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Counseling Children After Natural Disasters: Guidance for Family Therapists


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After natural disasters, most children exhibit typical symptoms, which can be mitigated when parents and teachers provide emo-tional support and facilitate adaptive coping strategies. However, some children may experience clinical symptoms, which require professional counseling. This article guides family therapists in (a) identifying children's typical and clinical symptoms after a natural disaster, (b) training parents and teachers in basic interventions, and (c) implementing developmentally appropriate clinical inter-ventions that integrate play. A multimodal, three-phase approach of Cognitive Behavior Therapy, Play Therapy, and Family Play Ther-apy is described. COUNSELING CHILDREN WHO HAVE SURVIVED NATURAL DISASTERS Natural disasters are a persistent threat to families in North America. In 2005, the Federal Emergency Management Agency (FEMA, 2006) declared 48 fed-eral disasters such as hurricanes, tornados, floods, and fires. The most promi-nent natural disaster of 2005, Hurricane Katrina, was identified as the costliest hurricane in United States history with over $81 billion in damage and the deadliest in 77 years with approximately 1,833 fatalities (Knabb, Rhome, & Brown, 2005). A 70% increase in U.S. major disasters has occurred in the last decade from 319 disasters between 1986 and 1995 to 545 disasters be-tween 1996 and 2005. Unfortunately, scientists are predicting high numbers of storms in the next ten years (National Oceanic and Atmospheric Adminis-tration [NOAA], 2006). These natural disasters will cause fear and disruption in the lives of countless children and families.
Content may be subject to copyright.
The American Journal of Family Therapy, 36:79–93, 2008
Copyright © Taylor & Francis Group, LLC
ISSN: 0192-6187 print / 1521-0383 online
DOI: 10.1080/01926180601057598
Counseling Children After Natural Disasters:
Guidance for Family Therapists
University of South Florida, Tampa, Florida, USA
After natural disasters, most children exhibit typical symptoms,
which can be mitigated when parents and teachers provide emo-
tional support and facilitate adaptive coping strategies. However,
some children may experience clinical symptoms, which require
professional counseling. This article guides family therapists in (a)
identifying children’s typical and clinical symptoms after a natural
disaster, (b) training parents and teachers in basic interventions,
and (c) implementing developmentally appropriate clinical inter-
ventions that integrate play. A multimodal, three-phase approach of
Cognitive Behavior Therapy, Play Therapy, and Family Play Ther-
apy is described.
Natural disasters are a persistent threat to families in North America. In 2005,
the Federal Emergency Management Agency (FEMA, 2006) declared 48 fed-
eral disasters such as hurricanes, tornados, floods, and fires. The most promi-
nent natural disaster of 2005, Hurricane Katrina, was identified as the costliest
hurricane in United States history with over $81 billion in damage and the
deadliest in 77 years with approximately 1,833 fatalities (Knabb, Rhome, &
Brown, 2005). A 70% increase in U.S. major disasters has occurred in the
last decade from 319 disasters between 1986 and 1995 to 545 disasters be-
tween 1996 and 2005. Unfortunately, scientists are predicting high numbers
of storms in the next ten years (National Oceanic and Atmospheric Adminis-
tration [NOAA], 2006). These natural disasters will cause fear and disruption
in the lives of countless children and families.
Address correspondence to Jennifer Baggerly, University of South Florida, 4202 E. Fowler
Ave., EDU162, Tampa, FL 33620. E-mail:
80 J. Baggerly & H. A. Exum
During natural disasters, children are one of the most vulnerable popu-
lations because their neuro-physiological systems are subject to permanent
changes and their coping skills are not developed enough to manage catas-
trophic events (Perry, Pollard, Blakely, Baker, & Vigilante, 1995; Speier, 2000).
Most children exhibit typical, temporary symptoms during and after disasters;
yet these symptoms can be mitigated when parents and teachers provide
emotional support and facilitate adaptive coping strategies. However, some
children may experience clinical symptoms, which require developmentally
appropriate counseling interventions that integrate play (Baggerly, 2004b,
Family therapists must be prepared to provide developmentally appro-
priate interventions to children who experience distress after natural dis-
asters. However, the literature for family therapists on this topic is sparse.
Miller (1999) described treatment for Post-Traumatic Stress Disorder (PTSD)
for children and families but does not incorporate developmentally appro-
priate approaches of play. Wittenborn, Faber, Harvey, and Thomas (2006)
discussed integrating play therapy techniques into family therapy but did not
address natural disasters. The purpose of this article is to guide family thera-
pists in (a) identifying children’s typical and clinical symptoms after a natural
disaster, (b) training parents and teachers in basic interventions, and (c) im-
plementing developmentally appropriate clinical interventions that integrate
play. A multimodal, tri-phase approach of Cognitive Behavior Therapy, Play
Therapy, and Family Play Therapy is described.
Children’s typical symptoms after natural disasters include fear, depression,
self-blame, guilt, loss of interest in school and other activities, regressive be-
havior, sleep and appetite disturbance, night terrors, aggressiveness, poor
concentration, and separation anxiety (Speier, 2000). However, symptoms
vary from minimum to severe based on a child’s developmental level, per-
sonal experiences, emotional or physical health, and the responses of par-
ents to the incident (Vogel & Vernberg, 1993). For children 5 years old
and younger, typical symptoms include separation anxiety, excessive cling-
ing, crying, whimpering, screaming, and regressive behavior such as thumb
sucking and fear of the dark (National Institute for Mental Health, [NIMH],
2001). For children 6 to 11 years old, typical symptoms include extreme
withdrawal, increased fighting and aggression, hyperactivity and inattentive-
ness, irrational fears, irritability, sleep disruption, school refusal, complaints
of stomachaches, and emotional numbing (NIMH, 2001). For adolescents 12
to 17 years old, typical symptoms include flashbacks, nightmares, emotional
numbing, avoidance of reminders of the trauma, substance abuse, and de-
pression (NIMH, 2001). They may also experience headaches, stomachaches,
Counseling After Natural Disasters 81
risk-taking behaviors, lack of concentration, decline in responsible behavior,
apathy, and rebellion at home or school.
Although many children will recover from these typical symptoms with basic
family and school support after a natural disaster, some children experience
ongoing symptoms that disrupt their daily functioning. Vernberg, LaGreca,
Silverman, and Prinstein (1996) found 55% of elementary school children
in their study exhibited moderate to very severe symptoms three months
after Hurricane Andrew. In contrast, McDermott, Lee, and Judd (2005) found
22.6% of children in their study had abnormally high emotional symptoms
six months after exposure to a wildfire disaster.
Children’s clinical symptoms may result in a diagnosis of Acute Stress
Disorder (ASD), Post Traumatic Stress Disorder (PTSD), other anxiety disor-
ders, or depression disorders. Indicators of childhood PTSD include the fol-
lowing symptoms that persist longer than 30 days after the event: persistent
re-experiencing of the event through intrusive memories, frightening dreams
(with or without recognizable content), repetitive play in which themes or
aspect of the disaster are expressed, increased arousal such as irritability or
hypervigilance, and avoidance of things related to the disaster (American Psy-
chiatric Association, 2000). Rates of PTSD in children after natural disasters
vary. Evans and Oehler-Stinnett (2006) found 41% of children in their study
who experienced a severe tornado had PTSD symptoms that meet DSM-IV-
TR criteria. Vernberg et al. (1996) found 30% of children in their sample who
experienced Hurricane Andrew had severe symptoms of PTSD. Conversely,
Shannon, Lonigan, and Finch (1994) found 5% of 5,687 school-aged children
surveyed who experienced Hurricane Hugo met criteria for PTSD.
Children’s development of PTSD is influenced by the following five fac-
tors: (a) exposure to traumatic events during and after the disaster, (b) pre-
existing demographic characteristics, (c) occurrence of major life stressors,
(d) availability of social support, and (e) type of coping strategies used to
manage disaster-related stress (Vernberg et al., 1996). These researchers also
found that children’s symptoms persisted due to interactions between daily
life hassles and the severity of the disaster, stressful life events, e.g., parent’s
divorce or loss of employment, and loss of support from overburdened com-
munity systems and schools. In addition, McDermott, Lee, and Judd (2005)
found that younger children and children with higher levels of exposure and
threat had higher prevalence of PTSD than older children and children with
lower levels of exposure and threat.
When diagnosing children, counselors should ask parents, other rela-
tives, and teachers whether children’s behaviors would be considered “nor-
mal” for a given child prior to the disaster. To assess the impact of trauma
82 J. Baggerly & H. A. Exum
in children, Ohen, Myers, and Collett (2002) suggest several different assess-
ments. When a diagnosis of PTSD is the goal, they suggested the clinician-
administered scales of the Children’s PTSD Inventory [CPTSDI] (Saigh et al.,
2000) or the Clinician-Administered PTSD Scale for Children [CAPS-C] (Nader
et al., 1996). If clinician administered assessments are too time consuming,
then Ohen et al. (2002) recommended the self-reported Child PTSD Symp-
tom Scale [CPSS] (Foa, Johnson, Feeny, & Treadwell, 2001) for a quick first
screen or the culturally sensitive Children’s PTSD-Reaction Index [CPTS-RI]
(Frederick & Pynoos, 1998) or the Impact of Event Scale-Revised [IES-R] (Weiss
& Marmar, 1996). The Trauma Symptom Checklist for Children – Alternative
[TSCC-A] (Briere, 1996) assesses for trauma and more general psychopathol-
ogy, which provides for helpful follow along over time. For younger chil-
dren, the Angie/Andy Cartoon Trauma Scales [ACTS] (Praver, DiGiuseppe,
Pelcovitz, Mandel, & Gaines, 2000) for ages 6 to 12 or the Pediatric Emo-
tional Distress Scale [PEDS] (Saylor, Swenson, Reynolds, & Taylor, 1999) for
ages 2 to 10 were recommended. Since accurately diagnosing children with
PTSD is very difficult due to their limited cognitive and expressive skills
(Cohen, Berliner, & March, 2000), counselors are advised to provide treat-
ment even if symptoms do not meet a formal diagnosis of PTSD.
Due to the large number of children that will experience typical symptoms
after a natural disaster, family therapists can maximize their efforts by train-
ing parents and teachers to provide supportive responses and basic inter-
ventions for their children (Harper, Harper, & Stills, 2003). In a study by
Wolmer, Laor, Dedeoglu, Siev, and Yazgan (2005), children exposed to the
1999 earthquake in Turkey who received teacher led interventions had sig-
nificantly higher functioning compared to a matched control group. These
researchers concluded that teachers may become efficient clinical mediators
due to the central role in the lives of children. Parents also play an important
role in their children’s recovery because children take their cues on how to
respond to the disaster from their parents (FEMA, 2004a). If parents are out of
control of their feelings and behavior, then children will feel more helpless
and scared. If parents are appropriately upset but maintain optimism and
control of their feelings and behavior, then children will feel more secure.
Therefore, it is important to teach parents and teachers how to maintain a
non-anxious presence by enacting self-soothing strategies such as relaxing
their body (Rank & Gentry, 2003).
Family therapists should help parents and teachers focus on maximiz-
ing children’s protective factors of good communication skills, strong self-
efficacy, and positive coping skills (Vernberg et al., 1996). To maximize
good communication skills, encourage parents and teachers to schedule
Counseling After Natural Disasters 83
regular times to talk with their children about their emotions, concerns,
and plans for the future. Since young children may not be able to verbal-
ize their feelings, other communicative modes, e.g., playing, drawing, or
singing, may be more effective (Webb, 2004). Coloring books and free flow
drawings are also useful ways for children to express themselves (Corder
and Haizlip, 1996). A hurricane coloring book that helps children express
their own story, feelings, thoughts, and behaviors is available on the web at . A parent and child
coping workbook, entitled After the Storm (La Greca, Sevin, & Sevin, 2005),
also offers playful activities.
To maximize children’s sense of self-efficacy, parents and teachers
should reassure children that symptoms of nightmares, crying, etc. are typical
and usually temporary. Providing a handout of typical children’s cognitive,
emotional, physiological, behavioral, and spiritual symptoms will help par-
ents and teachers focus on the normalcy of children’s responses, rather than
seeing them as pathological. (Please see Figure 1). Children’s self-efficacy
can also be enhanced by quickly re-establishing a routine that is stable and
manageable (FEMA, 2004a). During the early phases of a natural disaster
the normal rules, expectations, and responsibilities at home and at school
are usually relaxed (Haizlip, 1999). However, parents and teachers should
remember that they do need to reestablish normal structure as much as
possible. For example, parents could re-establish routines of reading bed-
time stories or saying nightly prayers to comfort and reassure their children.
Teachers can resume regular classroom routines of readings, projects, and
limited homework. In addition, parents and teachers can promote children’s
self-efficacy by encouraging them to participate in social and school activities
as well as community rebuilding activities.
Parents and teachers should help children identify or learn positive cog-
nitive, emotional, physiological, behavioral, and spiritual coping strategies
that fit their unique coping style (Please see Figure 2). Felix, Bond, and
Shelby (2006) recommend playing a game of “Go Fishing for Coping Skills”
in which children discern adaptive from maladaptive coping skills by match-
ing categories of cards with adaptive coping skills and discarding maladap-
tive coping skills. For teenagers, positive coping strategies will include group
interventions that process emotions through expressive arts, drama, and rap-
ping/singing. Teens can also write letters to encourage survivors, first respon-
ders, and political leaders and participate in recovery efforts such as cleaning
apark or reading to younger children.
Disturbing Dreams
Counselors may need to train parents and teachers how to respond to their
children’s disturbing nightmares related to the natural disaster. Younger chil-
dren’s dreams related to the distressing event may change into generalized
84 J. Baggerly & H. A. Exum
FIGURE 1 Normal things that happen to normal kids after something scary.
nightmares of monsters or of rescuing others. Children in middle to late
childhood are more likely to experience sleep disturbances as they begin to
understand the finality of loss (NIMH, 2001).
To help children effectively process disturbing dreams, parents and
teachers can learn Dahlen’s (1999) Traumatic Dream Defusing Process
(TDDP) of creating a safe sleeping environment and giving voice to spe-
cific details, feelings, and thoughts from the dreams. Parents and teachers
help children defuse the strength of the dream and regain sense of control
by helping them record the dream in a journal. For younger children, par-
ents and teachers encourage children to draw or color their dreams and then
bury them in a structured ceremony. This symbolic burial gives children the
power to bring an end to the significance of the dreams. Another method is
Counseling After Natural Disasters 85
FIGURE 2 Things you can do to feel better.
to ask children to blow their fearful dreams into a balloon and then release
the inflated balloon. This activity helps children feel more in control as they
see their dreams disappear.
For children who experience typical symptoms after a natural disaster, fam-
ily counselors should provide parent and teacher consultation as described
above along with supportive counseling, crisis intervention, and resources
and referrals to meet basic needs (Harper et al., 2003). However, if children
continue to experience persistent symptoms that disrupt their functioning
weeks after the natural disaster is over, then more intensive counseling is war-
ranted. Herman (1997) recommends a three phase trauma recovery approach
of (a) establishing safety, (b) retelling the trauma story, and (c) reconnecting
86 J. Baggerly & H. A. Exum
with others. When working with children after natural disasters, we recom-
mend applying Herman’s approach via a multimodal three-phase approach as
follows: (a) establish safety and manage symptoms through Cognitive Behav-
ior Therapy, (b) facilitate the child’s retelling of their trauma story through
play therapy, and (c) reconnect the child with others through family play
Cognitive Behavioral Therapy
Cognitive Behavior Therapy (CBT) has been proven to decrease children’s
symptoms related to ASD, PTSD, other anxiety disorders, and depression
(Cohen et al., 2000; Compton et al., 2004). When working with children after
natural disasters, CBT procedures that incorporate play therapy techniques
can be used to establish safety and manage symptoms (Knell, 2000; Shelby,
2000). To increase children’s sense of safety, family therapists should create a
child friendly environment by providing toys. In addition to inviting children
to play with the toys, family therapists can ask children to (a) play a game
of identifying indicators that they are safe at the present time, (b) draw a
picture of a safe place, and (c) develop a safety plan for future disasters.
To manage hyper-arousal symptoms, family therapists can teach children
self-soothing relaxation techniques to calm their bodies and deactivate their
“fight or flight response” (Perry et al., 1995). These procedures include (a)
taking deep breathes through playful activities such as blowing soap bubbles
or pinwheels; (b) progressive muscle relaxation by tensing muscle groups
like a toy soldier and relaxing like a rag doll; and (c) focusing on positive
images by drawing happy places, engaging in mutual story telling with a
positive ending, or meditating on peaceful places (Baggerly, in press).
Family therapists should teach children methods of managing intrusive
thoughts of disaster related events that are encoded in their implicit memory
(Perry et al., 1995). These procedures include (a) “changing the tape” by
replacing negative thoughts with a predetermined positive song, story, or
saying such as “I’m safe right now and I know it because I have . . .” and (b)
grounding activities such as rubbing stomach and hands together (Shelby,
Bond, Hall, & Hsu, 2004). Family therapists can also amend Baranowsky,
Gentry, and Schultz’s (2005) 5-4-3-2-1 sensory grounding and containment
procedure by asking children to play a 3-2-1 game. For this game, ask children
to identify three objects above eye level, three sounds everyone can hear,
and three things they can touch; then two things they see, hear, and touch;
followed by one thing they see, hear, and touch.
To help children manage avoidance of disaster related stimuli, family
therapists should implement systematic desensitization procedures of pairing
relaxation with a step-by-step hierarchy of exposure to the stimuli (Wolpe,
1969). For example, a child may be afraid to take a bath after a hurricane
because of the association that occurred when the family sought shelter in
Counseling After Natural Disasters 87
the bathtub during the hurricane. The family counselor should teach the
child to relax and then ask him to wipe his face with a wet wash clothe,
gradually progressing to washing in a sink, then near the tub, etc. (Baggerly,
Green, Thorn, & Steele, in press). Parents will need to be involved with these
procedures and provide positive reinforcements for each accomplished step.
Due to their egocentric and concrete cognitions, some children may
misattribute the cause of natural disasters to their bad dreams or someone’s
bad behavior. Family therapists should identify their misattributions and give
accurate information. Procedures to correct misattributions include (a) mak-
ing a Q-sort of possible reasons for the disaster and asking children to sort
them as true or untrue; (b) creating a blame box for younger children to
put in drawings of who or what they blame and then drawing the correct
reason together; (c) developing a puppet show in which puppets ask about
misattributions and another puppet gives accurate reasons; and (d) acting
out a radio show of people calling in with questions and an expert giving
correct information (Shelby et al., 2004). Many of the play-based procedures
described above are demonstrated in a video by Baggerly (2006) available at
Play Therapy
After helping children establish a sense of safety and manage symptoms,
family therapists should help children retell their trauma story. Since chil-
dren ages two to ten years old are still in the cognitive developmental stage
of pre-operations or concrete operations, the most developmentally appro-
priate way for young children to communicate their trauma story is through
play (Kottman, 2001; Landreth, 2002). Landreth stated “Play is the child’s sym-
bolic language of self-expression. . . . Play is children’s way of working out
balance and control in their lives . . . that is essential to children’s emotional
development and positive mental health” (Landreth, 2002, p. 18).
Children often repeatedly reenact a specific traumatic event in their play
in an attempt to create a concrete narrative of traumatic events so they can
master frightening images (Baggerly, 2005c; Terr, 1990). For example, a 5-
year-old boy who experienced Hurricane Katrina named a toy dinosaur “the
sea monster.” He spun the sea monster in circles and repeatedly knocked
down the doll family and furniture in the doll house. Later, he used the army
men to kill the sea monster. Clearly, the boy was re-enacting his hurricane
experience in order to gain mastery of a scary situation.
Play therapy helps children process their trauma narrative, aids in resolv-
ing symptoms, builds resiliency, and resumes the process of normal devel-
opment (Gil, 1991; Shelby, 2000). During play therapy, the family counselor
should provide selected toys such as bendable doll families, zoo animals,
rescue vehicles, medical kits, etc., as recommended by Landreth (2002), so
children can express their trauma narrative through play. While children are
88 J. Baggerly & H. A. Exum
playing, family therapists should provide therapeutic responses of reflecting
content and feelings, facilitating decision making, encouraging, enlarging the
meaning, and facilitating accurate understanding (Baggerly, 2005c; Landreth,
2002). These play therapy procedures are demonstrated in a video by Bag-
gerly (2005a) available at
After each play session, consult with parent and provide them helpful re-
sponses to their child’s concerns. If the child wants to play out their resolved
trauma story for their parents, instruct the parents to reflect their child’s feel-
ings and strengths and provide reassurance of their support.
There is a long history of using play therapy to treat traumatized chil-
dren, beginning with Anna Freud’s work with children after London was
bombed in World War II (Freud & Burlingham, 1943). The effectiveness of
play therapy was revealed in Bratton and Ray’s (2000) comprehensive liter-
ature review of 82 play therapy research studies and a meta-analysis of 94
play therapy outcome research studies, which showed a large positive effect
of .80 on treatment outcomes (Ray, Bratton, Rhine, & Jones, 2001). Recently,
Shen’s (2002) research with Chinese children who experienced earthquake
related trauma symptoms revealed that children who received 10 sessions of
child-centered play therapy had significantly lower anxiety and suicide risks
than did control group children. Given these positive results of play therapy
and its unique developmentally appropriate approach, family therapists are
encouraged to obtain play therapy training. Play therapy training information
is available at and
Family Play Therapy
The final phase in trauma recovery is reconnecting children with others. To
accomplish this, family therapists can integrate play into family therapy so
that parents can enter their children’s world and develop emotional con-
nectedness (Gil, 1994; Wittenborn et al., 2006). “Play techniques can engage
parents and children in enhanced communication, understanding, and emo-
tional relatedness” (Gil, 1994, p. 42). Play in family therapy can also help
children and parents make sense of their lived traumatic experience, solve
problems, and build resilience as a family unit.
These goals can be facilitated through family play activities that utilize
avariety of mediums. If a sand tray and numerous miniatures are available,
ask the family to use these to create their world before the disaster, after the
disaster, and how they hope it will be in the future. Afterwards, the family
counselor should ask each family member to share their thoughts and con-
tributions to their sand tray world (Carey, 1999). If puppets are available, ask
each family member to choose and name two puppets. Then ask the family
to make up a story that has a beginning, middle, and an end. Afterwards, the
family counselor should interview each puppet to process feelings, percep-
tions, strengths, and problem solving strategies (Gil, 1994).
Counseling After Natural Disasters 89
Family art activities accomplish the above described goals in a medium
that is available to most family therapists (Gil, 1994). Provide three large,
poster-size pieces of paper, crayons, and markers and ask families to make
amural of their life before the natural disaster, afterwards, and in the future.
Family members can enhance the murals by pasting images from magazines,
if available. After the mural is complete, lead the family in processing feelings,
perceptions, strengths, and problem solving strategies. Another art activity is
to provide one large piece of paper and ask each family member to draw a
special place where they would like to live (DeTrude, 2003). Ask them not to
talk until everyone is finished. Then ask each family member to describe the
sights, sounds, and smells of their special place. Finally, ask family members
to make one positive comment about each person in the family. This activity
helps families focus on hopes and dreams, giving them a sense that there is
life after a disaster.
Recognizing children and adolescents’ typical and clinical traumatic stress
symptoms after natural disasters will guide family therapists in providing
needed therapeutic interventions. Since most of the recovery takes place at
home and at school, family therapists must teach parents and teachers to
understand symptoms and intervene with reassurance of normalcy, extra at-
tention and nurturance, re-establishing routine, open communication, and
facilitating adaptive coping strategies. If children experience clinical symp-
toms, family therapists are encouraged to follow the model of (a) establishing
safety and managing symptoms through Cognitive Behavior Therapy, (b) fa-
cilitating the child’s retelling of the trauma story through play therapy, and (c)
reconnecting the child with others through family play therapy. In doing so,
counselor will help children, families, and communities develop resilience
after natural disasters.
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... Mental health issues often take a back seat to the more proximate effects of natural disasters because concerns related to mental health often become apparent much later. Literature suggests that children are more vulnerable to adverse impact on psychological health following natural disasters 3,4 including floods. These include developmental regression, anxiety, fears, depression, nightmares, sleep related difficulties, poor concentration, 4,5 hyperactivity, and aggression. ...
... Literature suggests that children are more vulnerable to adverse impact on psychological health following natural disasters 3,4 including floods. These include developmental regression, anxiety, fears, depression, nightmares, sleep related difficulties, poor concentration, 4,5 hyperactivity, and aggression. In terms of long-term morbidity, post-traumatic stress disorder (PTSD) is arguably the utmost important. ...
Trisomy 21 is one of the commonly identified genetic causes of Intellectual Disability. Such children experience a lack of attention and neglect by parents and teachers due to their slow response to intervention, which sometimes becomes demotivating for caregivers. However, with the recent medical advances and institutional support, avenues have been opened to help overcome the challenges related to Down's Syndrome. The present case study highlights the life skills training of a 7 year old child with Down's Syndrome, studying in a special education institute of Lahore. The post-assessment showed that consistent practice of behavior modification procedures led to significant improvements in the adaptive functioning of the child.
... Mental health issues often take a back seat to the more proximate effects of natural disasters because concerns related to mental health often become apparent much later. Literature suggests that children are more vulnerable to adverse impact on psychological health following natural disasters 3,4 including floods. These include developmental regression, anxiety, fears, depression, nightmares, sleep related difficulties, poor concentration, 4,5 hyperactivity, and aggression. ...
... Literature suggests that children are more vulnerable to adverse impact on psychological health following natural disasters 3,4 including floods. These include developmental regression, anxiety, fears, depression, nightmares, sleep related difficulties, poor concentration, 4,5 hyperactivity, and aggression. In terms of long-term morbidity, post-traumatic stress disorder (PTSD) is arguably the utmost important. ...
... All kinds of natural disasters not only caused lots of property losses and casualties, but also had a severe and lasting impact on people's psychological health [2,3]. Studies have found that physiological and psychological disorders after natural disasters include anxiety, post-traumatic stress disorder (PTSD), depression [4][5][6][7], fear, night terror, aggression, inattention, sleep disorders [8], extreme shyness and enuresis in children [9]. Moreover, the adverse effects of natural disasters on people's psychological health would not disappear automatically with the end of the disaster. ...
... At 17:00 on July 20, the flood control response was upgraded from level II to level I. Flood disaster caused by heavy rainstorm resulted in severe casualties and property losses. As of August 2, a total of 14.5316 million people in 150 Henan counties were affected, 89,001 houses were collapsed, 8.72 million acres of crops were damaged, and direct economic loss was 114.269 billion yuan. 302 people died and 50 people were missing, in which 292 people died and 47 people were missing in Zhengzhou. ...
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Background: In 2021, a once-in-a-century heavy rainstorm suddenly attacked Zhengzhou, an important inland city in northern China. However, there have been no studies on the psychological health of disaster-stricken residents. This study is the first to comprehensively report on the mental health status and related factors of local ordinary residents after the heavy rainstorm. Objective: The purpose of this study is to investigate the mental health status and related influencing factors of local ordinary residents after the flood disaster, and to provide reference for government departments to formulate disaster psychological intervention countermeasures based on evidence-driven strategies. Methods: The snowball sampling technique was used in this study, and measurement tools of Rainstorm Exposure Questionnaire, Subjective Perception of Rainstorm, Post-Traumatic Stress Disorder Checklist-Civilian version (PCL-C), Depression, Anxiety and Stress Scale-21 (DAS-21) and Chinese version of Social Support Rating Scale (SSRS) were used to evaluate the rainstorm exposure, subjective perception of the rainstorm, psychological symptoms and social support of the disaster-stricken residents within a week after the rainstorm. Logistic regression analysis was used to examine the psychological status and related factors of local residents after the rainstorm disaster. Results: A total of 469 valid samples were obtained in this study. All the subjects were in the disaster area and experienced the rainstorm personally, with normal intelligence. The statistical results showed that 25.37% people had experienced at least three rainstorm-related stresses, nearly 20.26% people had post-traumatic stress disorder (PTSD) symptoms, and 39.3%, 53.92% and 65.83% people had depression, anxiety and stress symptoms, respectively. Multivariable logistic regression analyses indicated that female (all p < 0.05), the divorced, agricultural workers/farmers (all p < 0.05), students (all p < 0.05), people experiencing at least three rainstorm-related stresses (p < 0.05 or p < 0.01), people with lower satisfaction at the social flood fighting measures (p < 0.05 or p < 0.01) and people with low social support (p < 0.05 or p < 0.01) were all independent risk factors for poor psychological health, and college education or above (p < 0.05 or p < 0.01), the lower degree of worrying about themselves (all p < 0.01), family members (all p < 0.01) and family property (all p < 0.01) were all related to higher psychological health among flood survivors after the disaster. Conclusions: Rainstorm could cause local residents to have various degrees of psychological symptoms. This study identified factors associated with the psychological health of disaster-stricken residents, which could be used to develop psychological interventions in improving psychological health of local residents.
... The present study aimed to compare psychological symptoms and coping strategies in preschoolers, schoolchildren, and adolescents during the first weeks of home confinement due to Existing literature on children's reactions to other natural disasters, such as earthquakes and floods, suggested that preschoolers show less psychological distress and exhibit fewer cognitive problems than older children (Salmon & Bryant, 2002). However, the results were often contradictory, as other findings suggested that preschoolers suffer from a high incidence of generalized or specific fears, including separation anxiety, loss of language skills, and exhibit behavioral problems (e.g., temper tantrums and aggression), dependency, irritability, sleep problems, and specific regressive behaviors (e.g., thumb sucking, bedwetting, and tics) (Baggerly & Exum, 2007;Corrarino, 2008;Dyregrov & Yule, 2006). ...
... First, we analyzed differences in children's psychological symptoms by age group, including preschoolers (3-5 years), schoolchildren (6-12 years), and adolescents (13-18 years). We expected preschoolers to be more dependent on their parents, more irritable, and show increased sleep problems than older children (Baggerly & Exum, 2007;Corrarino, 2008;Jiao et al., 2020). We also anticipated that parents of schoolchildren would report greater cognitive and behavioral difficulties, such as difficulty concentrating, irritability, and arguing with family members (Nearchou et al., 2020Romero et al., 2020). ...
The present study aimed to compare psychological symptoms and coping strategies in 1480 preschoolers, schoolchildren, and adolescents during home confinement due to COVID-19. We enrolled parents from Italy, Portugal, and Spain who completed a survey between the second and fourth week of lockdown. The results showed that preschoolers displayed more sleeping difficulties, temper tantrums, and dependency while adolescents' reactions were more related to COVID-19 worries and uncertainty. Schoolchildren showed more difficulty in concentrating. Adolescent girls showed higher anxiety levels than schoolchildren boys. Schoolchildren relied more on emotion-oriented strategies, which were linked to increased internalizing and externalizing symptoms in all ages. Task-oriented strategies, regardless of the child's age, work best to cope with stress. Our findings provide information for professionals and parents about children's most common and adaptive coping strategies according to age. Furthermore, they contribute to the early detection of long-term psychological maladjustment in children.
... Melalui jenis permainan khusus ini, anak-anak berusaha mengatasi pikiran dan peristiwa menakutkan yang membingungkan yang dialami. Bermain adalah cara anak yang mengalami trauma untuk "mengekspresikan seluruh pengalaman trauma mereka, seringkali menghasilkan pengalaman emosial" (Baggerly & Exum, 2007 Terapi bermain didefinisikan sebagai model sistematis dan teoritis untuk membangun hubungan interpersonal dimana terapis bermain terlatih menggunakan kekuatan terapi bermain untuk membantu klien dalam mencegah atau menyelesaikan kesulitan psikososial dan mencapai pertumbuhan dan perkembangan yang optimal (Landreth, 2012). Anak-anak yang mengalami bencana sangat membutuhkan lingkungan yang aman dan menyenangkan melalui terapi bermain. ...
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Kejadian bencana terus meningkat di Indonesia. Sebagian besar dari kejadian bencana tersebut merupakan bencana lingkungan hidup seperti angin puting beliung, banjir dan tanah longsor. Banjir besar-besaran terjadi di beberapa kabupaten di Kalimantan Tengah pada bulan November 2021. Berdasarkan data dari BPBD Kota Palangka Raya, tercatat 31.013 warga yang terdiri atas 8.876 keluarga menjadi korban banjir. Selain dampak fisik, dampak psikologis pasca bencana banjir perlu menjadi perhatian. Dampak psikologis yang terjadi yaitu berupa kecemasan, stres dan trauma pada para korban. Trauma pada korban bencana alam tidak dapat dibiarkan berlarut-larut agar korban bencana dapat terus melanjutkan kehidupannya secara normal, maka diperlukan terapi trauma/ pemulihan trauma (trauma healing). Khusus untuk anak-anak usia sekolah, maka sebaiknya dilakukan dengan pendekatan pedagogis. Pendekatan pedagogis yang digunakan mengacu pada pola perkembangan dan pendidikan yang telah ditempuh atau sedang dialami oleh korban pengungsian khususnya anak-anak, sehingga proses trauma healing dapat berjalan dan berpengaruh sebagaimana yang diharapkan. Selain pemulihan trauma pasca bencana juga perlu adanya pendidikan lingkungan yang memiliki peran strategis dalam mencegah dan mengurangi resiko bencana lingkungan hidup. Pendidikan lingkungan harus dapat memfasilitasi berbagai proses belajar pada ranah kognitif dan kesadaran, sikap dan perilaku, dan tindakan kolektif untuk melembagakan perilaku ramah lingkungan dan sensitif bencana.. Kata Kunci: bencana banjir; trauma healing; pendidikan lingkungan
... Counseling helps children as well as their families to recover as quickly as possible at their home or even at school. As well, therapists can follow the treatment path by performing "play therapy, " "communication with the child, " and "behavioral therapy" methods [46]. Art therapy is suitable for the treatment of children experiencing natural disasters [47]. ...
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Background The outbreak of coronavirus began in China in December 2019. It became a pandemic and a public health emergency. There have been numerous reports related to post-traumatic stress disorder outbreaks in the COVID-19 crisis. After a natural disaster, children are at a higher risk for post-traumatic stress disorder. The current study is a review of the scientific literature on the effect of COVID-19 on the prevalence of symptoms of post-traumatic stress disorder in children. We searched PubMed, Web of Science, and Scopus databases until February 02, 2022. The search strategy was based on a combination of the following keywords “child,” “COVID-19,” and “post-traumatic stress disorder.” Results By searching the Web of Science, Scopus, and PubMed databases, 173 articles were retrieved. After reviewing the inclusion criteria and in terms of eligibility, 10 articles met the inclusion criteria out of the remaining 46 articles. Based on the findings, 80% of the articles were cross-sectional and 20% of them were longitudinal. The articles reviewed in this study reported an increase in the prevalence of post-traumatic stress disorder in children during or after the COVID-19 pandemic. Conclusions In summary, the findings of this review showed that restrictions and fears of COVID-19 had negative psychological effects on children. As well, one of the most important issues that arose at the time of the tragedy was that children were suffering from post-traumatic stress disorder. Given that post-traumatic stress disorder can be treated, it is essential to choose the appropriate therapeutic intervention approach in order to better deal with the negative effects in children.
... During the COVID-19 pandemic, schools across the country transitioned to remote learning. Projections of the impacts of remote learning on students during the pandemic suggest high levels of learning loss and exacerbated levels of learning inequities, particularly among low-income, African-American, and Hispanic students, who are more likely to receive low-quality or no remote instruction 23,46,47 . Though our dataset does not include information on whether school closures resulted in virtual learning, research from the pandemic suggests that remote learning can result in lower levels of academic achievement among the most vulnerable student populations. ...
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Climate change impacts such as disasters and higher temperatures can disrupt academic learning and reduce academic performance. Here, we use two-ways linear fixed effects regression to estimate the effects of short-term school closures (1–5 days) due to wildfires, natural hazard impacts, infrastructure, and student safety on academic performance in California, focusing on mathematics and English scores from state assessments and college preparatory exams. Wildfires are responsible for the majority of school closures. Wildfires generate significant negative impacts on academic performance among younger students. We primarily find insignificant impacts on academic achievement due to school closures from other causes, including from the interaction between number of closure days and socioeconomic and racial/ethnic makeup of the school, across all causes. The effects of school closures lasting more than one week (6–10 days) are also generally insignificant, except for the negative impacts of wildfire closures on elementary school students. These results suggest that older students are resilient to most unexpected short-term school closures (1–5 days) or that teachers can make up lessons effectively after schoolwide closures.
... The limited literature that has examined the experiences of children and youth post-disaster has largely focused on risk factors associated with negative outcomes rather than protective factors, resulting in a deficit-based approach (10)(11)(12). While understanding the risk factors and vulnerabilities of children and youth post-disaster is important, the need to understand the protective factors and strengths they possess is equally pressing as they can serve to mediate resiliency processes following the adverse experience of disaster (13,14). ...
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Children and youth are among the most vulnerable to the devastating effects of disaster due to the physical, cognitive, and social factors related to their developmental life stage. Yet children and youth also have the capacity to be resilient and act as powerful catalysts for change in their own lives and wider communities following disaster. Specific factors that contribute to resilience in children and youth, however, remain relatively unexplored. This article examines factors associated with high levels of resilience in 100 children and youth aged 5- to 18-years old who experienced the 2016 Fort McMurray, Alberta wildfire. A mixed-methods design was employed combining quantitative and qualitative data. Quantitative data was obtained from the Children and Youth Resilience Measure (CYRM-28) which measured individual, caregiver, and context factors influencing resilience processes among the participants. Qualitative data was collected through semi-structured interviews to gain further insight into the disaster experiences of children and youth. Quantitative findings reveal higher than average levels of resilience among the participants compared to normative scores. Qualitative findings suggest high levels of resilience were associated with both caregiver factors (specifically physical caregiving), and individual factors (primarily peer support). We discuss how physical caregiving and peer support during and after the wildfire helped mitigate the negative effects of disaster, thus bolstering children and youth's resilience. Implications for understanding the specific social-ecological factors that facilitate and support resiliency processes and overall recovery of children and youth following disaster are also discussed.
From the year 2000 to the year 2022, Indonesia has had a number of natural disasters that were big enough to be called "national disasters." After a natural disaster occurs, it has a significant physical and social impact. The Simple Multi Attribute Rating Technique (SMART) method is applied to determine the handling priority after a disaster due to the simple calculation process. The physical and psychological impacts caused by natural disasters in Indonesia are often ignored consciously. With the aim of normalization, it is necessary to repair and restore all aspects of public or community services as part of an effort to rehabilitate post-disaster areas. It is important to recognize the contribution to post-disaster reconstruction for victims who lost daily routine activities, emotional disturbance, family loss, and a sense of security. Trauma can be categorized as acute versus chronic and early versus late. The focus of this study was examining the presence of play spaces for post-disaster recovery. The hope is that this research aims to find out the extent of the presence of play spaces in providing services for post-disaster rehabilitation and reconstruction.
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Preprint of the article published in a print journal The Guidance Journal of the Philippine Guidance and Counseling Association
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Purpose To assess the effects of childhood trauma through the child's self-report of trauma symptoms. Although designed for use with children ages 8-16, the author reports it may also be utilized with 17 year-olds, with the caution that the wording may be overly simple for this age (Briere, 1996). Conceptual Organization The 54-item Trauma Symptom Checklist for Children (TSCC) consists of two validity scales (Under-response and Hyper-response), six clinical scales (Anxiety, Depression, Post-traumatic Stress, Dissociation, Anger, and Sexual Concerns) and eight critical items which examine situations that may require follow -up, such as suicidality (Briere, 1996; Hunter et al, 2003). Item Origin/Selection Process Items were selected based on factor analyses and consultation with experts in the field of psychopathology.
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This article discusses posttraumatic nightmares as a symptom of PostTraumatic Stress Disorder. The differences between ordinary nightmares and posttraumatic nightmares are described. A Traumatic Dream Defusing Process is presented for working with posttraumatic dreams in counseling following a traumatic event. Techniques for assisting survivors to process their traumatic dreams outside of the counseling session are addressed.
Hurricane Katrina was an extraordinarily powerful and deadly hurricane that created catastrophic damage and inflicted large loss of life. The complex genesis of Katrina involved the interaction of a tropical wave, the middle tropospheric remnants of Tropical Depression Ten, and an upper tropospheric trough. Katrina generated an intense burst of deep convection over the low level center during the afternoon of August 25, 2005, while positioned over the northwestern Bahamas. It made it first appearance in the US as a Category 1 hurricane on the Saffir-Simpson Hurricane scale, with maximum sustained winds of 70 knots, near the border of Miami-Dade County and Broward County. A precise measurement of the storm surge produced by Katrina along the northern Gulf Coast is complicated by many factors, including the widespread failures of tide gauges. Estimates of the insured property losses by Katrina ranges between $20 billion and $60 billion.
The authors used an integrative conceptual model to examine the emergence of posttraumatic stress disorder (PTSD) symptoms in 568 elementary school-age children 3 months after Hurricane Andrew. The model included 4 primary factors: Exposure to Traumatic Events, Child Characteristics, Access to Social Support, and Children's Coping. Overall, 62% of the variance in children's self-reported PTSD symptoms was accounted for by the 4 primary factors, and each factor improved overall prediction of symptoms when entered in the analyses in the order specified by the conceptual model. The findings suggest that the conceptual model may be helpful to organize research and intervention efforts in the wake of natural disasters.
This article addresses how Maslow's hierarchy of basic human needs can be used as a framework for cross-cultural counseling with children in crisis; that is, children of the world who are unable to fulfill adequately their basic human needs because of extreme circumstances such as natural disaster, violence, various forms of child abuse, extreme poverty, lack of school and community resources, and emotional abandonment. Assessment of child needs is discussed and counseling strategies are presented; strategies that include supportive counseling techniques, crisis intervention techniques, program development, delivery of social services and resources, referral to helping agencies, and counselor consultation with parents and other significant adults in the lives of children.
Childhood trauma has profound impact on the emotional, behavioral, cognitive, social, and physical functioning of children. Developmental experiences determine the organizational and functional status of the mature brain. The impact of rruumufic experiences on the development and function of the brain are discussed in context of basic principles of neurodevelopment. There are various adaptive mental and physical responses to trauma, including physiological hyperarousal and dissociation. Because the developing brain organizes and internalizes new information in a use-dependent fashion, the more a child is in a state of hyperarousal or dissociation, the more likely they are to have neuropsychiatric symptoms following trauma. The acute adaptive states, when they persist, can become maladaptive traits. The clinical implications of this new neurodevelopmental conceptualization of childhood trauma are discussed. Le trauma de l'enfance a un impact profond sur le fonctionnement émotionnel, comportemental, cognitif, social et physique des enfants. Les expériences en matière de développement déterminent l'organisa-tion et le fonctionnement du cerveau arrivé à maturité. L'impact d'expériences traumatiques sur le développement et le fonctionnement du cerveau sont discutés dans le contexte de principes de bases de neurodéveloppe-ment. Il existe plusieurs résponses mentales et physiques d'adaptation au trauma, parmi lesquelles l'excitation physique intense et de la dissociation. Parce que le cerveau qui se développe organise et internalise les nouvelles “informations” d'une manière liée B l'utilisation et en dépendant, plus un enfant se trouve dans un état d'excitation ou de dissociation et plus il risque d'y avoir des symptǒmes neuropsychiatriques aprés le trauma. L'“état” adaptatif aigu peut devenir persistent et conduire à des “traits” d'inadaptation. Les implications cliniques de cette nouvelle conceptualisation de neurodéveloppement du trauma de l'enfance sont discutées.