of her brother.

THOMAS P. DEMARIA (tdemaria@liu.edu) is a Fellow of the American Psychological Association and director of the Doctoral Psychology Psychological Services Center and Trauma Team at Long Island University Post, Brookville, N.Y. DAVID J. SCHONFELD is founder and director of the National Center for School Crisis and Bereavement, pediatrician-in-chief at St. Christopher’s Hospital for Children and chief of pediatrics at Drexel University College of Medicine, Philadelphia, Pa.

Originally published in the December 2013/January 2014 Phi Delta Kappan 95 (4), 13-17. © 2013 Phi Delta Kappa International. All rights reserved.