Wednesday, November 23, 2005

Emotional First Aid

A School's Guide to Crisis Intervention
by Servio Carroll, Ed.S., NCSP, Crisis Intervention Team Sheridan (WY) School District No. 2
Overview
A crisis happens when one's coping mechanisms are overwhelmed by a situation. This inability to cope is a potentially dangerous situation because, as our stress levels rise, our excitability and impulsivity increase and our coping mechanisms and behavior options sharply decrease. Crises usually happen following large changes or losses in a person's life. Potential crisis situations are separation from meaningful relationships (like in death or divorce), flunking out of school, moving to a strange town, birth of a new child in the family, loss of security, loss of freedom, etc. Crises are normal occurrences in everyday lives and most people experience and successfully cope with these situations. The experience strengthens one's ability to handle future similar situations.
The ability to help people in distress is not the exclusive property of mental health professional. We have been successfully dealing with crises (both our own and our acquaintances') for many years, and have developed useful ways of dealing with these situations. Since in most cases we will encounter the distressed individual long before "professional" help is available, this Guide was created to give you the basics of Emotional First Aid. Don't be surprised if you find that some of the suggestions sound like "common sense."
Helping the Individual in Crisis
People in crisis act differently than normal. Depending on the crisis event and their coping ability, the changes may come about slowly, suddenly or be delayed. If you know the person in crisis, you will recognize they are not acting as usual, but be unsure as when to intervene. Most of us find this intervention uncomfortable and shy away from the person, with a wealth of rationalizations. Whether this is right or wrong, it's culturally accepted. However, shying away is much more difficult to do when an unexpected and sudden event takes place. ...and you are there! So what can you do to help bring equilibrium to the situation and help others regain their emotional balance?
1. Make Contact. It is important to make physical or emotional contact with the person in crisis. Depending on your relationship with the person, you might touch, shake or hold their hand, make eye contact, offer or accept a soda, cup of coffee, etc.
2. Suspend Judgment. When trying to understand the person in crisis it is helpful to listen in a special way that is listening without judging or placing expectations on the person. Since the person may be afraid of gossip, assure him that what is discussed will remain confidential. Some questions you might be asking yourself are: How does the person actually handle a crisis? Whom does she usually go to? What kind of supports does he have?
3. Clarify the Problem. People in crisis are often so nervous and disorganized that they are unable to be objective and define what the problem is. You may be able to help clarify the problem.
4. List Choices. A person in distress is often unable to see the alternatives available. You may be able to help the person list specific options available.
5. Encouragement. Sometimes a person in crisis will be "stuck" or "spinning their wheels," unable to make any progress. He might need encouragement to take some kind of action or to make a decision that would start the coping process again. This does not mean that you should make decisions for other people but that the person in crisis may need a little push to make her own decision.
6. Give Information. One of the most important services you can provide to many people is information on resources available in the community. Information about visiting nurses, legal aid, food cooperatives, YMCA, YWCA, social clubs, welfare, etc. if often unknown to many people. You can act as a link or advocate to these resources.
© 1998 National Association of School Psychologists, 4340 East West Highway, Suite 402, Bethesda MD 20814 301-657-0270.

Read more!

Cultural Perspectives on Trauma and Critical Response

Adapted by Kris Sieckert, NCSP, NEAT Central Region Facilitator
This article is a condensed version of Chapter 7 of the National Organization for Victim Assistance (NOVA) Community Response Team Training Manual. It was written by Kris Sieckert with the permission of Dr. Marlene Young, NOVA Executive Director.
Using the American Heritage Dictionary of the English Language to define culture, we find the following: "The totality of socially transmitted behavior patterns, arts, beliefs, institutions and all other products of human work and thought characteristic of a community or population." In other words, cultures are a means for sharing wisdom and skills that are necessary to the survival of the community, the individual and the community area of humanity. Therefore, our culture shapes how we identify and interpret the threat of traumatic events and how we manifest our distress in response to these events.
Cultural IdentitiesIt is important that crisis responders attempt to understand their own cultural identities as they reach out to serve others. NOVA identifies the following as sources of cultural identities:
Nationality ReligionIncome AgeEducation Sexual OrientationRural/Urban Mental/Physical AbilitiesGender ProfessionEthnicity "Location in Life"
NOVA also identifies the following concepts and attitudes shaped by culture:
Birth CommunitarianismMarriage AmbitionDeath AcquisitionsMale/Female PowerLanguage/Dialect WealthSpirituality ChildrenIndividualism ElderlyHomosexuality Dress"Differentness"
Crisis responders are encouraged to use the lists to identify important sources of cultural identity in their lives, to initially access the cultural backgrounds of individual victims or groups they serve, and to find significant commonalities in order to establish a basis of communication.
Interpreting Traumatic EventsCulture influences what type of threat is perceived as traumatic and how we interpret the meaning of the traumatic event. Culture also influences how individuals and communities express traumatic reactions. While reactions to trauma seem to be common throughout all cultures and based in the physiology of human beings, manifestations of responses may differ significantly. Culture forms a context through which the traumatized individuals or communities view and judge their own response. If people think that the society around them will not accept them as victims, there is a tendency to withdraw and be silent. Culture may affect the response of immediately "non-traumatized to trauma" and the traumatized. This is a critical issue for many people who are victims. Their own culture or the culture in which they exist may reject or stigmatize them and may be perceived as an additional injury. Cultures may help define healthy pathways to new lives after trauma. The routines and traditions may aid survivors of a tragedy in feeling re-oriented or rendering life predictable.Trauma and culture are particularly complicated today. Multiple identifications require complex reasoning for negotiating the environment. With an increase in life stress and a decrease in the capacity to screen and moderate the impact of a trauma, cultural traumas can be transmitted across time and generation as a bond for survival.
Accommodating and Integrating Cultural StandardsPrior to cross-cultural work, education is needed about a culture's routines, traditions and impact of family relationships. Be prepared to accommodate and integrate such cultural standards into crisis response work. Attention should be paid to the following issues:
Geography, climate and environmentHistory of a cultureLanguage of cultureRoutines and rituals of culture
No matter what the preconditions to introduction to other cultures, caregivers should be prepared to convey respect and good will:
Say "Hello" and request the opportunity to talk with people.
Acknowledge differences and apologize for discrepancies between your behaviors and the people with whom you are talking.
Be aware of your own cultural biases and try to be non-judgmental with those with whom you interact.
Always say "please" and "thank you" when appropriate; always request permission to do things.
Protocol for Crisis Work Across CulturesOrientation to caregiving interventions:• Participate in access rituals. These often involve ceremony, food and expressions of good will.
• Explain purpose of intervention and the need for reciprocal questions. Many cultures find questions intrusive. Yet, for the caregiver, they may be essential in the establishment of understanding. Questions and answers are often the only way to clarify differences in language, customs and unconscious behaviors.
• Express an appreciation and respect for the culture's strengths in coping with trauma. Every culture has means to deal with trauma and can explain those means. Their understanding of trauma and its implications is inherent in their eventual integration of a tragedy into their lives.
• Express a willingness to learn about the ethnic group involved. One method to convey this is to ask, "If I were a victim of this trauma, how would you expect me to deal with it?"
• Acknowledge your limitations and differences. These may include the inability to speak or understand the language, confusion over certain customs or rituals or spiritual understandings.
• Establish your competence in understanding trauma's impact whether or not you understand the traumatic impact of an event or the meaning of that impact.
Practical Problems:• Deal with immediate environmental problems such as financial loss, secure shelter, family conflict, etc. that the individual is having difficulty handling by himself.
• Build trust.
• Assist the survivors or victims with financial resources or compensation, if possible.
• Help the survivors focus on something tangible that they can accomplish over the next few days.
Crisis Intervention with Cultural Focus:• Search for the meaning of suffering and pain relevant to the dominant cultural group involved.
• Search for the meaning of death in the culture.
• Search for the meaning of life in the culture.
• Make an effort to acknowledge your limitations with language or other communication concerns, and ask the survivors to tell you if you say something wrong or do something offensive.
• Ask survivors to tell their story and talk to them about the crisis reaction.
• Ask survivors if their families should be present during discussions or if they would like to have clergy members present.
• Ask survivors if they would like to go to a place of worship or if there are any ceremonies or rituals that are particularly directed at crisis in their culture.
• Ask survivors to describe what they would like you to do to be of assistance to them and then tell them truthfully what you can or can't do.
• Useful cross-cultural interventions include: reduction of isolation, relaxation techniques, meditation, education about crisis in culturally relevant terms, helping individuals to develop control, increase self-esteem and self-regulation.
• Be aware of culturally specific communication techniques such as the use of eye contact, the integration of food and drink in discussions, the pace of conversation, body language and so forth.
Hints for Helping:• Dress appropriately: Men should wear suits and women should wear dresses in most cultures. An outside team of crisis responders may convey their respects through respectful clothes.
• Establish commonality with survivors through access rituals and mutual interests: Eat what is offered; drink what is offered. Ask about family, friends, pets, plants and loved ones.
• Search for linguistic equivalency even if you do not know the language of the culture.
• Greet and say good-bye to survivors in their own language.
• Allow survivors to direct you through cultural protocols and follow their directions.
• Participate in defined ritual, as allowed or requested.
• Apologize when you do something wrong.
• Clearly define your objectives and give references of specific other situations that are similar to this one in which you were helpful.
• Find out and use appropriate body language.
• Bring a gift of commemoration.
• Be aware of spiritual beliefs in the culture.
• Ensure that written communications are either in the appropriate language or are linguistically and structurally correct to facilitate translation.SourceYoung, M. (1998). Community response team training manual (second edition). NOVA: Washington, DC.

Read more!

Helping Children Cope with Loss, Death and Grief:Response to a National Tragedy

The security and safety that was a hallmark of our American society was shattered by the events of September 11th. Never before in our nation’s history have so many lives been lost in a single day. Communities are impacted by multiple losses that stretch their capacities to cope. It is difficult to predict how students, adults and schools will be able to deal with the harsh realities of life in the coming weeks, months and years. Children who have experienced the loss of one or both parents, siblings, other relatives, friends, or neighbors are now suffering from profound grief. How can caring adults help these children deal with loss of this magnitude? How can we begin to understand and respond to the depths of their suffering? One thing we do know is that this will be an extremely difficult and painful task. Children and adolescents will need all the support they can get and they will require a long time to recover. Life may not be the same for anyone in this country, but those youngsters who have sustained personal losses may require significant assistance from trained, caring adults.
Expressions of Grief
Talking to children about death must be geared to their developmental level and their capacity to understand the related facts of the situation. Children will be aware of the reactions of significant adults as they interpret and react to information about death and tragedy. The range of reactions that children display in response to the death of significant others may include:
Emotional shock and at times an apparent lack of feelings, which serve to help the child detach from the pain of the moment;
Regressive (immature) behaviors, such as needing to be rocked or held, difficulty separating from parents or significant others, needing to sleep in parent’s bed or an apparent difficulty completing tasks well within the child’s ability level;
Explosive emotions and acting out behavior that reflect the child’s internal feelings of anger, terror, frustration and helplessness. Acting out may reflect insecurity and a way to seek control over a situation for which they have little or no control;
Asking the same questions over and over, not because they do not understand the facts, but rather because the information is so hard to believe or accept. Repeated questions can help listeners determine if the child is responding to misinformation or the real trauma of the event.
Helping Children Cope
The following tips will help teachers and parents support children who have experienced the loss of parents or loved ones. Some of these recommendations come from Dr. Alan Wolfelt, Director of the Center for Loss and Life Transition in Fort Collins, Colorado.
· Allow children to be the teachers about their grief experiences: Give children the opportunity to tell their story and be a good listener.
· Don’t assume that every child in a certain age group understands death in the same way or with the same feelings: All children are different and their view of the world is unique and shaped by different experiences. (Developmental information is provided below.)
· Grieving is a process, not an event: Parents and schools need to allow adequate time for each child to grieve in the manner that works for that child. Pressing children to resume "normal" activities without the chance to deal with their emotional pain may prompt additional problems or negative reactions.
· Don’t lie or tell half-truths to children about the tragic event: Children are often bright and sensitive. They will see through false information and wonder why you do not trust them with the truth. Lies do not help the child through the healing process or help develop effective coping strategies for life’s future tragedies or losses.
· Help all children, regardless of age, to understand loss and death: Give the child information at the level that he/she can understand. Allow the child to guide adults as to the need for more information or clarification of the information presented. Loss and death are both part of the cycle of life that children need to understand.
· Encourage children to ask questions about loss and death: Adults need to be less anxious about not knowing all the answers. Treat questions with respect and a willingness to help the child find his or her own answers.
· Don’t assume that children always grieve in an orderly or predictable way: We all grieve in different ways and there is no one "correct" way for people to move through the grieving process.
· Let children know that you really want to understand what they are feeling or what they need: Sometimes children are upset but they cannot tell you what will be helpful. Giving them the time and encouragement to share their feelings with you may enable them to sort out their feelings.
· Children will need long-lasting support: The more losses the child or adolescent suffered, the more difficult it will be to recover. This is especially true if they lost a parent who was their major source of support. Try to develop multiple supports for children who suffered significant losses.
· Keep in mind that grief work is hard: It is hard work for adults and hard for children as well.
· Understand that grief work is complicated: When death results from a terrorist act, this brings forth many issues that are difficult, if not impossible, to comprehend. Grieving will also be complicated by a need for vengeance or justice and by the lack of resolution of the current situation: Perpetrators may still be at large and our nation is at war. The sudden nature of death and the fact that many individuals were considered missing rather than dead further complicates the grieving process.
· Be aware of your own need to grieve: Focusing on the children in your care is important, but not at the expense of your emotional needs. Adults who have lost a loved one will be far more able to help children work through their grief if they get help themselves. For some families, it may be important to seek family grief counseling, as well as individual sources of support.
Developmental Phases in Understanding Death
It is important to recognize that all children are unique in their understanding of death and dying. This understanding depends on their developmental level, cognitive skills, personality characteristics, religious or spiritual beliefs, teachings by parents and significant others, input from the media, and previous experiences with death. Nonetheless, there are some general considerations that will be helpful in understanding how children and adolescents experience and deal with death.
Infants and Toddlers: The youngest children may perceive that adults are sad, but have no real understanding of the meaning or significance of death.
Preschoolers: Young children may deny death as a formal event and may see death as reversible. They may interpret death as a separation, not a permanent condition. Preschool and even early elementary children may link certain events and magical thinking with the causes of death. As a result of the World Trade Center disaster, some children may imagine that going into tall buildings may cause someone’s death.
Early Elementary School: Children at this age (approximately 5-9) start to comprehend the finality of death. They begin to understand that certain circumstances may result in death. They can see that, if large planes crash into buildings, people in the planes and buildings will be killed. However, they may over-generalize, particularly at ages 5-6 - if jet planes don’t fly, then people don’t die. At this age, death is perceived as something that happens to others, not to oneself or one’s family.
Middle School: Children at this level have the cognitive understanding to comprehend death as a final event that results in the cessation of all bodily functions. They may not fully grasp the abstract concepts discussed by adults or on the TV news but are likely to be guided in their thinking by a concrete understanding of justice. They may experience a variety of feelings and emotions, and their expressions may include acting out or self-injurious behaviors as a means of coping with their anger, vengeance and despair.
High School: Most teens will fully grasp the meaning of death in circumstances such as the World Trade Center or Pentagon disasters. They may seek out friends and family for comfort or they may withdraw to deal with their grief. Teens (as well as some younger children) with a history of depression, suicidal behavior and chemical dependency are at particular risk for prolonged and serious grief reactions and may need more careful attention from home and school during these difficult times.
Tips for Children and Teens with Grieving Friends and Classmates
Many children and teens have been indirectly impacted by the terrorists’ attacks. They have learned of the deaths of people close to their friends and classmates - parents, siblings, other relatives and neighbors. Particularly in areas near the World Trade Center or Pentagon, it is not unusual to find several children in a given classroom who lost a family member - or even multiple family members. Additionally, all over the country, children have been impacted by the death of a family member at either the attack site or on board one of the four hijacked planes. Seeing their friends try to cope with such loss may scare or upset children who have had little or no experience with death and grieving. Some suggestions teachers and parents can provide to children and youth to deal with this "secondary" loss:
Particularly with younger children, it will be important to help clarify their understanding of death. See tips above under "helping children cope."
Seeing their classmates’ reactions to loss may bring about some fears of losing their own parents or siblings. Children need reassurance from caretakers and teachers that their own families are safe. For children who have experienced their own loss (previous death of a parent, grandparent, sibling), observing the grief of a friend can bring back painful memories. These children are at greater risk for developing more serious stress reactions and should be given extra support as needed.
Children (and many adults) need help in communicating condolence or comfort messages. Provide children with age-appropriate guidance for supporting their peers. Help them decide what to say (e.g., "Steve, I am so sorry about your father. I know you will miss him very much. Let me know if I can help you with your paper route...") and what to expect (see "expressions of grief" above).
Help children anticipate some changes in friends’ behavior. It is important that children understand that their grieving friends may act differently, may withdraw from their friends for a while, might seem angry or very sad, etc., but that this does not mean a lasting change in their relationship.
Explain to children that their "regular" friendship may be an important source of support for friends and classmates. Even normal social activities such as inviting a friend over to play, going to the park, playing sports, watching a movie, or a trip to the mall may offer a much needed distraction and sense of connection and normalcy.
Children need to have some options for providing support - it will help them deal with their fears and concerns if they have some concrete actions that they can take to help. Suggest making cards, drawings, helping with chores or homework, etc. Older teens might offer to help the family with some shopping, cleaning, errands, etc., or with babysitting for younger children.
Encourage children who are worried about a friend to talk to a caring adult. This can help alleviate their own concern or potential sense of responsibility for making their friend feel better. Children may also share important information about a friend who is at risk of more serious grief reactions.
Parents and teachers need to be alert to children in their care who may be reacting to a friend’s loss of a loved one. These children will need some extra support to help them deal with the sense of frustration and helplessness that many people are feeling at this time.
Resources for Grieving and Traumatized Children
At times of severe stress, such as the trauma of the terrorist attacks on our country, both children and adults need extra support. Children closest to this tragedy may very well experience the most dramatic feelings of fear, anxiety and loss. They may have personally lost a loved one or know of friends and schoolmates who have been devastated by these treacherous acts. Adults need to carefully observe these children for signs of traumatic stress, depression or even suicidal thinking, and seek professional help when necessary.
Resources to help you identify symptoms of severe stress and grief reactions are available at the National Association of School Psychologist’s website - www.nasponline.org.

Read more!

Children and Fear of War and Terrorism

Tips for Parents and Teachers
National Association of School Psychologists
Terrorist attacks in our country and threats or realities of war are frightening experiences for all Americans. Children may be especially fearful that threatened or actual military action overseas will result in more personal loss and violence here at home. Because repeated scenes of destruction of lives and property are featured in the news media, they understand that “enemies of the United States” can cause harm in this country.
Adults need to help children feel safe at a time when the world seems to be a more dangerous place. Parents and teachers in particular must help youngsters understand current events factually, how events do or do not impact their lives, and how to handle their emotional reactions. The degree to which children are affected will vary depending on personal circumstances. Children who have suffered a personal loss from, or had firsthand exposure to, terrorist acts or military actions will be much more vulnerable. Also at greater risk are children whose parents are in the military or in active duty in the reserve forces, and those children whose parents are involved in emergency response or public safety.
All children, however, are likely to be affected in some way by war or terrorism involving our country. For many, the guidance of caring adults will make the difference between being overwhelmed and developing life-long emotional and psychological coping skills. Teachers and caretakers can help restore children’s sense of security by modeling calm and in-control behavior. It is crucial to provide opportunity for children to discuss their concerns and to help them separate real from imagined fears. It is also important to limit exposure to media coverage of violence.
Emotional Responses
Emotional responses vary in nature and severity from child to child. Nonetheless, there are some similarities in how children (and adults) feel when their lives are impacted by war or the threat of war:
Fear: Fear may be the predominant reaction--fear for the safety of those in the military as well as fear for their own safety. Children's fantasies of war may include a mental picture of a bomb being dropped on their home. While their worries are probably exaggerated, they are often based on real images of terrorist attacks or war scenes. When children hear rumors at school and pick up bits of information from television, their imaginations may run wild. They may think the worst, however unrealistic it may be. Any publicized threat of war or terrorism close to home may also add to their fear.
Loss of control: Military actions are something over which children--and most adults--have no control. Lack of control can be overwhelming and confusing. These feelings were experienced by most people in the immediate aftermath of the terrorist attacks. Children may grasp at any control that they have, including refusing to cooperate, go to school, part with favorite toys, or leave their parents.
Anger: Anger is a common reaction. Unfortunately, anger is often expressed at those to whom children are closest. Children may direct anger toward classmates and neighbors because they can’t express their anger toward terrorists or countries with whom we are at war. Some children may show anger toward parents who are in the military, even to the extent that they do not want to write letters. Knowing that those who are involved in the military are volunteers only helps to justify anger. Patriotism and duty are abstract concepts, especially for younger children who are experiencing the concrete reality of separation from a loved one.
Loss of stability: War or military deployment interrupts routines. It is unsettling. Children can feel insecure when their usual schedules and activities are disrupted, increasing their level of stress and need for reassurance.
Isolation: Children who have a family member in the military, but who don't live near a military base, may feel isolated. Children of reserve members called to active duty may not know others in the same situation. Such children may feel jealous of friends' undisturbed families and may strike out at signs of normalcy around them. Another group of children who may feel isolated are dependents of military families who have accompanied a remaining parent back to a hometown or who are staying with relatives while both parents are gone. Not only do these children experience separation from parents, but they also experience the loss of familiar faces and surroundings.
Confusion: This can occur on two levels. First, children may feel confused about terrorist attacks and war, what further dangers might arise, and when the violence will stop. Second, children may have trouble understanding the difference between violence as entertainment and the real events taking place on the news. Today's children live in the world of Armageddon, Independence Day, Air Force One, and cartoon Super Heroes. Some of the modern media violence is unnervingly real. Youngsters may have difficulty separating reality from fantasy, cartoon heroes and villains from the government soldiers and real terrorists. Separating the realities of war from media fantasy may require adult help.
What Can Parents and Teachers Do?
Everyone, including adults, feels stressed during times of crisis and uncertainty. If your children or students seem to need help beyond what is normally available at home or school, seek mental health services in your community. School psychologists, counselors and social workers can help identify appropriate services and help with the referral process. For most children, adults can provide adequate support by the following actions:
Acknowledge children's feelings:
Knowing what to say is often difficult. When no other words come to mind, a hug and saying “This is really hard for you/us” will work. Acknowledge that you don’t like war either, but we hope that our military can stop the terrorists or help bring peace to other countries.
Try to recognize the feelings underlying children's actions and put them into words. Say something like, “I can see you are feeling really scared about this," or “It is hard to think that your dad had to go so far away to help our country, ” or “I know it will feel great when your mom comes home.”
Sometimes children may voice concern about what will happen to them if a parent does not return. If this occurs, try saying, “You will be well taken care of. You won't be alone. Let me tell you our plan.”
Some children will be afraid that the United States will be attacked. Tell them this is a real concern and life offers no absolute promises. Nonetheless, reassure them that our government has taken many steps to prevent attacks from terrorists and that the military conflict is very far away. For younger children, saying that you love them and will keep them safe is often sufficient. For older children, you can discuss specifics such as heightened security in airports and significant public buildings.
At times when your children or students are most upset, don't deny the seriousness of the situation. Saying to children, “Don't cry, everything will be okay," does not reflect how the child feels and does not make them feel better. Nevertheless, don't forget to express hope and faith that things will be okay.
Older children, in particular, may need help clarifying what they believe about war and the role of the United States in the specific conflict. Questions such as, "Could my parent shoot someone?" and “Are we killing innocent people in other countries?" are issues which may need discussion.
Always be honest with children. Share your fears and concerns while reassuring them that responsible adults are in charge.
Help children to feel personally safe:
Differentiate between terrorism and war. Our homes and schools are not at risk. Only a very few people in the world are terrorists. The war itself will be carried out far away.
Help children understand that precautions are being taken to prevent terrorism (e.g., bomb-sniffing dogs, passport checks, heightened airport security) or attacks on the United States. While these efforts might seem scary or frustrating to children, explain that these precautions might actually make them safer now than they were before.
Deal with fears such as the end of the world. Discuss what is realistic modern technology of war versus science fiction. If children are imagining Star Wars-type battles, help them to understand that even the most sophisticated weapons available are not capable of reaching distant targets as seen in the movies. Let children share their fears regarding war in our own country, most of which are unrealistic and a result of rumor and anxiety. Put these fears in perspective as to what is realistic.
Let children who are worried about a loved one know that the chance of returning from a war against terrorism is very high. Advances in medicine and technology have greatly reduced potential losses from military actions. Our military is very powerful and many other countries are helping us as they did in the Gulf War, during which the U.S. lost very few lives. Acknowledge that the loss of any life is sad, but that their individual family member is likely to be fine.
If participation in a faith community is part of your family life, talk to your faith leader about how to help your child think about the concepts of death and killing, in age-appropriate terms. This can be very important to calming children’s fears for their own safety and that of loved ones.
Try to maintain normal routines and schedules to provide a sense of stability and security.
Stop children from stereotyping people from specific cultures or countries. Children can easily generalize negative statements. Adding tolerance curriculum to school lessons during this time can help prevent harrassment of students and improve their sense of safety.
Help children maintain a sense of control by taking some action:
Send letters, cookies or magazines to those in the military and public safety jobs.
Help older children find a family who has a parent on active duty and arrange some volunteer babysitting times for that family or offer to provide meals occassionally.
If a family member is away, make plans for some special activities:
Gatherings with other families who have a loved one on active duty can help provide support for you as well as for your children.
Special parent and child times can provide an extra sense of security, which might be needed. Let your child know that you will set aside a particular half hour each day to play. Make the time as pleasant and child centered as possible. Return phone calls later and make your child the real focus of that special time.
Involve children in planning how to cope. Control and ownership are fostered when children help to plan strategies for dealing with a situation. Children often have practical and creative ideas for coping.
Pay special attention to children who may feel isolated:
Children who are new in school due to relocation may benefit from a special network of “friends” to help orient the student to new school routines and encourage participation in school activities.
Children who are one of a few with parents involved in the military may need extra attention to their feelings of separation and fear of loss.
Expect and respond to changes in behavior:
All children will likely display some signs of stress. Some immature, aggressive, oppositional behaviors are normal reactions to the uncertainty of this situation.
It is important to maintain consistent expectations for behavior. Be sure children understand that the same rules apply.
Some children may have difficulty at bedtime, particularly those whose parents are on active duty. Maintain a regular bedtime routine. Be flexible about nightlights, siblings sharing a room, sleeping with special toys, and sitting with your child as they fall asleep. Doing so typically does not cause life-long habits.
Children may play “war,” pretend to blow things up, or include images of violence in artwork and writing. This may be upsetting to adults under current circumstances, but it is a normal way for children to express their awareness of events around them. Gently redirect children away from violent play or efforts to “replay” the terrorist attacks, but don’t be overly disapproving unless the play is genuinely aggressive. Talk with children about their art or written images and how they feel. Share your reactions. Help them to consider the consequences of war or terrorist acts—what happens if a building blows up or a bomb explodes? For children who seek pretend play as an outlet, encourage role playing of the doctors, firemen, policemen, etc. who have helped to save lives. If a child seems obsessed with violent thoughts or images for more than a few days, talk to a mental health professional.
Some children may be at increased risk of suicide because of their emotional reaction to increased stress and any pre-existing mental health problems. Consult a mental health professional immediately if your child shows signs of suicidal thinking or talk, or other self- destructive behaviors. (See www.nasponline.org for information about helping suicidal children.)
Extra support, consistency, and patience will help children return to routines and their more usual behavior patterns. If children show extreme reactions (aggression, withdrawal, sleeping problems, etc.), talk to your school psychologist regarding the symptoms of severe stress disorders and the possible need for a referral to a mental health agency.
Keep adult issues from overwhelming children:
Don't let your children focus too much of their time and energy on this crisis. If children are choosing to watch the news for hours each evening, find other activities for them. You may also need to watch the news less intensely and spend more time in alternative family activities.
Know the facts about developments in the war and protections against terrorism at home. Don’t speculate. Be prepared to answer your children’s questions factually and take time to think about how you want to frame events and your reactions to them.
Try not to let financial strains be a major concern of children. Although the economic impact of the terrorist attacks and resulting military action may result in job cutbacks, or going from a civilian job to active duty in the military may cut family income, children are not capable of dealing with this issue on an ongoing basis. Telling children that you need to be more careful with spending is appropriate, but be cautious about placing major burdens on children.
Take time for yourself and try to deal with your own reactions to the situation as fully as possible. This, too, will help your children and students.
Coordinate between school and home:
Parents and other caregivers need to let school personnel know if a family member is being called to active duty or sent overseas. Tell your child’s teacher if he or she is having difficulties and what strategies make your child feel better. If necessary, seek the help of your school psychologist, counselor or social worker.
Teachers should let parents know if their child is exhibiting stress in school. Provide parents with helpful suggestions or information on community resources. Maintain general academic and behavioral expectations, but be realistic about an individual child’s coping skills.
Teachers should share with parents information about social studies/history lessons and other relevant discussions that take place in the classroom. This will help parents understand what their children are learning and can foster thoughtful discussion at home.
Invite parents with relevant professional experience to come to school to talk about their jobs, in age appropriate terms, and how their skills contribute to the war effort or safety at home.
Create a sense of collective security between home and school. This will help children feel safe and provide a sense of protection.
Resources
There are many organizations and agencies with helpful information about helping children and families cope with the stress of war, terrorism and other crises:
American Psychological Association www.apa.org
National Association of School Psychologists www.nasponline.org
National Center for Post Traumatic Stress Disorder www.ncptsd.org/facts/specific/fs_children.html

Read more!

Managing Strong Emotional Reactions to Traumatic Events

Tips for Parents and Teachers
Our society has been plagued by a number of traumatic events in recent years—schoolyard shootings, the Oklahoma City bombing, floods and tornadoes, and the terrorist attacks of September 2001. When a large-scale tragedy occurs, it can cause strong and deeply felt reactions in adults and children. How adults express their emotions will influence the reactions of children and youth. Parents and teachers can help youngsters manage their feelings by both modeling healthy coping strategies themselves and closely monitoring their own emotional state and that of the children in their care.
Common Reactions to Trauma
It is not uncommon to feel any or all of the following:
Shock/disbelief
Fear
Guilt
Grief
Confusion
Shame/loss
Anger
These reactions are often closely linked and can be difficult to separate, (e.g., where does grief end and outrage begin). Children, in particular, may have trouble understanding and talking about their feelings. Emotional reactions take place over a period of time and may not happen in any particular order. They can affect our behavior, our ability to function, and our overall sense of well-being. The intensity and ways we express our reactions will vary depending on our personal experience, general mental health, other stress factors in our lives, our coping style, our ability to self-monitor our emotional state, and our support network. This is true for both adults and children. Children of all ages may need guidance and support from the significant adults in their lives (parents, teachers, coaches, etc.) as they work through their thoughts and emotional reactions to the event.
Anger: A Natural Reaction
For many people, adults and children alike, anger will be a natural extension of other emotions because it is a defensive mechanism that makes us feel more in control. As well, anger with the perpetrators of these horrible acts is, in many ways, justified. The desire to “retaliate” can be strong—but quite harmful if not redirected to a positive outlet. In some situations, a significant factor in the expression of anger is the lack of a concrete “enemy” on which to focus our feelings. As long as there is doubt about the identity of the perpetrators and a lack of closure, or when the trauma is a natural disaster, anger and other strong emotions have no specific target. Such situations can lead to more inappropriate expressions. Adults must ensure that children do not “take out” their anger in inappropriate ways, such as lashing out at classmates or neighbors who might be unfairly associated with the perpetrators of violence because of their ethnicity or other affiliations. The key is to direct anger and other strong emotions in socially and psychologically healthy ways.
Recognizing Anger
The first step in helping children manage their anger is getting your anger under control. Be aware of cues in your own behavior. If necessary, ask someone you trust (a family member, friend or colleague) to give you feedback on your anger reaction. Observe the behavior of other adults around you and your child(ren) and be supportive if they show signs of increased anger.
Signs of Anger in Adults
Short temper/impatience.
Sleep problems.
Eating problems.
Restlessness and agitation.
Hitting and slamming objects, pets, or people.
Desire to inflict harm.
Verbal outbursts toward family, friends, or fellow workers.
A sense of losing control over your life.
Poor concentration or attention span.
Obsessing about the event.
Physical health affected; increase in blood pressure, dizzy, headaches, heart rate elevated, clenched jaw, knot in the stomach, and tight muscles, etc.
You feel life should be fair, but it is not; and things are not how you want them to be.
Signs of Anger in Children
Behavioral outbursts, many times without an obvious cause.
Sleep problems.
Fights at school or home.
Physical attacks on others or animals, even among pre-schoolers.
Disobedience from otherwise well behaved child(ren).
Child state he/she is really sad and does not know why.
Complaints of stomachaches and headaches; or vague aches and pains.
Other reactions similar to those of adults.
Dealing with Anger
Some people have more problems than others dealing with anger. They either try to deny or ignore their feelings and keep them inside, or overreact and “blow-up.” These negative coping strategies can be physically and emotionally unhealthy. Pretending we don’t feel badly can have long-term affects that may eventually cause us to “lose it.” Conversely, psychological research shows that acting out your anger will not relieve it, but instead will make it more intense. We can learn to control or diffuse anger by how we think about the event or people involved and by finding other ways to regain our sense of control and security. Anger can also mask other emotions, such as grief, loss, or fear. It is important to address these related emotions as a way to deal with angry feelings.
Controlling Your Anger
Admit you are angry.
Recognize this is a common reaction to an overwhelming event. It is how you control and manage your reaction that makes the difference.
Try to identify the related emotions that may be fueling your anger, (e.g., sorrow, fear.)
Find appropriate outlets for these related and equally important emotions, (e.g., talk with family members or friends, seek grief counseling, get involved in activities to help victims, etc.)
Understand that it not just the actual event that drives your anger, but how you think about it.
Develop a “positive” outlook and look for what can be done to help rather than harm.
Stop, take a deep breath, visualize something peaceful or enjoyable, and try to relax for a few minutes.
Avoid/decrease negative ways to cope, such as misuse of alcohol or drugs.
Find an acceptable outlet, such as exercise, getting involved with your favorite hobby, sports.
Distract yourself from continuing to think about the event -- call a friend, go to a movie.
Keep a sense of humor.
Turn off the TV and radio; play your favorite music.
Keep to your daily routines.
Consult your doctor or a mental health specialist if your reactions continue to intensify, or you feel like doing harm to yourself or others.
If you are seeing a mental health professional, be sure to share your angry feelings with him or her.
Helping Children Control Anger
Realize they will imitate your responses and reactions.
Let them understand anger is a normal emotion under these circumstances that can even include feelings of revenge. However, acting out anger, hurting others, and uncontrolled anger is not okay.
Answer their questions honestly and openly; but on their level of understanding based on age.
Make family time to talk to the child(ren) about their reaction to the events.
Have child(ren) come up with ideas on how to help those who have been injured, left homeless, or otherwise effected by the tragedy.
Teach them to stop, take a deep breath, and imagine a restful scene or enjoyable activity for a few minutes as a way to relax.
Turn off the TV and make sure violence in the media is restricted or monitored.
Try to understand and encourage children to talk about their fears/sense of loss.
Try to help them see how they would feel if someone hurt, yelled at, or hit them.
Sports, exercise, or other physical activity can be quite helpful.
Be flexible in discipline and monitor your reactions to their misbehaviors.
Seek mental health or physician consultation if these reactions do not clear up after 30 days.
Keep family and school routines; get back to a normal life schedule as soon as possible.
If age permits, get the child involved in volunteer work or community service, such as the Red Cross or Animal Shelter, where a child can feel that he/she is making a difference.
Warning Signs of Serious Emotional Trauma
While strong emotional reactions to tragic events are normal, most will fade over the following weeks and most children soon will be able to resume normal activities with minimal displays of anger or anxiety. However, if any of the following symptoms or behaviors continue beyond a few weeks, or if any of these symptoms are exhibited to such a degree that it severely impacts the child’s ability to participate in school or home activities, parents and teachers should seek mental health services for evaluation and possible treatment.
Disruption in peer relationships (little or no interactions with friends, significant increase in conflict with classmates or friend).
Strained family relationships (high degree of misbehavior, lashing out against family members, refusal to participate in normal family routines).
Significant decrease in school performance.
Ongoing physical complaints with no apparent cause.
Use of chemicals, alcohol (or increase in comparison to previous behavior).
Repeated nightmares and reporting strong fears of death, violence, etc.
Repetitive play re-enacting the traumatic events.
Low self esteem, negative talk about self (if this was not apparent prior to the trauma).
General lack of energy and lack of interest in previously enjoyed activities.
Parents and teachers can help children overcome traumatic effects of a tragedy or disaster and use the process as an opportunity to teach them how to cope more effectively and deal with new challenges. (Interestingly, the Chinese sign for “crisis” is two symbols – “Danger” and “Opportunity.”) Depending on the scope of the event, the process may take time and patience and the willingness to reach out to friends, neighbors, and co-workers to lend mutual support.

Read more!

A National Tragedy: Helping Children Cope

Tips for Parents and Teachers
Whenever a national tragedy occurs, such as terrorist attacks or natural disasters, children, like many people, may be confused or frightened. Most likely they will look to adults for information and guidance on how to react. Parents and school personnel can help children cope first and foremost by establishing a sense of safety and security. As more information becomes available, adults can continue to help children work through their emotions and perhaps even use the process as a learning experience.
All Adults Should:
1. Model calm and control. Children take their emotional cues from the significant adults in their lives. Avoid appearing anxious or frightened.
2. Reassure children that they are safe and (if true) so are the other important adults in their lives. Depending on the situation, point out factors that help insure their immediate safety and that of their community.
3. Remind them that trustworthy people are in charge. Explain that the government emergency workers, police, firefighters, doctors, and the military are helping people who are hurt and are working to ensure that no further tragedies occur.
4. Let children know that it is okay to feel upset. Explain that all feelings are okay when a tragedy like this occurs. Let children talk about their feelings and help put them into perspective. Even anger is okay, but children may need help and patience from adults to assist them in expressing these feelings appropriately.
5. Observe children’s emotional state. Depending on their age, children may not express their concerns verbally. Changes in behavior, appetite, and sleep patterns can also indicate a child’s level of grief, anxiety or discomfort. Children will express their emotions differently. There is no right or wrong way to feel or express grief.
6. Look for children at greater risk. Children who have had a past traumatic experience or personal loss, suffer from depression or other mental illness, or with special needs may be at greater risk for severe reactions than others. Be particularly observant for those who may be at risk of suicide. Seek the help of mental health professional if you are at all concerned.
7. Tell children the truth. Don’t try to pretend the event has not occurred or that it is not serious. Children are smart. They will be more worried if they think you are too afraid to tell them what is happening.
8. Stick to the facts. Don’t embellish or speculate about what has happened and what might happen. Don’t dwell on the scale or scope of the tragedy, particularly with young children.
9. Keep your explanations developmentally appropriate. Early elementary school children need brief, simple information that should be balanced with reassurances that the daily structures of their lives will not change. Upper elementary and early middle school children will be more vocal in asking questions about whether they truly are safe and what is being done at their school. They may need assistance separating reality from fantasy. Upper middle school and high school students will have strong and varying opinions about the causes of violence and threats to safety in schools and society. They will share concrete suggestions about how to make school safer and how to prevent tragedies in society. They will be more committed to doing something to help the victims and affected community. For all children, encourage them to verbalize their thoughts and feelings. Be a good listener!
10. Monitor your own stress level. Don’t ignore your own feelings of anxiety, grief, and anger. Talking to friends, family members, religious leaders, and mental health counselors can help. It is okay to let your children know that you are sad, but that you believe things will get better. You will be better able to support your children if you can express your own emotions in a productive manner. Get appropriate sleep, nutrition, and exercise.
What Parents Can Do
1. Focus on your children over the week following the tragedy. Tell them you love them and everything will be okay. Try to help them understand what has happened, keeping in mind their developmental level.
2. Make time to talk with your children. Remember if you do not talk to your children about this incident someone else will. Take some time and determine what you wish to say.
3. Stay close to your children. Your physical presence will reassure them and give you the opportunity to monitor their reaction. Many children will want actual physical contact. Give plenty of hugs. Let them sit close to you, and make sure to take extra time at bedtime to cuddle and to reassure them that they are loved and safe.
4. Limit your child’s television viewing of these events. If they must watch, watch with them for a brief time; then turn the set off. Don’t sit mesmerized re-watching the same events over and over again.
5. Maintain a “normal” routine. To the extent possible stick to your family’s normal routine for dinner, homework, chores, bedtime, etc., but don’t be inflexible. Children may have a hard time concentrating on schoolwork or falling asleep at night.
6. Spend extra time reading or playing quiet games with your children before bed. These activities are calming, foster a sense of closeness and security, and reinforce a sense of normalcy. Spend more time tucking them in. Let them sleep with a light on if they ask for it.
7. Safeguard your children’s physical health. Stress can take a physical toll on children as well as adults. Make sure your children get appropriate sleep, exercise, and nutrition.
8. Consider praying or thinking hopeful thoughts for the victims and their families. It may be a good time to take your children to your place of worship, write a poem, or draw a picture to help your child express their feelings and feel that they are somehow supporting the victims and their families.
9. Find out what resources your school has in place to help children cope. Most schools are likely to be open and often are a good place for children to regain a sense of normalcy. Being with their friends and teachers can help. Schools should also have a plan for making counseling available to children and adults who need it.
What Schools Can Do
1. Assure children that they are safe and that schools are well prepared to take care of all children at all times.
2. Maintain structure and stability within the schools. It would be best, however, not to have tests or major projects within the next few days.
3. Have a plan for the first few days back at school. Include school psychologists, counselors, and crisis team members in planning the school’s response.
4. Provide teachers and parents with information about what to say and do for children in school and at home.
5. Have teachers provide information directly to their students, not during the public address announcements.
6. Have school psychologists and counselors available to talk to students and staff who may need or want extra support.
7. Be aware of students who may have recently experienced a personal tragedy or a have personal connection to victims or their families. Even a child who has merely visited the affected area or community may have a strong reaction. Provide these students extra support and leniency if necessary.
8. Know what community resources are available for children who may need extra counseling. School psychologists can be very helpful in directing families to the right community resources.
9. Allow time for age appropriate classroom discussion and activities. Do not expect teachers to provide all of the answers. They should ask questions and guide the discussion, but not dominate it. Other activities can include art and writing projects, play acting, and physical games.
10. Be careful not to stereotype people or countries that might be associated with the tragedy. Children can easily generalize negative statements and develop prejudice. Talk about tolerance and justice versus vengeance. Stop any bullying or teasing of students immediately.
11. Refer children who exhibit extreme anxiety, fear or anger to mental health counselors in the school. Inform their parents.
12. Provide an outlet for students’ desire to help. Consider making get well cards or sending letters to the families and survivors of the tragedy, or writing thank you letters to doctors, nurses, and other health care professionals as well as emergency rescue workers, firefighters and police.
13. Monitor or restrict viewing scenes of the event as well as the aftermath.
For information on helping children and youth with this crisis, contact NASP at (301) 657-0270 or visit NASP’s website at www.nasponline.org. NASP represents 22,000 school psychologists and related
professionals throughout the United States and abroad. NASP's mission is to
promote educationally and psychologically healthy environments for all children
and youth by implementing research-based, effective programs that prevent problems,
enhance independence and promote optimal learning. This is accomplished through
state-of-the-art research and training, advocacy, ongoing program evaluation,
and caring professional service.//-->
Modified from material posted on the NASP website in September 2001.
© 2002, National Association of School Psychologists, 4340 East West Highway, Suite 402, Bethesda, MD 20814, (301) 657-0270, Fax (301) 657-0275; www.nasponline.org

Read more!

Tuesday, November 01, 2005

Psychology in Indonesia

The monumental moment for psychology in Indonesia was when Mr. Slamet Imam Santoso separated psychology from medical faculty in University of Indonesia. Since then psychology become an independent faculty, and Mr. Santoso was then well known as the father of psychology of Indonesia.

Psychology department which was located in Rawamangun has been shifted to The New Campus Depok.

Read more!