THE AFTERMATH OF HURRICANE IVAN: HELPING CHILDREN COPE

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THE AFTERMATH OF HURRICANE IVAN HELPING
CHILDREN COPE
FRANK J. ZENERE, Ed.S FLORIDA CRISIS RESPONSE TEAM
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WHAT HAPPENS

• Crisis and trauma throw people so far out of
  their range of balance that it is difficult to
  quickly restore equilibrium
• Crisis reactions may be precipitated by either
  acute or chronic stress
• Acute stress caused by sudden, arbitrary and
  often random event
• Chronic stress occurs repeatedly over time with
  each recurrence further challenging a persons
  adaptive resources

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THE CRISIS RESPONSETHE SHORT-TERM CRISIS
REACTION

• The normal human response to trauma follows a
  similar pattern called the crisis reaction It
  occurs across gender, ethnicity, age and culture

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THE PHYSICAL RESPONSE

• The physical response to trauma is based on the
  humans more primitive instincts It includes
• Physical shock, disorientation and numbness
• Frozen Fright
• Fight-or Flight response
• Adrenaline and hormone increase
• Body may relieve itself of excess materials
• Physical senses heightened (sight, sound,
  feeling, taste, smell)
• Heart and respiratory rates increase
• Vascular dilation and muscle engorgement

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THE PHYSICAL RESPONSE cont.

• Exhaustion
• Physical arousal associated with the fight or
  flight syndrome cannot be prolonged indefinitely
  and results in physical exhaustion
• Caregiver Reaction
• Production of chemical oxytocin, primarily in
  women, may produce Tend and Befriend reaction
  as effort to protect children or loved ones

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THE EMOTIONAL REACTION

• Our emotional reactions are heightened by our
  physical response
• Stage 1 Shock, disbelief and denial
• Stage 2 Cataclysm of emotions including
  anger/rage, fear/terror, sorrow/grief,
  confusion/frustration, self blame/guilt
• Stage 3 Reconstruction of equilibrium the
  emotional roller coaster that seeks balance

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TRAUMA AND LOSS

• Trauma is accompanied by a multitude of losses
• Loss of control over ones life
• Loss of faith in ones religious/spiritual belief
  system
• Loss of trust in other people
• Loss of worldview of fairness and justice

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TRAUMA AND LOSS cont.

• Trauma is accompanied by a multitude of losses
• Loss of significant persons
• Loss of meaningful and sentimental property
• Loss of a sense of immortality and
  invulnerability
• Loss of future and expected rights of passage
• Trauma losses result in bereavement and the need
  for integration

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TRAUMA AND REGRESSION

• Trauma is often associated with regression to an
  earlier stage of development mentally and
  physically
• Individuals may do things that later seem
  childish
• Examples include loose humor, diminished impulse
  control, free floating irritation, assuming a
  fetal position, referring to authority figures
  such as parents, law enforcement or
  administrators as mommy or daddy

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TRAUMA AND REGRESSION cont.

• Individuals may feel childish Examples include
• Feeling small
• Wanting someone to take care of them
• Feeling weak
• Feeling as if things are out of control as if one
  were a child again
• Using language that is highly simplified
• Withdrawing and seeking nurture

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TRAUMA REACTIONSPRESCHOOL-AGE CHILDREN

• Play hurricane games
• Fear of storm
• Withdrawal
• Anxiety
• General behavioral problems
• Thumb sucking
• Bedwetting

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TRAUMA REACTIONSPRESCHOOL-AGE CHILDREN

• Clinging to parents
• Sleep disturbances
• Fear of dark
• Regressive behavior
• Loss of appetite

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TRAUMA REACTIONSELEMENTARY-AGE CHILDREN

• Extreme withdrawal
• Disruptive behavior
• Difficulty paying attention
• Outburst of anger
• Stomach aches
• Headaches
• Depression

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TRAUMA REACTIONSELEMENTARY-AGE CHILDREN

• Anxiety
• Emotional numbing
• Fears
• Of dark
• Of being left alone
• Of being separated from family
• That something bad will happen to family
• That they caused some part of the disaster

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TRAUMA REACTIONSELEMENTARY-AGE CHILDREN

• Irritability
• Aggressiveness
• Nightmares
• School avoidance

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TRAUMA REACTIONSMIDDLE AND HIGH SCHOOL-AGE
CHILDREN

• Sleeping and eating disturbances
• Agitation
• Irritability
• Delinquency
• Physical complaints
• Poor concentration
• Depression

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LONG-TERM CRISIS REACTIONS

• Not all victims of trauma/crisis suffer
  significantly from long-term stress reactions
• Many victims may continue to be reminded or
  re-experience some degree of crisis reactions
  over a longer period of time
• These crisis reactions are often associated with
  trigger or kindling events, environmental cues,
  that remind the person of the trauma. These cues
  can bring back the intense emotion and physical
  reactions of the original trauma

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LONG-TERM CRISIS REACTIONS cont.

• Trigger Events vary with different
  victims/survivors but may include
• Sensing (seeing, hearing, touching, smelling,
  tasting) something similar to what one was
  acutely aware of in the original incident
• Anniversaries of the event
• Proximity of holidays or significant life
  events to the trauma/crisis

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LONG-TERM CRISIS REACTIONS cont.

• SUMMARY
• Survivors of trauma/crisis may experience stress
  reactions for years.
• Long-Term Stress Reactions are natural responses
  to terrible events.
• Unresolved stress reactions may result in several
  forms of post traumatic behavior.

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LONG-TERM STRESS REACTIONS

• Persistent symptoms of increased physical arousal
  (not present in pre-crisis state) such as
• Difficulty falling or staying asleep
• Irritability or outbursts of anger
• Difficulty with concentration
• Hyper-vigilance heightened startle response
• Physiologic reactivity at exposure (anxiety,
  fear, panic attack) that symbolizes incident

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RECOVERY FROM TRAUMA

• Many people live through trauma and are able to
  reconstruct their lives without additional help
• 20/60/20 Rule
• About 20 of those experiencing trauma will adapt
  and return to normal function within a short
  period of time
• About 60 will experience some type of stress
  reaction that will, for a period of time, impair
  function
• About 20 will suffer extensive impairment in one
  or more of their life functions

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RECOVERY FROM TRAUMA cont.

• Recovery from immediate trauma is often affected
  by the following factors
• The severity of the incident and level of crisis
  reaction
• The ability to understand what happened
• The persons pre-crisis stability
• The nature and breadth of ones support system
• Access to help
• The degree to which ones experience is validated
  by culture and others

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RECOVERY FROM TRAUMA cont.

• Recovery issues for survivors include
• The victim gaining some meaningful perception of
  control over the event
• Working out an understanding of the incident and,
  as needed, a redefinition of worldview and values
• Re-establishing a sense of future and personal
  goals
• Re-establishing a sense of meaning, integration
  of the event into a personal narrative

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HELPING CHILDREN AFTER DISASTER RECOMMENDATIONS

• Meet and greet students
• Remain calm and reassuring
• Acknowledge and normalize feelings/reactions
• Encourage expression about disaster-related
  events
• Promote positive coping and problem-solving
  skills
• Emphasize childrens resiliency

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HELPING CHILDREN AFTER DISASTER RECOMMENDATIONS

• Establish/reinforce routines and expectations
• Provide opportunities for children to share their
  concerns
• Involve children in activities that allow them to
  make choices and resume a sense of control over
  their environment.
• Incorporate information about the disaster into
  related subject areas, as appropriate.

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HELPING CHILDREN AFTER DISASTER RECOMMENDATIONS

• Listen to and observe childrens behavior.
• Be sensitive to the disruption that relocation
  may cause.
• Consider the developmental level and unique
  experiences of each child.
• Involve students in recovery-related
  activities/projects.
• Identify children at risk and make a referral to
  the appropriate school or community-based
  resource.

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STUDENTS WHO ARE AT HIGH RISK

• Had a high level of exposure
• Felt like they might die during the disaster
• Were physically injured
• Witnessed a grotesque destruction
• Suffered significant loss
• Are grieving for victims
• Relocated following the disaster
• Had preexisting anxiety disorders or mental
  health problems

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STUDENTS WHO ARE AT HIGH RISK

• Had inadequate parental support
• Are separated from their family
• Used inadequate coping mechanisms
• Experienced previous trauma

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POST-DISASTER ACTIVITIES CLASSROOM DISCUSSION

• Where were you during the hurricane?
• Who was with you during the hurricane?
• What do you remember about the hurricane?
• What was the worst part of your hurricane
  experience?
• How did you feel before, during, and after the
  hurricane?

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POST-DISASTER ACTIVITIES CLASSROOM DISCUSSION

• Do you know anyone who was injured during or
  after the hurricane?
• What did you learn from this experience?
• What would you do differently if another
  hurricane was to strike?
• What can you do to help others affected by the
  hurricane?
• How will this hurricane change you, your family,
  and your community?

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HELPING CHILDREN AFTER DISASTER RESPONSES TO
QUESTIONS

• How do I respond to students when they ask, Why
  did this happen?
• How can I help students with their lessons?
• How do I assist students in understanding why
  some families experienced losses while others did
  not?
• How do I help students deal with anxieties about
  the future?

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HELPING CHILDREN AFTER DISASTER SUGGESTIONS
FOR PARENTS

• Listen to your childs concerns, anxieties and
  fears validate their feelings.
• Offer realistic reassurances of safety and
  comfort.
• Provide structure and routine in the home
  environment.
• Encourage involvement in family and community
  recovery efforts.

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HELPING CHILDREN AFTER DISASTER SUGGESTIONS
FOR PARENTS

• Be aware of abrupt changes in your childs
  behavior make appropriate professional contacts.
• Provide factual information and talk in hopeful
  terms regarding the future.
• Be prepared to tolerate regressive and acting out
  behaviors during the early post disaster phase.

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AFTER FRANCES TAKING CARE OF ME

• Be with other people.
• Express your feelings/reactions.
• Seek information and advice.
• Reassure yourself.
• Maintain healthy lifestyle/routines.
• Seek professional help.