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Debbie’s Perception of a Life Threat - School Shootings & Ruminative Coping Styles
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In the last section, we discussed four stages of children's reactions to disasters. These four stages were the recoil phase, the postimpact phase, the recovery and reconstruction phase, and other reactions.
In this section, we will discuss three contributing factors regarding children's reactions to disaster and terrorism. These three contributing factors are aspects of traumatic exposure, preexisting characteristics of the child, and aspects of the recovery environment.
Debbie, age 11, began therapy a month after a school shooting incident. There were no fatalities. Debbie and her classmates had been held hostage, and Debbie had witnessed her teacher being shot. Debbie's mother, Brandy, age 37, stated, "I just don't know how to help Debbie! It sounds awful, but she's driving me crazy. She's always been so independent, but now she follows me everywhere! If I go to the bathroom and close the door, she gets upset! I know she went through something truly awful, but how does a kid end up acting like this?"
3 Contributing Factors Regarding Children's Reactions to Disater & Terrorism
♦ Contributing Factor # 1 - Traumatic Exposure
I stated to Brandy, "There are three factors which can influence a child's reaction to witnessing traumatic event. The first of these factors are the aspects of traumatic exposure." I explained to Brandy that there are six aspects of traumatic exposure.
Six Aspects of Traumatic Exposure
-- (1) The first, and one of the most significant, is the presence or perception of a life threat. I stated, "The more children feel their lives are threatened, the higher the incidence of PTSD symptoms. Children who have been in hostage situations, like Debbie, are very likely to feel that their life is in danger."
-- (2) A second significant aspect of traumatic exposure occurs when the trauma or disaster has led to the death of a loved one. I stated to Brandy, "Because Debbie saw her teacher being shot, she is likely to experience grief and guilt, which can heighten stress reactions. Debbie may be trying to reconcile why she survived when her teacher did not, and may wonder if she could have done more to prevent the death."
Other aspects of traumatic exposure include:
-- (3) Loss of possessions
-- (4) Disruption of everyday life
-- (5) Duration and intensity of life-threatening events
-- (6) Proximity to the event.
Clearly, Debbie’s life was disrupted, and she was very close to the event. Additionally, because her classroom was held hostage for several hours, the duration of Debbie’s experience was extensive.
Think of a child you are currently treating for disaster or terrorism-related PTSD. What aspects of traumatic exposure influence his or her stress reaction?
♦ Contributing Factor # 2 - Preexisting Characteristics of the Child
A second factor that can influence a child’s reaction to a traumatic event are the preexisting characteristics of the child. I stated to Brandy, "A child with preexisting anxiety, depression, or a ruminative coping style are potential risk factors for stress reactions. In addition, children with preexisting academic difficulties or attention problems may exhibit greater post-disaster problems than children without such difficulties." As you know, children with a lower socioeconomic status may also have more severe stress reactions to disaster or terrorism.
♦ Contributing Factor # 3 - Aspects of the Recovery Environment
In addition to aspects of traumatic exposure and preexisting characteristics of the child, a third factor that can influence a child’s reaction to a traumatic event is aspects of the recovery environment. After a disaster, variations in the recovery environments can either magnify or attenuate a child’s stress reaction.
For example, the influx of social support that tends to occur after a natural disaster tends to help minimize children’s post-disaster distress. As you have experienced, the parent’s psychosocial functioning following a disaster may also have a strong impact on children’s stress reactions. In a study by Swenson following Hurricane Hugo, mother’s distress was associate in the persistence of emotional and behavioral difficulties in child survivors. Additionally, if a child experiences a major life event, such as a death in the family or a parental divorce, in the months following a traumatic incident, the child may be at higher risk for the persistence of PTSD symptoms.
♦ Technique: "Schedule Alone Time"
To assist Brandy in providing a positive recovery environment for Debbie, I suggested the "Schedule Alone Time" technique. I stated to Brandy, "One of the most helpful things you can do for Debbie is to help her reestablish her sense of security and stability. Clearly, you cannot be with Debbie 24 hours a day. But giving Debbie frequent predictable time to spend with you can help Debbie feel a sense of constancy."
Brandy decided that she would schedule a special mother-daughter time with Debbie every evening at 6:30 for half an hour. Several weeks later, Brandy reported, "It’s amazing! After spending a few weeks spending our "special time" together, I can actually take a whole shower without Debbie looking for me. And yesterday, she actually said she would rather stay home than go to the grocery store with me, because she wanted to work on her clay project some more!"
Think of your Debbie. Would the schedule alone time technique be beneficial in helping him or her reestablish feelings of security and stability?
In this section, we have discussed three contributing factors in children's reactions to disaster and terrorism. These three contributing factors are aspects of traumatic exposure, preexisting characteristics of the child, and aspects of the recovery environment.
In the next section, we will discuss three focus areas for assessing children exposed to disaster or terrorism. These four focus areas are, the child's behavior and emotion, the severity of the stressors, and coping.
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