Crisis/Trauma

There seems to be a linear relationship between the proximity of the crisis and how much trauma you experience.

Duration of exposure and relationship to the crisis victim are also a significant factors.

The greater the initial reaction to a crisis, the greater the threat of long term trauma.

Some of the effects of a crisis can be observed in behaviours, such as:

• Exaggerated startle response
• Hyper-vigilance
• Increased irritability
• Sleep disturbance
• Disturbed memory and concentration

The perception of threat can be more important than the crisis event itself. So it is important as a professional to not only access the traumatizing factors, but also the subjective threat as experienced by the victim. The more negative the perceptions, the greater the trauma.

In the special case of children, their observations of extreme adult reactions can elevate their perception of the threat.

On the other hand, developmental immaturity may be a protective factor because the child may not understand the magnitude of the crisis.

There are both internal and external factors that effect someone’s resilience in a crisis.

Internal factors – have a more valuable long term influence than initial influence to a crisis:
• Coping style
• History of mental health
• Level of emotional self regulation
• Developmental level
• Trauma history
• Self-esteem
• Locus of control
• Religious belief systems

External Factors:
• Living with a nuclear family
• Parents who are caring, affectionate, and competent and demonstrate warmth, structure, high expectations, and guidance.

External Factors that Increase risk:
• Family violence.
• Family mental health issues
• Caregiver overreaction to trauma
• Poverty and or financial issues related to the trauma (breadwinner dies)

Social resources that promote resiliency:
• Close peer friendships.
• Access to positive adult role-models outside of the family.
• Strong connections to pro-social organizations.
• Positive school experiences.

Coping Strategies:

Active coping strategies include thoughts and actions that focus directly on the problems. (positive thinking, positive re-appraisal of the stressor, etc.)

Avoidance coping strategies are those that include thoughts and actions that focus away from a stressful situation. In extremely high stress situations, the initial response of avoidance may reduce the negative response arousal and give the person time to develop coping strategies.

Active coping strategies are associated with reduced incidents of mental health problems.

A history of mental illness can reduce resistance to crisis.

Because of temperament, some children are more prone to severe mental reactions, such as anxiety or stress, so they have more difficulty with the self regulation of emotion and they would most likely take longer to regroup in a crisis situation.

In terms of long term resilience, higher intellectual functioning has been found to be more helpful in that people are able to come up with coping strategies to deal with the issues.

A history of prior traumas increases future traumas.

It is difficult to observe if a child will be resilient after a crisis, but you can observe levels of self-esteem and competence, which are shown to contribute to reduced anxiety, conduct problems, etc. in relations to a crisis.

Crisis Interventions:

If you are observing a student fight –: appraise the situation, send a responsible student for help from the nearest adult. Calmly take charge in the following way: Announce your presence, call the fighting students by name. Don’t invade their personal space. Try humour. Don’t threaten with consequences, but instead, give them choices (you can go to the principal’s office or the nurse’s office). Remove the audience and continue to talk calmly, telling them to stop, and then when they stop, if adult assistance is available, physically separate them. Take them to the office and provide medical assistance if needed, and have the school administrator follow up with consequences.

If there happens to be a threatening person outside the building-: Call the police. Make an announcement with the warning signal. Direct custodians to quickly lock all outside doors, and alert security staff. Have an administrator walk cautiously through the halls to locate and direct students.

If gunshots are fired-: Direct all personnel to stay away from windows and doors. Keep faculty appraised of the situation. Lie down on the floor (Lights off, doors locked, etc.)
If outside, lie down and take shelter if possible. You want to avoid people running for and clustering about the school doors, as that makes them targets.

Case of a bomb threat-: The person receiving the calls tries to get information from the caller by remaining calm and asking “where is the bomb, what kind is it, when will it go off, why was it planted, who are you?” While trying to get that info, make note of characteristics (gender, accent, age, background noises, etc.). Schools must decide if they should evacuate. Consider: what is the recommendation of the police. What is the level of unrest and violence in the community? What is the nature of the information provided by the caller, and how credible is it? Weather – is this a crank call on a nice day.

In the case of a school evacuation, you should have pre-set evacuation procedures. These procedures should be reviewed every year. Every classroom should know where to go.

If there is a severe crisis, there are things which occur minute by minute and hour by hour:

In the first hour, the response team would be mobilized. The response team is likely to be made up of a crisis coordinator, a medical liaison, a media liaison, a parent-family liaison, a counseling liaison, and a campus liaison. The main tasks which need to be done in the first hour are: addressing the human safety needs and providing medical assistance. Summon help. Secure the crime scene. Contain the media. Verify the facts and provide a crisis fact sheet. Deliver the injury of death notifications. Communicate with parents and other family members.

In order to get help, you can use the National Organization for Victim Assistance (NOVA) 202.232.6682 http://trynova.org . NASP has NEAT (National Emergency Assistance Team) 301.657.0272 http://www.nasponline.org/NEAT/resources.htm

Stressful life events which make you less resilient:
Relocation
Death of a family member
Poverty
Being a victim of a crime
Serious illness
Suicidal ideation.

Grieving process stages:

• Denial
• Bargaining
• Anger
• Depression
• Acceptance.

In children, watch for: Night terrors, academic or behavioural regression, and fear of the future.

Caregiver’s phases in dealing with crises.

• Heroic phase (activities include search and rescue, assessment of damage, information gathering, immobilization of resources) Emotional reactions include Emotional numbness, uncertainty and fear, disbelief, denial, anger, self blame, delusions of invulnerability, increased heart rate, senses can become more acute, and over activity.
• Honeymoon phase (2-3 weeks to 3-6 months) Emotional reactions add digestion problems, headaches, changes in appetite, and inability to sleep. Activities which emerge: clean up and relief efforts – they become super-volunteers.
• Disillusionment phase (2 months to 1-2 years after event). Emotional reactions add Survivor’s guilt, isolation, intrusive thoughts, depression, crying, anger, apathy, repression, sleep disturbances, PTSD, increased injuries, psychosomatic illnesses, drug/alcohol use and abuse, social withdrawal. Activities in this phase characterize as a second disaster. People leave you alone. All the assistance goes away, lots of paperwork, lawsuits in cases, and you begin to think about rebuilding and restoring.
• Reconstruction stage (several years after the event). Emotional/physical reactions include estrangement, roll confusion, anger and frustration, moodiness, isolation and detachment, some resolution, psychosomatic illnesses, real illnesses (allergies, shortness of breath and chest pains, and ulcers). There are often long waits for additional assistance, insurance payoffs, lawsuit resolutions, and federal program approvals.

Filed under: EDC 510-511 Consultation in Schools and Practicum
Copyright: November, 2003 - David Profitt