Assisting Children in Trauma Due to Homelessness by Jeanne Stamp

In the aftermath of the storms, all those who have been working with children newly made homeless, have realized the importance of understanding the effects of trauma, grief, and loss. While it is obvious that those who evacuated due to the storms were traumatized by this life-threatening event, it hasn’t always been as obvious that no matter how one becomes homeless, – it is traumatic. Grief and loss are inextricably woven into the emotional mix. While adults have a difficult time dealing with these emotions, it is even more difficult for children - dealing with feelings they do not understand and cannot identify, events they do not understand, and situations over which they have no control. All this while they contend with natural developmental issues at various ages and stages that can be affected and arrested by such trauma.

Children have neither the emotional nor intellectual development to be able to make sense of traumatic events on their own. They need adult assistance, not only immediately after the crisis, but also throughout the recovery period. Research shows that it is often not the trauma itself, but rather what occurs in response to the trauma, that determines the amount of time to recover and the completeness of the recovery. Below are some things adults can do to assist children in dealing with traumatic events at each stage of the crisis. When a child’s psychological needs are addressed appropriately, there is a good chance that any emotional damage will not become deep-rooted or cause lasting emotional problems.

Children who experience an initial traumatic event before they are 11 years old are three times more likely to develop psychological symptoms than those who experience their first trauma as a teenager or later. But children are able to cope better with a traumatic event if parents, friends, family, teachers and other adults support and help them with their experiences. Adults should help as soon as possible after the event. It’s important to remember that all children are different and will not all react the same even to the same set of stressors. Some children may immediately be very upset and emotional, while other children may never show distress because they don’t feel upset, still others may not give evidence of being upset for several weeks or even months. Children may not show a change in behavior, but they may still need help. Care should be taken that one does not read problems into what are normal variations in a child’s development and behavior. However, it is also important that adults do not ignore actual indicators of significant problems. These problems may not go away of their own volition, and may become more significant with time and inaction. Children’s common reactions to trauma are listed below along with helpful adult responses.

According to the UCLA Mental Health in Schools Program and FEMA For Kids: Resources for Parents & Teachers, children may exhibit the following behaviors after a disaster or other trauma such as losing one’s home:

¨ Become emotionally chaotic, become upset over the loss of a favorite toy, blanket, teddy bear or other items (which reinforces their feelings of loss). There may be events or issues that adults might consider insignificant, but which are important to the child.
¨ Exhibit excessive affect or very little affect, rapid emotional swings, can’t seem to control their emotions, or seem numb.
¨ Experience memory loss or memory confusion.
¨ Change from being quiet, obedient, and caring to loud, noisy, and aggressive or may change from being outgoing to shy and afraid.
¨ Become depressed, tearful, sad or unhappy.
¨ Develop nighttime fears. They may be afraid to sleep alone at night, with the light off, to sleep in their own room, or have nightmares or bad dreams.
¨ Be afraid the event will reoccur, or develop non-specific fearfulness.
¨ Become easily upset, crying and whining, and exhibiting attention-seeking behaviors.
¨ Lose trust in adults, after all, their adults were not able to control the traumatic situation.
¨ Revert to younger behavior such as bed-wetting and thumb sucking.
¨ Be fearful of letting parents out of their sight and refuse to go to school or childcare (separation anxiety).
¨ Feel guilty that they caused the disaster because of something they said or did.
¨ Be inattentive, and easily distracted, have difficulty concentrating or remaining focused.
¨ Worry a lot in general, or become fixated on a particular worry, become afraid of wind, rain, or sudden loud noises.
¨ Have symptoms of illness, such as headaches, vomiting, or fever.
¨ Become angry, or lash out, especially as self-injurious behavior or threats to others, or they may destroy things.
¨ Experience changes in eating patterns - eating too much or too little.
¨ Be easily agitated, appear anxious, or hyper-vigilant, and always seems on their guard; their behaviors seem beyond their control.
¨ Engage in ritualistic and repetitive behavior.
¨ Isolate self, avoid friends and family.
¨ Older youth may experiment with substances, or develop school avoidance, and runaway behavior.
¨ Alienate others, or interact inappropriately, thus damaging relationships.
¨ Become excessively reactive and resistant to authority.
¨ Exhibit more severe concerns: become disoriented, not grounded in time and place, preoccupied with death and/or bizarre thoughts, experience flashbacks, appear delusional, overreacts strongly to emotional triggers.

Adults can intervene in some very positive ways to help counteract some of these reactions by children. Below is a list of ways that adult intervention can help traumatized children to a more positive outcome. Responding to Crises: A Few General Principles is from A Resource Aid Packet: Responding to a Crisis at School, Center for Mental Health in Schools (2000) that focuses on short-term and long-term response for a more positive recovery. Response is divided into two major time frames and purposes:

Immediate Response: Focused on Restoring Equilibrium, adults can:

o Be calm, direct, informative, authoritative, nurturing, and problem-solving-oriented to give the child a sense of security that someone knowledgeable and reliable is in charge.

o Counter denial, by encouraging students to deal with facts of the event. This diminishes fantasy and exaggeration, allowing the child to deal with a more manageable problem than that which their imagination can create.

o Give accurate information and explanations of what happened and what to expect (in age-appropriate terms). This facilitates cognitive understanding at any stage of development.

o Never give unrealistic or false assurances. This undermines trust in the people the child needs most to feel are trustworthy.

o Talk with children about their emotional reactions and encourage them to deal with such reactions in a planned manner. This will normalize their feelings and help them to gain control over their reactions. It will also provide caring adults with opportunities to correct information and assist with coping strategies.

o Convey a sense of hope and positive expectation — that while crises change things, there are ways to deal with the impact that will allow for the child’s safety and well-being.

o Provide simple choices that can help the child feel in control of something, in their lives, no matter how small.

o Move the child from victim to actor by building on coping strategies that they have displayed in the past, planning realistic and appropriate actions they can take, and, when appropriate, having the child assist with efforts to restore equilibrium.

o Reduce or minimize children’s or adolescent’s exposure to upsetting images. For example, after a disaster, eliminate viewing without an adult present, restrict media viewing, discuss news shows and other programming with children, and actively encourage alternative activities (e.g., reading, athletic activities, games with friends). After 9/11, children living in Chinatown lost media coverage when the towers collapsed because their broadcast signals were beamed from the Twin Towers. These children subsequently had far fewer nightmares and drew no pictures of people jumping from the towers.

o Connect the student with immediate social support: peers, buddies, staff, and family, to provide support, guidance, and other forms of assistance.

Long Term Response for Recovery: Fostering Resilience

Fostering resilience can have a positive effect on long-term recovery. Resilience is the ability of children and adults to positively adapt to life’s adversities, especially highly stressful or traumatic events. Resilience is developed through attitudes, behaviors, emotional, and physical make up and positive coping and adaptive strategies. Children who are resilient tend to bend with stress rather than break. They seem to have a “bounce back” quality. This does not mean that they do not fully experience hardship or traumatic events, or that these things are not upsetting and temporarily unsettling, but it means the child has ultimately learned to surmount hardship without long-lasting detrimental effect. (Luthar, Cicchetti, & Becker, 2000, O’Leary, 1998; O’Leary & Ickovics, 1995; Rutter, 1987, Management Institute, Salem OR, APA Task Force on Resilience in Response to Terrorism).

To foster resilience in children for long-term recovery, adults can:

o Help the child identify supportive and trustworthy adults in their lives, including coaches, pastors, teachers, and extended family members.

o Help the child to create positive connections and a sense of belonging, at school, church or other places. Maintain social connections. Youngsters’ friendships and social activities are important for normalizing children’s and adolescents’ lives and promoting good adjustment.

o Help the child become part of a team or group for a sense of belonging.

o Help the child to talk about their feelings on an ongoing basis. This enables parents and other caring adults to correct any misinformation or misperceptions and to provide reassurance about

safety. However, do not pressure a child into talking about something they are not ready to discuss. Sometimes describing behaviors and concrete actions rather than feelings is easier for children, at least at a time closer to the trauma. Dealing with the concrete - such as who did what - may be an easier task closer to the trauma.

o Help the child break down problems into little pieces that they can more easily address. The idea of mastery and control over an event is another important ingredient for resilience.

o Help the child see the choices in any situation and to be thoughtful about their behaviors for a sense of control. Their experience has been one of a total loss of control. Giving them choices will help them feel empowered and will be important in their adjustment.

o Help the child develop relaxation techniques.

o Help the child develop positive self-statements that will help to develop self-confidence in their ability to handle adversity.

o Help children and adolescents resume normal roles and routines or develop new routines. Youngsters feel safe and secure when their activities are predictable and not always focused on the negative events.

o Help children and youth stay healthy and fit by eating well and getting regular exercise and proper sleep. Maintaining good health is important for coping with stress.

o Help the child by modeling positive coping strategies and behaviors.

o Help the child by helping their parents with developing trust and coping strategies. Children are very loyal to their parents’ beliefs. If their parents convey a sense of trust, being in control and empowered, children will be more likely to feel the same.

o Help the child by setting clear and consistent limits and enforcing them. Enforcing limits helps the child know that someone is in control, and that someone will help them to be in control even when they don’t feel capable of controlling themselves or the situation.

o Help children and youth by gaining for yourself an understanding of how the brain deals with traumatic events. The right brain is highly involved in flashbacks and hyper-arousal, so helping traumatized people “stay” in the left brain is often a much more helpful approach. Adults can help children with this shift by helping the child to concentrate on concrete thoughts and activities that involve the left brain. Avoid the emotional triggers to the right brain (which can cause flashbacks and retraumatizating of the child) from exposure to the traumatizing events, exposure to others who are highly emotional, or pressure to talk about feelings or events they are not ready to share.

o Help the child who is experiencing more severe symptoms or having difficulty developing and using coping strategies, having flashbacks, or having serious emotional difficulties, by referral to a mental health professional with specialized knowledge and skills in working with children who have been traumatized. Traditional counseling techniques that focus on emotions and feelings are often counter-productive, because they take the student back into feeling powerless, helpless and overwhelmed.

When caring adults understand children’s reactions to trauma, including the trauma of losing one’s home, and gain understanding of children’s expected reactions as well as appropriate adult responses to assist in fostering resiliency, children are much more likely to recover quickly and develop positive coping and problem-solving skills that empower them with a sense of control and mastery for life’s unexpected challenges.

Jeanne Stamp is a Senior Program Coordinator at the Texas Homeless Education Office in Austin, TX.