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How Parents Can Prevent the Long-Term Effects of a Trauma

Aug 17, 2007
Let us hope that your child will not experience any major trauma in his or her developing years. But even if a trauma should occur, it doesn't have to be a "life-shattering event." More than fifty years of research, beginning with the study of children who experienced the London bombings in World War II, has shown us that children can adapt surprisingly well to most of life's hardships. They may not bounce back immediately, but they can adjust to a wide variety of stresses and go on to live satisfying and successful lives.

Childhood trauma comes from many sources. Sometimes it can occur over an extended period of time, as with cases of neglect or maltreatment or repeated family violence. But for most children a trauma is a single event, such as the death of a parent, a hospitalization, a natural disaster, or a severe accident.

Although the majority of children exposed to a trauma do well and have only mild, transitory symptoms, some develop significant problems, which can continue to affect them many years after the trauma is over. These problems come in different forms, from symptoms that look like ADHD, to depression, to psychosomatic problems like headaches and stomachaches. As we shall see, there are many risk factors that can predispose a child to short- as well as long-term problems, and many of them are within your control.

Most parents may feel they are not trained to help children who have been through a traumatic event. In many cases the parents are in distress themselves and coping with their own psychological reactions. However, traumas bring out the "hero" in all of us. Parents can reduce the risk of trauma as well as utilize interventions that can make a difference in helping their children overcome even the most unimaginable circumstances.

To understand exactly what parents can do, it is helpful to think in terms of four stages of prevention that apply to children from preschool age through adolescence. (They don't apply to infants and toddlers, but there are other, more general preventive techniques that should be considered for them.)

STAGE ONE: TRAUMA PREPAREDNESS

Your first job of prevention begins even before a trauma occurs. If you are in a part of the country where natural disasters are common, you have probably already taken steps to prepare for the possibility of that kind of trauma. You may have talked to your children about where to stand and what to do if an earthquake strikes, or shown your teenagers how to help you prepare your house in the event of a hurricane or tornado. But there are other types of traumas that children can be prepared for.

Children as young as three can be taught to dial 911 and ask for help in an emergency. At this age they also should know what to do if a fire breaks out in the home. Older children can learn about first aid, and adolescents can learn CPR.

The Federal Emergency Management Agency (FEMA) suggests that you develop a "Family Disaster Plan" by taking four simple steps. First, learn what hazards exist in your community and how to prepare for each. Then meet with your family to discuss what you would do in each situation. Next, take steps to prepare for a disaster, such as posting emergency phone numbers, designating an out-ofstate family contact, assembling disaster-supply kits for each member of your household, and installing smoke detectors on each level of your home. Teach your children how to recognize danger signals.

Make sure they know what smoke detectors, fire alarms, and community-warning systems (horns, sirens) sound like. Finally, practice your Family Disaster Plan so that everyone will remember what to do if a disaster does occur. Contact your local emergency-management or civil-defense office or the local Red Cross chapter for literature about how your family can create a disaster plan.

Children can even be psychologically prepared for unforeseen events, like a sudden illness or a family death. Not a day goes by that the television news doesn't report a story of a tragedy that affects some child. Understandably, most parents don't see these stories as topics they want to discuss with their children, but protecting children from the real misfortunes that befall people all around them only leaves them psychologically unprepared.

Children don't mind talking about difficult subjects. They usually find it comforting when they see their parents calmly and directly confronting even the most serious events. When a parent asks questions like "What do you think would happen if Dad or Mom got sick and couldn't work anymore?" or "What would you do if there was a shooting in your school?" children learn that problems and their solutions can be anticipated.

STAGE TWO: RESPONDING TO THE TRAUMA

Obviously, the first step to take when children experience a trauma is to see if they have been physically harmed. Sometimes children may be able to tell you if they are in pain, but since shock is a common initial reaction to trauma, they might not be able to communicate even a serious problem, and an immediate medical examination may be required.

Depending on the type of trauma that has occurred, parents should next be concerned about their child's safety and psychological security. Shelter may have to be found and other steps taken to "normalize" a child's life as soon as possible. Above all, the family should be kept together and children should remain with their primary caretakers.

Experts advise parents to remember that normalization is a direction, not a destination. When a child's environment and routine go back to being predictable, this is a chance for healing to begin, but it may be many months and even years before it is complete. Parents should be aware of the many psychological symptoms that can indicate that a child is working through the effects of a trauma:

- refusal to return to school and "clinging" behavior, such as shadowing the mother or father around the house

- persistent fears related to the catastrophe, particularly fears about being permanently separated from the parents

- sleep disturbances, including nightmares or bed-wetting, that persist more than several days after the event

- irritability and loss of concentration

- behavior problems not typical for the child

- physical complaints (stomachaches, headaches, dizziness) for which a physical cause cannot be found

- withdrawal from family and friends, listlessness, decreased activity, preoccupation with the events of the trauma

STAGE THREE: EMOTIONAL HEALING

The emotional healing process begins after the child's outward routine has been reestablished. The exact nature of this healing will of course depend on the extent of the trauma. In every case, however, parents can help their child to be aware of her feelings and learn to communicate them effectively. Healing will also involve correcting misconceptions or distortions that children typically have about the event, such as self-blame. It will include empowering the child or adolescent so that she doesn't feel like a victim.

Emotional healing should also include educating family members and even close friends of the child who has been traumatized. Participation in self-help groups and exposure to inspirational literature can be useful for older children and teens. Most experts recommend a holistic approach to healing, which includes attention to diet, exercise, and other lifestyle habits, as well as to spiritual issues.

In the case of very serious trauma, or when a child has several different risk factors, counseling may also be indicated. Counseling focuses on building a relationship of trust with a traumatized child and helping her to express her feelings and conflicts in words, via symbolic play, or through one of the different art therapies. Counseling sessions may involve a symbolic reenactment of the traumatic event to help the child fully master her painful feelings and memories. Sometimes, if symptoms of fearfulness and anxiety are severe, medication is recommended.

This phase of emotional healing ends with the elimination or significant reduction of any psychological and physical symptoms. The child should once again have an age-appropriate sense of mastery and control. There should be an observable shift from a "victim" status to a "survivor" status, reflected in the way the child speaks and behaves. The child should once again be able to confront the normal developmental challenges of family, school, and friends.

STAGE FOUR: POST TRAUMA AWARENESS

It wasn't very long ago when clinicians thought that Post-Traumatic Stress Disorder (PTSD) was only an adult problem. Now we know that children and teens can suffer from the same disorder, unable to "put the trauma behind them." Symptoms of PTSD in children can come in many different shapes and forms, often mimicking other disorders. When children are diagnosed with PTSD, psychotherapy is usually recommended.

Many children don't develop the severe symptoms to warrant a diagnosis of PTSD, yet the trauma continues to have long-lasting effects on their development. As we shall see, there are many things parents can do in this stage to reduce the aftereffects of a trauma.
About the Author
Angela Abbette is an enthusiastic writer an avid user of the Parenting information found at uPublish.info Articles
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