Recovery and Adjustment

One of the eight core actions of Psychological First Aid is connection with social support. The goal is to help establish both brief and / or ongoing contacts with primary and other sources of support, including safe family members, friends and helpful community helpful resources. An equally important objective is for the adults actively to promote and facilitate the continuation of every-day routines and previously enjoyable activities.

Children and young people may not necessarily wish immediately to speak about their feelings and thoughts about the incident. However, the adults need to inform them that they are available to listen whenever they feel ready to talk. A part of respectful and responsible listening is knowing the types of questions to ask and at the right time; based on best case analysis of the environment /situation and the child’s seeming state of mind. Asking about the details of the event may not be appropriate as this could evoke a re-experience of the traumatic event.

Social media can be a source of positive support. However, for older children and young people, a discriminate and / or proportionate use of social media is advisable. The adults will need to model and discourage the viewing of media coverage where there are graphic images and constant reminders. Younger children, in particular may believe that the event is happing all over again which could trigger higher levels of stress hormones and fear reactions.

The National Child Traumatic Stress Network (NCTSN): Psychological First Aid for Schools: Field Operations Guide. 2017.

Social Support

Coping With a Traumatic Event

Coping With A Traumatic Event

The aim here is to provide information about stress reactions and coping to reduce distress and promote adaptive coping.

There is the need for caution when considering the support needs of persons who have experienced a tragic event. It is not safe to assume that everyone who has experienced the traumatic event will be traumatised and requires specialist intervention. In fact, research suggests that persons who received counselling / therapy immediately following a major trauma experienced longer-term negative consequences than those who did not receive this type of intervention at the same time.

Re-traumatization has been shown to prevent and or delay the recovery process.

Counselling or therapy may be suggestive of the deficit model, where common reactions to grief and loss are pathologised; and people are viewed as ‘defective.’

The provision of information and advice on coping with trauma has been shown to promote resilience. Young people may be directed to resources and sources of support.

Furthermore, helping individuals to identify their strengths and existing coping mechanisms can be an insightful and energising starting point to navigate the recovery process. It is also important to prompt young people to be aware of both the positive and negative consequences of even a coping mechanism as the extreme use of a coping mechanism can be counterproductive and potentially harmful. At the same time, young people could be encouraged to be open to learn new coping strategies as well as to unearth dormant skills.

Research indicates that group debriefing can be harmful as not everyone will have witnessed the same scenes and young people can be re-traumatised by what they hear. An alternative to 'debriefing’ is a ‘closed’ group coaching and coping session, where participants are screened based on their proximity to the event. The focus is on thoughts, emotions, reactions, and what they do, think, and say that they found helpful in times of difficulty. They are then coached to think about how they could use these personal resources, as well as learn new ways of coping with the tragedy. This group discourse can provide examples to other group members of strategies they may wish to explore for themselves.

Here is an opportunity for you to think back to the principles and strategies presented throughout the resource so far and to apply them to a scenario.

This activity was used during the face-to-face training as a group discussion. Conversations were had about the use of language in describing death by suicide. For more information on this topic, refer back to the section on Bereavement and Loss.

If you wish to engage in this activity as an individual, read this scenario and reflect upon the following questions:

How would you communicate the incident to staff, pupils and parents?

Identify who is most vulnerable following the incident;
- What support would you plan for them?
- How would you monitor those individuals?

How would you acknowledge the incident to the family?
- What arrangements would you make to memorialise the deceased?
- What precautions would you need to take?

How would you ensure self-care for you and your senior leader?

Post Traumatic Growth

Disasters experience highlights the importance of acknowledging the capabilities and resilience of people in crises.

Credible research indicates that it is possible to bounce forward following a traumatic event. Leaders need to communicate an expectation of recovery as those affected need to gain a vision of survivor rather than being a victim.

The concept of post traumatic growth espouses the idea that human beings can be changed by their encounters with life’s challenges, sometimes in radically positive ways.

This is not a new proposition; as this theme is present in ancient spiritual and religious traditions, literature and philosophy. What however is reasonably new, is the systematic study of this phenomenon by psychologists, social workers, counsellors and scholars in other traditions of clinical practice and scientific investigation.

Forms of post traumatic growth:

New opportunities - Sometimes, people who must face major life crises develop a sense that new opportunities have emerged from their struggle, opening up possibilities that were not present before. For example, persons who experience severe injury in a motor vehicle crash or terror attack may resolve to and in fact train to become a medical personnel upon their recovery.
Relational changes - A change in relationships with others has been a positive outcome of tragedy; where some people experience closer relationships with specific people and can also experience an increase sense of connection to others who suffer. A heightened sense of empathy and commitment to advocate for, and support those who experience similar situations can also emerge.
Increased sense of own strength - Another area of possible change is an increase in the sense of one’s own strength. They may have thoughts such as “If I lived through that, I can face anything.”
Greater appreciation of life - A fourth aspect of post traumatic growth experienced by some people is a greater appreciation for life in general.
Deepening of one’s spiritual life – Finally, individuals have noted positive changes in the spiritual or religious domain. Some individuals experience a deepening of their spiritual lives, however, this deepening can also involve a significant change in one’s belief system.

Model of post traumatic growth (PTG) in children:

Pre-trauma Beliefs – These are, for example, an individual’s perceptions of the self, others, the world.

Trauma – An individual experiences a traumatic event, which may shatter their assumptions and perceptions of the self/others/world. Individuals may also be experiencing loss and grieving as a result of a traumatic event.

Social Support – Social support surrounding a child who has experienced a traumatic event, can provide the child with a safe environment. Social support, within the process of developing PTG, seems an important factor, however, dependent upon the source of that support.

Ruminative Thinking – Recurrent event-related thoughts that are intended to help the individual understand, resolve and make sense of the traumatic event. It is thought that repeated reflection on the beliefs and assumptions before and after the traumatic event, help the individual to rebuild an understanding of the ‘post-traumatic world’ (Vloet and Vloet, 2017).

Rumination is the focused attention on the symptoms of one's distress, and on its possible causes and consequences, as opposed to its solutions. Both rumination and worry are associated with anxiety and other negative emotional states. Some have suggested that there is a distinction between two different types of rumination: deliberate and intrusive. However, the impact of deliberate versus intrusive rumination on the development of PTG is unclear.

Competency belief – The model also incorporates self-system variables, or one’s internal beliefs and perceptions about the self. Included in this are one’s perceived competence and coping competency beliefs.

How can we understand post-traumatic success?

Connection – feeling an increased sense of connection, either to ourselves, others, or something else beyond (for example, religious or spiritual connection).
Compassion – showing increased compassion to others or ourselves following a traumatic event. This might also include forgiving others or ourselves.
Contribution – allowing the wounds or the trauma to lead to being of service and changing the world in a positive way.