Helping Children Deal with Trauma
by Nadia Ekenstam, LCSW, Primary Children’s Center for Safe and Healthy Families
More than two thirds of children report at least 1 traumatic event before reaching adulthood. You may have heard people talk about childhood trauma, but what does that all mean? Below are some common terms you may hear:
Traumatic events are intense situations that threaten or cause harm to a child’s emotional or physical well-being. The harm can be physical or emotional, real or perceived, and it can threaten the child or someone close to him or her.
Potentially traumatic events include abuse (physical, sexual, verbal, emotional), family, school, or community violence, natural disasters or pandemics, serious accidents or illness, bullying, separation from caregivers or loved ones, refugee or war experiences, military family-related stressors, and witnessing harm or a sudden loss of a loved one.
How can trauma can affect children?
After a traumatic event, children may react in many ways.
Child traumatic stress is when the intense fear and stress response that occurs during the trauma event overwhelms a child’s ability to cope.
Trauma responses occur when your child’s protective “alarm system” was turned “on” during the event; but isn’t turning “off” after the event.
Not all children have traumatic stress after a traumatic event. However, if they do, your child’s behavior or mood may change. They may:
Become more withdrawn and less interested in activities they used to enjoy.
Become sad, overly sensitive or easily startled/jumpy.
Avoid certain things or places.
Develop fears of things they weren’t afraid of before.
Become crankier and more irritable, angry or demanding.
Have changes with eating or sleeping or have more complaints about aches and pains in their body.
May have a harder time concentrating at home, school, or while playing.
May become clingier to their caregivers.
These reactions may show up right after the event, or later. They are often normal and protective reactions for a child who has experienced a trauma and may only be a problem if they continue for a long period of time.
The good news is that with time, most kids do well and return to their regular selves. For those who continue to struggle with these reactions, they may benefit from having support from a mental health therapist. Help is possible
What can you do to support your child?
With the help of supporting and caring adults, children can and do recover. Here are some things you can do to help support your child after experiencing a trauma.
We know that kids do best when parents are doing well. You can best help your child when you take care of yourself.
Maintain consistency, stick with your usual routines as much as possible.
Give your child extra reassurance and support.
Be patient.
Keep the door open for your child to talk about their thoughts, feelings and reactions; especially fears or worries.
Respond, don’t react. Model “calm”.
Use coping skills you’ve found helpful for yourself and your child.
How do I get help?
If you are worried about your child’s reactions and feel they may need to talk to a trained professional, a good place to start is with your family doctor/pediatrician. They often know your child and your family and can help you understand what behaviors are age-appropriate or of concern.
They can give you referrals and resources for mental health professionals who specialize in working with youth who have experienced trauma.
You may also contact your insurance company or Primary Children’s Center for Safe and Healthy Families.
Resources
Intermountain Free Emotional Health Hotline 833-442-2211
MyStrength app free 60-day trial: For help with mental health self-care. A guest account can be set up by visiting: mystrength.com. The Utah access code for the 60-day trial is UDHSguest33
May is National Mental Health Awareness Month. For more information, visit the National Alliance on Mental Illness (NAMI)
Choosing a Provider
by Heather Shotwell, LCSW, Pediatric Behavioral Health Clinical Manager
Choosing a therapist can be difficult. Often, you are unsure of where to start and what to expect. Also, during Covid-19, many therapists are seeing patients virtually, but that can also be effective. Here are some ideas to help you get started:
1. This can be hard for many parents. You may experience a wide range of feelings – sadness, frustration, worry, embarrassment, fear. Please know this is normal and be patient with yourself.
2. If you have insurance, consider using your mental health benefits to cover treatment.
Start by calling your insurance to find out if you have mental health benefits and what they cover. Look on the back of the card for a phone number for mental or behavioral health services. If you do not see one, look for a member or customer service number.
Call the number, inform the rep that you are a member and want to understand your mental health benefits.
They might ask for a diagnosis or what level of care your child needs. It is okay to say you don’t know, and you just want a general understanding of your mental health benefits.
Ask them if they use any methods to identify high performing providers.
3. When you begin to call providers, here are some things to expect:
Most providers will ask you some basic demographics, including your insurance.
They will ask you for some background information on what your child is doing or saying that has you concerned. Describe as best as you can these behaviors, as it will help the provider know if they can meet your needs.
Have a piece of paper and pencil available. Notes will help you track your phone calls and next steps.
4. Here are some questions to consider asking:
Does my child sound like other children you have treated or worked with?
Do you use tools/outcomes to show that children are improving? What are they?
What kind of the provider will I be working with? To understand the different types of mental wellness providers visit the National Alliance On Mental Illness (NAMI).
Can you describe this provider’s style and personality? Parents know their child best. You may have an idea of what type of provider might be a good fit for your child (male vs female, gentle versus upfront). Share this information with the provider. Also consider being open to other types of clinicians. There’s a lot of research to show the relationship your child has with the provider is a high indicator of success. Sometimes, being open to new personality types and genders can bring about more opportunities for your child.
How long is the wait for this provider?
What will happen in the first visit?
Will the provider talk with me alone?
How will the provider know what my child needs?
Are you contracted with my insurance?
What will the therapist be able to tell me what they talk about with my child?
What books or resources can I research while I wait for the appointment?
5. As you prepare for your visit with the therapist, consider bringing in notes on specific behaviors or concerns you have.
Consider talking with your child about what you are each hoping to accomplish with the visit. It is okay if your goals look different than your child’s. In the first visit, let the therapist know these goals. This will lead to you both creating a treatment plan. A treatment plan is a measurable goal and the strategies you, your child, and the therapist will use to accomplish this goal.
Discuss with the therapist, what indicators you will use to determine the goal s been reached.
How will you determine success and that your child’s mental health is improving? The treatment plan will help ensure everyone is on the same page.
Providers may have wait times. It may be best to call several providers and get placed on several waiting lists. Just remember to contact the other agencies once you have an appointment, so they can open that spot for others.
6. Here are some ideas for options while you wait for your appointment:
Attend a parent support group or parenting group. (Groups may be virtual right now.)
Make an appointment with your pediatrician to share your concerns.
Talk with your child’s school about any available resources they might offer.
See if your employer has an Employee Assistance Program that might be able to see you sooner for some brief therapy visits.
Study the books and resources your provider recommended. Be careful with Google!
Resources for Immediate Disaster Behavioral Health Response
Provided by Leah Colburn, CHMC, Children, Youth and Families, Program Administrator, Utah Division of Substance Abuse and Mental Health
Tips for Talking with and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers—Help recognize and address problems in kids affected by a disaster. Learn about signs of stress reactions that are common in young survivors at different ages, as well as how to help children through grief.
Understanding Child Trauma—Identifies events that children and youth may experience as traumatic, presents statistics on these experiences and their effects on children and youth, and lists signs of traumatic stress in kids of various ages.
Age-related Reactions to a Traumatic Event—Provides an overview of how children and adolescents may react to natural and human-caused disasters that they experience. It describes reactions typical within specific age ranges and offers tips to help children and adolescents cope.
Trinka and Sam: The Day the Earth Shook—This booklet tells the story two young mice who survive an earthquake. They show signs of sadness and fear that are common in children after an earthquake.as they seek out for help and support. Guidance is provided to help caregivers use the book to help their children understand and talk about their experiences with an earthquake.
Additional Resource for Acute Needs
SafeUT— This app answers crisis calls, and chats—about yourself or someone else—24/7. Counseling topics include depression, anxiety, loss, grief, suicide prevention, or life challenges. SafeUT is free and confidential.
National Suicide Prevention Lifeline—Support is available 24/7 for people in crisis, including challenging reactions to disasters. 1–800–273– TALK (1–800–273–8255). Spanish: 1–888–628–945
If you have any questions regarding injury prevention efforts, call 801.662.6586 or go to primarychildren's.org/safety