Most children who have lived through frightening events recover with safety, steady care from adults they trust, routine and honest explanation, and are not helped by being made to retell what happened. Strong reactions in the first weeks are common and understandable, but distress that persists for weeks or stops a child from eating, sleeping, playing or being with others needs the most experienced help the community has.
A first orientation to helping children after disaster, loss or violence, written without clinical advice that this guide cannot source.
Children Are Not Simply “Resilient”, And Not Simply Damaged
Two simple stories are both wrong. “Children are naturally resilient and will bounce back” is used to justify doing nothing. “Trauma damages a child for life” is not what the research shows either. Studies of children in disasters, war and adversity (reviewed by Masten and Narayan, 2012, recalled) find that many children come through well and some do not, and that the biggest difference lies in what surrounds the child, above all a stable, responsive relationship with at least one adult. Resilience is something the community supplies, not something children carry unaided. See Stability as Medicine.
What Is Known To Help
A widely cited review of mass-trauma care (Hobfoll and colleagues, 2007, recalled) identified five principles supported by the evidence: promote safety, calm, a sense of efficacy (for self and community), connectedness, and hope. For children these translate into:
- A safe place and the presence of familiar adults
- Calm adults, since children read adult panic
- Small, real jobs that give a sense of ability
- Contact with family, friends, play and ordinary routine
- Honest hope: Honest Optimism
The World Health Organization’s guide to psychological first aid (2011, recalled) sums up first-line help as look, listen and link: notice who needs help, listen without pressing, and connect people with practical support.
What Does Not Help
Questioning children about the event, or making them tell it again and again, does not reliably help and may do harm. Single-session group “debriefing” of people soon after an event has not been shown to prevent PTSD and may harm some (recalled; the adult version is discussed in Group Processing Sessions). Let children talk, draw or play when they choose, and listen; do not push. Do not punish reactions, and do not tell them not to feel what they feel.
When To Look For More Help
Distress is common in the first weeks. Look for more help when distress continues for weeks and affects eating, sleep, play and friendships, when a child seems frozen or numb, when a child talks of wanting to die or hurts themselves, or when behaviour is dangerous. Clinical diagnosis is beyond this guide and there may be no clinician available; the aim is that the most experienced, steady person in the community takes the child’s difficulty seriously. See Trauma & PTSD Management Without Professional Help, Recognizing Trauma Responses and, for suicidal talk, When Grief Becomes Dangerous.
Where The Detail Is
- Signs in children of different ages: How Children Express Trauma
- The adult relationship and routine: Stability as Medicine
- What to say: Honest Communication at Each Age
- Bereavement: Grief in Children
Common Mistakes
- Taking a quiet child to be fine.
- Asking a child to repeat the worst moment.
- Telling a child to be brave.
- Forgetting the carers. A distressed caregiver cannot calm a child; see Processing Your Own Grief.
What’s Next
- Learn next: How Children Express Trauma
- Combine with: Preventing Re-Traumatization