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Helping Children and Adolescents Cope with Violence and Disasters: What Community Members Can Do

Introduction

Each year, children experience violence and disaster and face other traumas. Young people are injured, they see others harmed by violence, they suffer sexual abuse, and they lose loved ones or witness other tragic and shocking events. Community members — teachers, religious leaders, and other adults can help children overcome these experiences and start the process of recovery.

What is Trauma?

"Trauma" is often thought of as physical injuries. Psychological trauma is an emotionally painful, shocking, stressful, and sometimes life-threatening experience (including witnessing events) that may involve physical injuries but also can happen without physical injury. Examples of trauma include a natural disaster, physical or sexual abuse, and terrorism.

Disasters such as hurricanes, earthquakes, and floods can claim lives, destroy homes or whole communities, and cause serious physical and psychological injuries. Trauma can also be caused by acts of violence. The September 11, 2001 terrorist attack is one example. Mass shootings in schools or communities and physical or sexual assault are other examples. Traumatic events threaten people’s sense of safety.

Reactions (responses) to trauma can be immediate or delayed. Reactions to trauma differ in severity and cover a wide range of behaviors and responses. Children with existing mental health problems, past trauma experiences, and/or limited family and social supports may be more reactive to trauma. Frequently experienced responses among children after trauma are loss of trust and a fear of the event happening again.

It’s important to remember:

  • Children’s reactions to trauma are strongly influenced by adults’ responses to trauma.
  • People from different cultures may have their own ways of reacting to trauma.

Helping Children: Commonly Experienced Responses to Trauma

Children age 5 and under:

  • Facial expressions of fear
  • Clinging to parent or caregiver
  • Crying or screaming
  • Whimpering or trembling
  • Moving aimlessly
  • Becoming immobile
  • Returning to behaviors common to being younger
  • Thumb sucking
  • Bedwetting
  • Being afraid of the dark.

Children age 6 to 11:

  • Isolating themselves
  • Becoming quiet around friends, family, and teachers
  • Having nightmares or other sleep problems
  • Refusing to go to bed
  • Becoming irritable or disruptive
  • Having outbursts of anger
  • Starting fights
  • Being unable to concentrate
  • Refusing to go to school
  • Complaining of physical problems
  • Developing unfounded fears
  • Becoming depressed
  • Becoming filled with guilt
  • Feeling numb emotionally
  • Doing poorly with school and homework
  • Loss of interest in fun activities.

Adolescents age 12 to 17:

  • Having flashbacks to the event (flashbacks are the mind reliving the event)
  • Having nightmares or other sleep problems
  • Avoiding reminders of the event
  • Using or abusing drugs, alcohol, or tobacco
  • Being disruptive, disrespectful, or behaving destructively
  • Having physical complaints
  • Feeling isolated or confused
  • Being depressed
  • Being angry
  • Loss of interest in previously enjoyable activities
  • Having suicidal thoughts

Adolescents may feel guilt for not being able to prevent injury or deaths. They also may have thoughts of revenge.

What Can Community Members Do Following a Traumatic Event?

Community members play important roles by helping children who experience violence or disaster. They help children cope with trauma and protect them from further trauma exposure.

It is important to remember:

  • Children should be allowed to express their feelings and discuss the event, but not be forced.
  • Community members should identify and address their own feelings; this may allow them to help others more effectively.
  • Community members can also use their buildings and institutions as gathering places to promote support.
  • Community members can help people identify resources and emphasize on community strengths and resources that sustain hope.

Community members need to be sensitive to:

  • Difficult behavior
  • Strong emotions
  • Different cultural responses.

Community members can help in finding mental health professionals to:

  • Counsel children
  • Help them see that fears are normal
  • Offer play therapy
  • Offer art therapy
  • Help children develop coping skills, problem-solving skills, and ways to deal with fear.

Finally, community members can hold parent meetings to discuss the event, their child’s response, how help is being given to their child, how parents can help their child, and other available support.

How Can Adults Help Children and Adolescents Who Experienced Trauma?

Helping children can start immediately, even at the scene of the event. Most children recover within a few weeks of traumatic experience, while some may need help longer. Grief, a deep emotional response to loss, may take months to resolve. Children may experience grief over the loss of a loved one, teacher, friend, or pet. Grief may be re-experienced or worsened by news reports or the event’s anniversary.

Children who continue to show problematic behaviors after the event may need help from a mental health professional.

Examples of problematic behaviors could be:

  • Refuse to go places that remind them of the event
  • Emotional numbness
  • Behave dangerously
  • Unexplained anger/rage
  • Sleep problems including nightmares.

Adult helpers should:

  • Pay attention to children
  • Listen to them
  • Accept/do not argue about their feelings
  • Help them cope with the reality of their experiences.

Reduce effects of other stressors

  • Frequent moving or changes in place of residence
  • Long periods away from family and friends
  • Pressures to perform well in school
  • Transportation problems
  • Fighting within the family
  • Being hungry.

Monitor healing

  • It takes time
  • Do not ignore severe reactions
  • Pay attention to sudden changes in behaviors, speech, language use, or in strong emotions.

Remind children that adults

  • Love them
  • Support them
  • Will be with them when possible.

Help for all People in the First Days and Weeks

Key step is to help adults so they can provide better care for their children. The first steps include creating safe conditions, remaining calm and friendly, and connecting to others. It is also important to be sensitive to difficult people and encourage respect for adult decision-making.

Do:

  • Get food
  • Get a safe place to live
  • Get help from a doctor or nurse if hurt
  • Contact loved ones or friends
  • Keep children with parents or relatives
  • Understand what happened
  • Understand what is being done
  • Know where to get help
  • Meet your own family’s needs.

Don’t:

  • Force people to tell their stories
  • Probe for personal details
  • Say things like “everything will be OK,” or “at least you survived”
  • Say what you think people should feel or how people should have acted
  • Say people suffered because they deserved it
  • Be negative about available help
  • Make promises that you can’t keep such as “you will go home soon.”

More About Trauma and Stress

Some children will have prolonged problems after a traumatic event. These may include grief, depression, anxiety, and post-traumatic stress disorder (PTSD). Some trauma survivors get better with some support. Others may need prolonged care by a mental health professional. If, after a month in a safe environment, children are not able to perform their normal routines or new behavioral and emotional problems develop, then consider contacting a health professional.

Factors influencing how one may respond to trauma include:

  • Being directly involved in the trauma, especially as a victim
  • Severe and/or prolonged exposure to the event
  • Personal history of prior trauma
  • Family or personal history of mental illness and severe behavioral problems
  • Limited social support; lack of caring family and friends
  • On-going life stressors such as moving to a new home, or new school, divorce, job change, and financial troubles.

Some symptoms may require immediate attention. Contact a mental health professional if these symptoms occur:

  • Flashbacks
  • Racing heart and sweating
  • Being easily startled
  • Being emotionally numb
  • Being very sad or depressed
  • Thoughts or actions to end life.

It also important to recognize in the confusion or chaos after a crisis event children and adults can be particularly vulnerable to predators. Adults caring for children must be mindful of the limitations of environments that are created for shelter or other services.

Trauma Resources from Other Government Agencies

National Center for Post Traumatic Stress Disorder
Phone: 802-296-6300
Email: ncptsd@va.gov
Website: http://www.ncptsd.va.gov 

Uniformed Services University of the Health Sciences
Center for the Study of Traumatic Stress
Phone: 301-295-2470
Website: http://www.centerforthestudyoftraumaticstress.org/factsheets.shtml 

National Resource Center for Child Traumatic Stress Network
Phone: 919-682-1552
Email: info@nctsn.org
Website: http://www.nctsn.org 

Center for Mental Health Services
Emergency Services and Disaster Relief Branch
Email: info@mentalhealth.org
Website: http://mentalhealth.samhsa.gov 

U.S. Department of Education
Phone: 1-800-USA-LEARN
TTY: 1-800-437-0833
Email: customerservice@inet.ed.gov
Website: http://www.ed.gov 

U.S. Department of Justice
Email: AskDOJ@usdoj.gov
Website: http://www.usdoj.gov 

Federal Emergency Management Agency
Phone: 1-800-480-2520
Website: http://www.fema.gov/kids