Monday, October 5, 2009

Trauma in Our Lives, Part Two: Helping a Child Through a Trauma

It is estimated that in the United States approximately five million children experience some form of trauma each year. Car accidents, natural disasters, abuse, sudden deaths of loved ones, and exposure to community violence are examples of events that can impact children. Trauma does not just happen to one person; it touches family members, friends, and others involved in children’s lives. When something traumatic has happened to your child, there are things you can do to help facilitate recovery.

Guidelines for helping a child who has experienced a trauma:

Do not be afraid to talk about the traumatic event. When a child brings up the topic of what happened, don’t avoid it. Listen, provide support and nurturance, and answer questions honestly and to the best of your ability. It’s okay to say that you don’t know something (such as why the tornado hit your house, where people go when they die, etc.). Follow the child’s lead in discussing the event; stick to answering his or her specific questions and don’t address the topic unless your child is the one to initiate it. Be aware of your own reaction to the trauma and do not over react or appear out of control with your own emotions in front of your child. Verbalizing your own feelings of sadness, hurt, and anger is appropriate.

Create predictability and safety in your child’s daily routines. Imposing structure and patterns increases a child’s sense of safety and control throughout the day. Keep consistent times for regular activities such as meals, homework, play, and bedtime. If there are changes in the routine, give explanations for them. Keep promises you make to your child during a crisis time so he or she knows he can count on you.

Notify other adults in the child’s life about what has happened. It will be important that adults who interact with children on a regular basis (e.g., teachers, coaches, other parents, etc.) are aware of what your child has experienced. This helps others have more awareness and sensitivity and may allow greater tolerance of trauma-related behaviors that might otherwise wear on one’s patience.

Discuss your expectations for behavior. Make sure your child knows the rules at home and the consequences for breaking them. Be consistent in your discipline and focus on reinforcing positive behaviors. While it is good to be flexible at times, make sure you provide a clear rationale for any changes you make to consequences. It may be tempting to refrain from enforcing rules when your child has been through something traumatic, however, following through on consequences provides predictability, consistency, and the sense that you as the parent are in control; all three provide emotional comfort and safety.

Keep your child safe. Physical safety is one piece of this and emotional safety is another. Try to limit exposure to activities, events, and other reminders of the trauma, especially if you see your child’s symptoms increase during such activities. It’s okay to stop an activity if you see it is upsetting or retraumatizing your child.

Recognize the impact that the trauma has had on you. Sometimes parents experience the same traumatic event as their children, and in other cases parents feel the vicarious effects of trauma that has happened to their child. Feelings of helplessness, guilt, and sadness are common reactions of parents of traumatized children. Seek help from friends, family member, and/or professionals to cope with the painful emotions you have. Do not expect your child to take care of you as you deal with your own emotions. For example, do not keep your child home with you to assuage your own fear of separation from him or her. It is important to take care of yourself in order to be able to best help your child.

Know when to ask for help. Following a trauma, it is normal for children to show signs of distress. You may notice signs of disorganization, such as poor concentration and confusion. Some children begin to display behaviors that are characteristic of younger children, such as clinginess, loss of toileting, and general fearfulness. A child may reenact an event or themes relating to the event through play and artwork. Physical complaints are also common. Symptoms will usually become less severe after a few weeks, however, if the severity persists, consider consulting a mental health professional.

Dr. Jessica Bloomfield is a psychologist at Southeast Psych who specializes in treating trauma, as well as depression, anxiety, and a range of other issues.