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  • Child psychologist offers 5 ways to help kids process tragedy

    by Cole Cosgrove

    Children may feel anxiety if they hear people talking about the explosions at the Boston Marathon, or see graphic images or media coverage. For advice about how to talk to kids and help them express their feelings, we turned to Bob Beilke, Ph.D., a pediatric and clinical child psychologist who has worked for 21 years at Mary Bridge Children’s Hospital & Health Center in Tacoma, Wash.

    During a tragedy, adults often watch a lot of news coverage. Should they do that around their child?

    We wouldn't want parents to inundate the child with a lot of media reports. We don’t want the child to have to hear the detailed information. It's bad enough to witness it or hear about it once, but it is traumatic to see and listen to it over and over again.

    Adults can contextualize it and may want more information, because information is helpful for the adult mind. But for a little child, too much information without an understanding of that information produces more anxiety, so we’d want to shield the child from a lot of that.

    Limit the amount of discussion about this particular incident.

    What are some ways to talk to my child about something like this?

    As a starting point, ask them a general question like, “Did you hear about something bad that happened today?”

    If the child says no, there’s no reason that a young child needs to know about this.

    Asking a general question as a starting point gives you an opportunity to ask, “What did you hear?” and provide some corrective information.

    Kids in middle school and high school may know more about it than kids in elementary school.

    Let’s say the child sees it on the news or someone talks about it. Depending on the age of the child, provide general information, though not specific information.

    In simple terms:

    • A bad person hurt some people.
    • This happened far away on other side of the country. It is not anywhere close to where we live.
    • Provide a lot of reassurances. "You are safe."

    What if my child asks, “Why did this happen?”

    In response to an older child, we might say that we don’t always know why people do things, other than the person was angry and felt that he wanted to punish other people for all the bad things that have happened in his own life.

    For younger kids, we might explain they’re just a bad person who’s angry at other people.

    What are some signs to watch for if my child is having anxiety about this?

    Anxiety is one of those things that’s very internalized, so some kids may not look or behave differently, but they may still have worries.

    Look for changes in appetite. Changes in routine. Things they normally would have enjoyed, they’re not doing. They might be more clingy with parents. Potentially nightmares. Tummy aches, headaches. Younger children may have regressive behavior, such as more crying, being irritable, or wetting the bed.

    For the older child, parents should ask general questions that allow the child to express their concerns. Ask, “What do you think about that? How are you feeling?”

    If they’re feeling scared, allow the child to supply that.

    If child is having nightmares about this, or the child is obsessed about this and keeps talking about it, or looks very anxious, that’s the time to consider talking to a counselor.

    How can I reassure my child?

    A parent has to be balanced about it, and don’t traumatize the child by your own conversations.

    They’re going to look to the parent for their sense of security. Kids will take their cue from their parent, so if the parent is calm, confident and reassuring, then the child will be reassured.

    But if a parent is anxious and frightening the child, the child isn’t going to be reassured at all.

    That’s where one’s presentation in how they present themselves communicates much more loudly than their words.

    The reality is this type of tragedy is a low frequency event. It doesn't happen often at all. Maintaining routines help comfort children. Routines offer predictability, and predictability offers a sense of normalcy and a feeling of security.


    Beilke offered these additional guidelines for those who want more details:

    10 GUIDELINES FOR TALKING WITH CHILDREN ABOUT TRAGIC EVENTS

    By Robert Beilke, Ph.D., pediatric and clinical child psychologist who has worked for 21 years at Mary Bridge Children’s Hospital & Health Center in Tacoma, Wash.

    Frightening events may cause distress and anxiety in children and youth. Parents will want to assist their children as best they can but may feel uncertain about how to approach this task. Below are some guidelines designed to assist parents in addressing these events with their children. It is my sincerest hope that these guidelines help parents communicate with their children and promote in them a sense of security, validation, understanding, and hopefulness.

    1. Be calm and present: Your presentation matters.

    • Children need to know they are safe. Your child will look to you for signs of their safety.
    • As much as possible, convey a sense of calm through your emotions, words, and behavior while remaining truthful. Children will be interested to know what their parents are thinking and feeling. Be honest with your children but be careful to offer a calm presentation.
    • Find adult outlets, away from children, to express any negative reactions you may have.
    • If your child witnesses your strong emotional reaction, calmly explain to him or her the reasons for your emotions and offer reassurances that you are all right and they are safe.

    2. Be informed: Have accurate information to counter rumors and half-truths.

    • Accurate information is a powerful coping tool for adults and children alike. Children should be provided information that reassures them. Even young children will wish to understand and make sense of the events surrounding them. Be prepared to counter misinformation with accurate information. This may require parents watching additional news coverage, but be careful you do not overwhelm yourself or overexpose your children to news coverage.
    • Even if children hear accurate information, their interpretation of news accounts may be distorted by their own lack of understanding. Therefore, listen to your child’s questions and fears. Ask your child what he or she understands from news reports. Remember, a child’s questions may come at the least expected time, for example, when you are busy. Stop what you are doing and spend time with your child.
    • Remember, knowing accurate information is a form of control over a situation that feels uncontrollable.
    • Temper your discussions with the knowledge that breaking news is often incomplete and more accurate information will come later.

    3. Be attentive: Listen to what your children say and how they behave.

    • Children may talk about these events. Take this opportunity to listen to what they say.
    • Children may show signs of stress or fear. For example, your child may display clingy or defiant behavior, insomnia, nightmares, lack of concentration, aches and pains, irritable mood, disinterest in normal routines or activities, anger, or fear. If this is the case, you may wish to ask questions about what she or he is thinking or feeling.
    • Some children may remain silent and show no signs of concern, however, they still may be burdened with the conflict.

    4. Be sensitive: Respond to your child.

    • One child may respond differently than another. You are the expert in understanding and reading your child. You know the telltale signs of anger, fear, sadness, or even neutrality. Validate your child’s emotional experiences. This is a frightening time and children realize it. To ignore or dismiss their feelings either causes the parent to lose credibility in the child’s eyes or sends the message that children cannot trust their own thoughts and feelings. Once you agree with your child that this is a frightening time, then you can assist her or him in feeling safe.
    • In a non-judgmental manner, accept your child’s emotional presentation and thoughts. Even if you believe your child’s response is inappropriate, you first validate the thoughts and emotions causing their reaction and then you may explore other perspectives with your child. By doing this, you allow an open exchange of ideas to continue.
    • Be flexible with your child. Some children will not need or want to talk. Children are amazing in their resilience and some may be coping just fine without parental intervention. If this is the case with your children, praise them for this and let them know the invitation stands for them to talk with you if they wish.
    • Other children may be disinterested and truly not have an opinion or concern about it. Younger children in particular may receive reassurance from a parent and then they will not be concerned further.

    5. Be direct: Talk with your children.

    • You may ask your children what they think or feel about the events, or what they hear and see on the television.
    • You may ask what your child’s friends or teachers are saying.
    • Limit your child’s exposure to television and other news coverage based upon what is appropriate for their developmental level. Preschool children will not benefit from watching news coverage but if they are exposed to it, they may be at risk for having their anxieties raised. This includes young children playing in the same room while a news program is on, even if the child appears inattentive to the news program. I am always amazed at how much even the youngest child picks up from his or her surroundings when adults believe the child is oblivious to what is going on around them. Elementary children may wish to watch the news but will be less interested than teenagers who should be allowed (within reason) to control the amount of information they receive and may welcome more frank discussions with you.
    • For older children, sit with your child as she or he watches the television coverage and explain the content of the news reports in terms he or she can understand.
    • A child’s developmental level should also gauge the type and amount of information provided to the child. Preschool children could know about these events, but will cope best with simplified explanations and reassurances. Elementary age children will understand in basic terms the issues involved and may even want to discuss them with you. Teens will require more adult-like information. Provide accurate information to youth in this age range.
    • With increased news coverage and news breaks occurring during regular programming, it is important for you to monitor more closely your child’s television viewing.
    6. Be consistent: Maintain your routines because they offer predictability and hope.

    • Routines help all people, especially children, experience a sense of control over their world. Consistency leads to predictability and predictability leads to security.
    • If it is not your family tradition to watch the news during meal times, then keep the family routine of eating together without the television or radio turned on.
    • Your consistent routine tells your child that life is stable in your home and in their immediate environment or local world. This offers hope to your child that their world, as they know it, will remain the same.
    • Resist the urge to keep your children from school or dramatically interrupt their social life. All families have some degree of flexible schedules and each day may be slightly different from another day. However, try to maintain as consistent a routine as possible because this tells your child she or he is safe.

    7. Be active: Offer your children ways in which they can do something.

    • Doing something addresses a child’s sense of helplessness.
    • Research shows that being active or doing something is a great way to cope with overwhelming stress and anxieties.
    • Be creative in what this will involve for your family.
    • Some examples of activities include: Writing letters, drawing pictures, displaying the American flag, raising and donating money to relief organizations, practicing tolerance and problem-solving in your personal relationships as your own expression of how to prevent and resolve conflicts, or practicing a safety plan in the event of a local disaster (remember, how a parent approaches this last activity is as important or even more important than the plan itself).
    • Find out what is happening at your child’s school. Schools may choose to incorporate classroom discussions, judicious watching of news coverage, art projects expressing students’ thoughts or feelings, or letter writing. School counselors could be available to talk with students about their feelings.

    8. Be comforting: Offer reassurance to convey a feeling of safety and security.

    • Tell your child that your neighborhood is safe and these events are a long way away. You can use maps, globes, or simply say it is a long way to even drive there.
    • Your child may need the reassurance that they will not be left alone, that you are thinking of them even when they are in school or at day care. Some children may need extra words or actions that convey your love for them.
    • Parents may worry about the threat of terrorism. Parents can reassure their child that our government is taking extra steps to keep us safe. The younger the child, the more concerned they will be with how they get along with friends and how things are at home or school. .
    • Remember, accurate information and correcting false information is comforting and is one way we become active.
    • For the very distressed child, other forms of coping may be helpful such as massages, physical exercise, deep breathing exercises, or other relaxation efforts.
    • If your child has experienced past traumatic events or the death of a loved one, then he or she may be more susceptible to becoming re-traumatized. The images or stories may trigger a child’s emotional or mental memory of a past trauma or grief. They may feel, think, or behave as they did when they were first traumatized. The current event itself may not be the issue for the child but merely the thing that reactivates the traumatic memory. For these children, parents may need to deal with the past trauma or grief. If the child saw a mental health professional in the past and if the child’s negative reaction does not resolve, then a brief check-in with their mental health provider may be necessary.

    9. Be tolerant: Avoid prejudice.

    • We live in a multicultural nation and therefore we need to demonstrate understanding and acceptance of people around us.
    • Clearly express your expectation to your child that he or she must resolve conflicts peacefully and make every effort possible to solve problems without fighting.

    10. Be Hopeful: Our children have a future.

    • Emphasize what is positive in your child’s life and project a positive presentation to your child.
    • Remember routines go a long way to promote a sense of hopefulness.
    • Emphasize how many people are safe rather than how many people are injured or killed.
    • Your calm parental presence will instill hope in your child that you are there for them. This provides children with immeasurable hope for the future.
    • Exercising expressions of your family’s religious faith may promote a sense of hopefulness.


    Additional related guidelines and topics:

    Caring for Kids after Trauma
    Helping Children and Adolescents Cope with Violence and Disasters
    Stopping School Violence
    Talking with Children about School Violence
    Talking with Children about Violence


    Posted on Apr 15, 2013 in Kids' Health