Sponsored by the HealthcareTrainingInstitute.org providing Quality Education since 1979
Add to Shopping Cart

Crisis Intervention: Assessment & Practical Strategies
Crisis Intervention: Assessment & Practical Strategies - 10 CEUs

Section 26
Timing Crisis Counseling for Children Following a Traumatic Event

CEU Question 26 | CEU Test | Table of Contents | Crisis
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs

First of all, it must be stressed that there are many possible forms of crisis intervention. Thus, it is absolutely vital that the exact form of the intervention used be operationalized and described. Secondly, the intervention Children Trauma Crisis Intervention social work continuing educationof Critical Incident Stress Debriefing was developed by Mitchell (1983) for application to groups of emergency workers not primary victims. Thirdly, "psychological debriefing" as described by Dyregrov (1991,1997) was developed for use with groups of survivors, and it makes group processes central to the whole intervention. Fourthly, the recently attempted meta-analyses of published random control trials have mainly examined very brief, individual crisis interventions bearing little resemblance to psychological debriefing and at times applied to situations where major stress reactions are not even expected (Bisson, et al. 2000; Dyregrov 1998; Yule 2001a).

It has to be admitted that there are very few studies that evaluate the effects of psychological debriefing with children. It has also to be faced that inappropriate intervention given by inadequately experienced people and given at the wrong time can possibly slow down natural recovery if not actually make things worse. There is a responsibility on child mental health services to undertake proper evaluations of crisis interventions.

Having said that, there is a need to respond to children traumatized by an emergency event. What should be done? There are two studies that have generally positive outcomes. Yule and Udwin (1991) screened some survivors from a shipping disaster--children from the same school--and provided a structured psychological debriefing 10 days after the incident. The children were offered help individually or in small groups, and it was found that those who scored highest on the screening battery were those who availed themselves of the offer. Five months later, the children were doing better than those in a neighboring school that had not arranged crisis help for their charges. However, in this natural experiment that was not planned, debriefing and early intervention are confounded.

Stallard and Law (1993) show more convincing evidence that debriefing greatly reduced the distress of girls who survived a school bus crash. The researchers provided help a few weeks after the crash, and the girls responded positively to only two group sessions.

However, we still do not know when best to offer such debriefing to survivors of a disaster, nor indeed whether all survivors benefit. There is evidence from work undertaken in the Armenian earthquake (Pynoos et al. 1993), in many action research studies undertaken under the auspices of UNICEF in Bosnia, and more recently from the Turkish and Greek earthquakes (Giannopolou 2000; Yule 2001b), that group interventions many months after an event can still greatly reduce psychological suffering.

Based on this slowly emerging evidence, on my own experience, and on many fruitful discussions with colleagues around the world, I make the following recommendations:
Schools and other agencies should undertake risk analyses and prepare to deal with emergencies.
Agencies charged with meeting the psychosocial needs of children after disasters should invest in training key staff.
Key staff also need to have experience in helping children who experience bereavement.
Children's safety, security, medical, and other physical needs need to be met before psychological interventions are offered.
There is little point in starting any psychosocial help until children are coming out of shock, dissociation, and disbelief. This means that group help should not be arranged during the first few days: 5-to-10 days after the incident seems optimal. Some contact needs to be made indirectly immediately; this can be by way of suitable leaflets.
Groups should be led by suitably prepared individuals with access to supervision.
Manuals based on good outcome studies should be used in preference to home-grown manuals.
Psychosocial interventions should not be confined to "one-off"--single occasion--meetings.
Children should be screened and monitored, and appropriate further help arranged as necessary.

The current debate regarding crisis intervention for primary survivors of disasters centers around the timing of the initial intervention. My argument is that during the first few days, children are likely to be in shock. They need reassurance and to be reunited with their parents. Thought should be given to such reunion occurring at the scene of the disaster, so that children can better link a variety of reminders with safety signals. Some contact should be made by mental health professionals, but the adult literature strongly suggests that the wrong sort of contact in the first few days may be harmful--hence, the recommendation that 5-to-10 days afterwards is probably optimal. Obviously, an issue as important as this should be settled by evidence rather than theorizing.
- Yule W, When disaster strikes--the need to be "wise before the event": crisis intervention with children and adolescents; Advances In Mind-Body Medicine, 2001 Summer, Vol. 17, Issue 3
The article above contains foundational information. Articles below contain optional updates.

Personal Reflection Exercise #12
The preceding section contained information about timing crisis counseling for children following a traumatic event.  Write three case study examples regarding how you might use the content of this section in your practice.

Online Continuing Education QUESTION 26
According to Yule, what is the optimal time after a traumatic event to begin crisis intervention and counseling for children? Record the letter of the correct answer the CEU Test.

Others who bought this Crisis/Trauma Course
also bought…

Scroll DownScroll UpCourse Listing Bottom Cap

CEU Test for this course | Crisis
Forward to Section 27
Back to Section 25
Table of Contents

The article above contains foundational information. Articles below contain optional updates.
How Intergenerational Trauma Impacts Families - April 21, 2020
Intergenerational transmission of trauma may be understood as the ongoing impact of traumatic events and situations that happened in prior generations and continues to impact the current generation. Trauma can...
Mother Teresa with a Blackbelt: An Interview with a Thriver Whose Own Trauma Helps Others Heal - August 05, 2019
Although I have not met Theresa Byrne face to face yet (my intention is certainly to do so), I feel a kinship with this conscious communicator whose musings inspire her...
Trauma After Abuse - July 10, 2019
Codependency robs us of a self and self-love. We’ve learned to conceal who we really are because we grew up pleasing, rebelling against, or withdrawing from dysfunctional parents. That sets...
The Importance of Healthy Living in the Treatment of Complex-PTSD - May 08, 2019
Treatment for complex post-traumatic stress disorder (C-PTSD) happens on many levels. In order to heal emotionally and mentally, we need to support the physical body as well. Research has found...
C-PTSD and Relationships - April 02, 2019
Complex Posttraumatic Stress Disorder (C-PTSD) is a term that researchers developed to explain the pathology that results from ongoing and prolonged exposure to trauma.1 Individuals suffering from complex trauma present different...

CEU Continuing Education for
Social Work CEUs, Psychology CEUs, Counselor CEUs, MFT CEUs


OnlineCEUcredit.com Login

Forget your Password Reset it!