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News & Views - October, 2001 Issue #86

How Secondary Trauma Impacts Adolescents In Residential Programs

“It is enough to be a decent American
and for children to
show pride in who we are as a country.
Children should not feel bad
because they can’t give blood.”

By Dr. Michael Conner
Bend, Oregon
541 388-5660

[Dr. Conner, Director and Researcher at Mentor Research Institute, is a clinical, medical and family psychologist who completed a research and training fellowship in graduate medical education and health education. He is Board Certified in Traumatic Stress, Emergency Crisis Intervention and Emergency School Response.]

In one violent traumatic moment the world of parents and their children became unpredictable, dangerous and frightening. The destruction of the Pentagon, the World Trade Center and four passenger airplanes has left a traumatic impression on America. The aftermath of this trauma is being felt in families, schools and cities across the country. The psychological impact can be powerful and lasting, both for those directly involved, as well as for the rest of us who are watching. Parents are naturally concerned for their child’s physical and emotional well being during times of crisis. They become worried and vulnerable to behavior motivated by separation and guilt. Residential boarding schools have unique abilities and responsibilities when facing the impact of violent trauma at a national and global scale. People respond differently after a crisis, a dangerous situation or a traumatic event. Everyone is changed and many are changed in ways they do not realize. This is especially true for children and adolescents. Some feel the brunt of the experience immediately. Others appear to be strong or even numb to their experience. Few recognize how a trauma can unconsciously influence their behavior. The teenager who is helping everyone else can become the greatest unseen tragedy.

Primary Trauma
People who were present during the destruction of the World Trade Center or Pentagon, or who observed the victims of the airplane crash experienced what is know as “primary trauma.” This trauma usually includes police, fire and rescue service professionals but also the individuals in or near the area of a violent and traumatic event. The impact on these people can be tremendous. They can experience dramatic changes in their thinking, emotions, memory, concentration, energy and ability to participate in activities. Many become accident-prone, stop eating, can’t sleep, become impatient and moody. They feel unable to work or return to school.

Secondary Trauma
The rest of us experiences what is called “secondary trauma.” There can be traumatic effects from watching television, reading newspapers and magazines, listening to others and talking about it. Comforting and empathizing with each other and victims can have either a beneficial or a traumatic emotional impact. There can be mild to severe consequences when secondary trauma is powerful, repeated or long in duration. Examples of secondary trauma include but are not limited to:

  • an increase or return of symptoms associated with emotional or psychological problems unrelated to the primary trauma
  • new problems or symptoms such as anxiety, panic, social withdrawal and mood swings
  • a return of previous symptoms, flashbacks or emotional memories from a past primary traumatic event that is related in content or feelings to the current primary traumatic event.

Some Children Are More Vulnerable
A report by the Surgeon General found that one out of 10 children, including teenagers, have serious emotional and psychological problems. Only one out of three of these kids receive appropriate care and treatment. Studies published by the National Institute of Mental Health suggest that as many as one out of five children have mild to moderate emotional and psychological problems that may result in further problems if they are exposed to prolonged or severe stress. This would include the stress associated with secondary trauma. Children who are at risk include and are not limited to:

  • children who are candidates or might already be on medications for learning, psychological and emotional disorders
  • children with moods disorders including depression, anxiety and panic, as well as impulsivity, obsessions, compulsions and disorders of thinking
  • children who have experienced a traumatic event involving abuse, neglect, a destructive accident, a devastating loss of safety, or outright violence – especially within the past 7 years
  • children who are immature and demonstrate developmental delays

Stress resulting from a traumatic event and subsequent events is of concern. We should monitor children who are at risk, especially children with a history of escaping and avoiding how they feel by isolating, skipping school, experimenting with alcohol and drugs, engaging in thrill seeking behavior, or taking their anger and frustration out on others.

Dealing With The Impact
The impact of a traumatic experience doesn’t end when people forget, nor does it simply end with the passage of time. Traumatizing a nation creates and perpetuates secondary trauma through media exposure, our government’s response, economic and social impacts, and the changing relationships between children, parents and teachers. Appreciating the breadth of this trauma is not easy. Not only are we grieving; many of us also ponder the possibility of biological warfare and other acts of terrorism. It will not be over for years; simply deciding it is time to get over it, is naive. On the other hand, heightening our awareness of these threats can increase the stress level in those who are unable to manage it due to a lack of conceptual and emotional skills. Some children are not developmentally ready to internalize the full meaning of what this country is facing.

There are clues that schools and programs should consider and be alert to recognize. Changes in behavior – primarily overreactions and under reactions are good signs that a child has been impacted and may need help. [For detailed information on traumatic incident stress see the handouts available at www.CrisisCounseling.com.]

Benefits of A Residential Program
I believe the behavioral changes associated with primary and secondary trauma following a violent traumatic event will occur regardless of whether a teenager is enrolled in a residential boarding school or remains in their home. There is every reason to believe that children will “weather” this trauma more successfully in a structured environment than they might if they returned to the environment that had led to their initial placement. Boarding schools, especially intervention and therapeutic programs, can offer structure, support and guidance at a much higher level than many families and public schools. Structure and guidance are recognized as key components in any traumatic incident stress treatment response.

Suggestions For Programs
Teenagers can have a particularly difficult time controlling the source of stress during a trauma of national and global proportions. For this reason, a boarding school has definite advantages and responsibilities. Interventions that that will help, many of which are already part of a most programs, are as follows:

  • Help students express their thoughts and feelings in a safe and open manner
  • Take time to talk about the events, especially when thoughts and feelings arise
  • Talk with people who care about you
  • Maintain a normal schedule and routine as much as possible
  • Doing something positive or doing something about the challenges we now face is more important than understanding every detail and looking at every picture, video and news special on television
  • Recognize that many people will feel guilty and that listening is more important than telling people to stop feeling that way

There are also things that programs can do that will create a structure and container capable of guiding children past these emotionally challenging times.

  • Promote activities where staff set healthy examples
  • Provide regular physical activity
  • Insure proper nutrition in all students
  • Insure adequate sleep
  • Teach and support time management
  • Provide opportunities for students to talk it out without conflict
  • Teach and support assertiveness and conflict resolution
  • Structure time for students to be alone
  • Provide opportunities to obtain assistance and help others
  • Provide opportunities for recreation and play

More than anything, programs, staff and adolescents need to restore balance to their lives. This is no time to become obsessed with what happened – especially if responsibilities to students, work or relationships suffer. Repeated and prolonged exposure to violent and traumatic images as well as written and verbal content can become depressing, create anxiety or produce a callous insensitivity. The greatest challenge may be to recognize the emotional impact that this traumatic event is having on you.

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