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After a crisis, kids may need mental health ‘first aid’

Sad girl (age 10) reading a post on social media. Getty Images.

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(NewsNation) — Even children who are not directly impacted by a school shooting can be affected by the traumatic event — particularly as video and images stream across our TVs, social media sites and internet browsers.

“Younger kids may interpret seeing the images as if those things are continually recurring,” said Pamela Vona, co-founder of the Center for Safe & Resilient Schools and Workplaces.

Intervening shortly after the time the content is consumed won’t prevent trauma, but it can help children reduce stress and recover more effectively.

Think of it in a physical sense like a neck brace. It won’t necessarily heal a wound, but it helps stop damage from getting worse.

Experts say the people best poised to combat that anxiety are likely already in a child’s life: their teacher, a soccer coach, religious leader or parents.

One approach is called Psychological First Aid. It’s aimed at reducing stress, anxiety and fear children feel in the wake of crisis by teaching educators to build on the relationship they already have with students. 

It’s simple enough, parents can use it, too.

HOW IT WORKS

Psychological First Aid (PFA) is not designed to be an end-all solution, and it isn’t therapy. Instead, the goal is to help kids feel safe enough to keep learning — because missing school, even for a short period, can have long-lasting impacts.

“After many school shootings, literally hundreds of students do not come back to school,” said Dr. Marlene Wong, who helped develop PFA after the 9/11 attacks. “The scope of so many of these tragic incidents happening, children feel like they’re living in an environment of threat that if it can happen there, it can happen anywhere. … Those are children who could really benefit from Psychological First Aid.” 

Wong says kids may want to stay home more often than usual, and even if they are in class, they could be more disruptive than usual. It can show up as being withdrawn, or afraid to do simple tasks by themselves — like go to the bathroom. Kids will be particularly vulnerable if they can recognize themselves in a tragedy, especially if kids are the same race as those targeted, Wong said. 

“One of the primary hallmarks of any traumatic experience is a loss of power in that moment,” Vona said.

Teachers are often the first people to see these signs. 

The keys of PFA are simple: Focus on listening to the child, and make them feel safe. Ask: “What is the most difficult part of this for you?” 

“As long as you’re validating a student’s feelings, letting them know you’re available to them, being consistent and predictable in the way you engage with them, it’s really hard to say the wrong thing,” Vona said.

Suppress the urge to give advice or judge any reactions they have. Instead affirm the ways they’ve tried to cope. It’s OK to offer up how you feel too, but it’s important to always offer hope. 

And practicing that first aid can help adults who may feel fear, stress or grief after trauma, too,

“Engaging in constructive actions for the benefit of others has a great healing effect,” Wong said.

UNDERSTANDING TRAUMA

In the 20 years since she first developed it, Wong and others at the Center for Safe & Resilient Schools and Workplaces have discovered Psychological First Aid is effective at helping kids cope whether they’ve directly witnessed a wildfire, school shooting or terrorist attack.

She says to understand how this model works, you have to understand how trauma affects our brains, whether experienced directly or second hand. Trauma lowers the brain’s ability to think rationally, shutting down everything except the urge to fight, flee, or shut down.

Talking about what happened with someone you trust releases chemicals that can calm you down and help your brain process emotions. 

That’s evidence that now we need to help these kids process to be able to come back to school, functioning at a level in which they’re able to actively engage in teaching and learning in that process,” Wong said. “When they feel safe … they have hope that they’ve weathered the storm.”

But just as a neck brace won’t fix a broken back, Psychological First Aid is just the first step of helping kids heal mentally.

In 2013, shortly after the Sandy Hook school shooting, a pilot program for PFA in schools was introduced. The results were promising but unclear, called an “efficient first-level,” of care for kids in crisis. 

A more recent report ties PFA to a tiered approach to mental health in students with long-term and short-term solutions. 

Specifically, it says Psychological First Aid is Part 1 of developing positive social skills that help students better understand their emotions — but it can’t exist in a vacuum. Schools need trained behavioral health specialists who can identify students with immediate needs, the research shows.

It also means working to reduce teacher burnout — because their relationships are the key to reaching children.

“You don’t need to have a fancy set of clinical skills,” Vona said of staff implementing PFA. “All of the work that you’ve done to building connection and belonging for those students in the school system, that’s going to serve you well.”

NewsNation’s Marty Hobe contributed.

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