My thoughts go out to those in Norway who have been affected by the tragic events in the past days, both in Oslo and Utøya. I can’t imagine the scale of this tragedy, and wish survivors all the strength and time needed to come to terms with the experience and the loss of loved ones. When you are looking for information about helping the youngsters and their families involved, below are some links to resources.
Several important things to do at this moment are:
- to tell children that they are safe and comfort them
- to organize any practical arrangements that are necessary
- if children are still separated from their primary caregivers, to organize their reunion
- to tell them that it is normal to feel distressed after such an abnormal event
- to pick up daily routines to restore a feeling of predictability and control
Perhaps the most important thing to say is that most people who experience a traumatic event are resilient: after some initial distress, they will feel better over time and won’t need mental health care. There is still controversy regarding ‘debriefing’ after trauma (see Bisson et al. below for a description of the discussion). From the current base of evidence it looks like it is not helpful to do debriefing shortly after an event and in my view, a safe rule would be: a child (or parent) needs to feel that it is okay, but not necessary, to talk about the experience.
When you are a parent, one thing we learned in our own research at the National Psychotrauma Center for Children and Youth is that you can’t trick a child: children notice very quickly how you feel, even if you think you hide your emotions. Make sure there is no discrepancy between what a child sees and hears from you: it is okay to say that you feel anxious/angry/… If you feel that you are overwhelmed by the experience, try to find other adults to support you and your child. In general, be attentive to your own needs (as in the airplane instructions: you won’t be able to help your child if you don’t have ‘oxygen’ yourself).
What kind of distress reactions to expect in youths? Common posttraumatic stress reactions in children and adolescents include: nightmares, repetitive intrusive thoughts about what happened, feeling anxious, avoiding thoughts/feelings/people related to the event, concentration difficulties, separation anxiety (not wanting to separate from caregivers/loved ones), over-alertness, irritability, and feeling guilty. Usually, children (as well as adults) show distress in the weeks after a traumatic event, which diminishes gradually.
What is a normal trajectory of recovery? As a rule of thumb we expect to see some improvement in four weeks. If a survivor doesn’t feel better at all after four weeks, it is a good idea to check with your GP or a mental health care professional whether extra services are needed. Of course, if you worry about your child, yourself or someone else before the four weeks have passed, do give a professional a call to discuss your worries.
General: the Norwegian Center for Crisis Psychology (Senter for Krisepsykologi) has this link in Norwegian, and Atle Dyregrov also made available this pdf: REAKSJONER UTØYA
For young people: I am still looking for a good website in English or Norwegian for you (any suggestions from readers are very welcome), this one was made by Headspace after the Australian bushfires and has some good information.
For parents: these are tip sheets about helping preschoolers, school-age children, and adolescents after trauma, by the U.S. National Child Traumatic Stress Network (NCTSN). Aftertheinjury from Children’s Hospital of Philadelphia may also be very informative.
For professionals: the complete Psychological First Aid guide is very comprehensive. This is the link to the full guide by the NCTSN
Specifically for teachers: for a short overview see my earlier post on supporting children in the classroom after trauma, and see also the toolkit for educators by the NCTSN
Bisson, J., Brayne, M., Ochberg, F., & Everly, G. (2007). Early Psychosocial Intervention Following Traumatic Events American Journal of Psychiatry, 164 (7), 1016-1019 DOI: 10.1176/appi.ajp.164.7.1016
If you think this information is helpful, please share the link.
Melissa Brymer from the US National Child Traumatic Stress Network sent a message that they are working hard on materials for people in Norway, these will be available on Monday at http://www.nctsn.org/resources/whats-new.
She also mentioned the website of the Norwegian Centre for Violence and Traumatic Stress Studies: http://www.nkvts.no
Update Wednesday: On the NCTSN website, there is now available
– a flyer about the psychological impact of the recent attacks: http://nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager1.pdf
– a tipsheet for youth about talking to journalists about the shooting: http://nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf
– a tipsheet for parents about media coverage: http://nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf
The Australian Child and Adolescent Trauma, Loss and Grief Network has information that is relevant for children and young people who have been affected by a traumatic event. The website is http://www.earlytraumagrief.anu.edu.au/
Of particular relevance are the pages on:
Psychological trauma in children and young people
and Information for parents and carers
Dr. David Berceli is a recognized international trauma therapy professional. TRE, Trauma Releasing Exercises is his contribution for people who have experienced severe of any type. At the moment it is reassuring to know that Dr. has already visited Norway several times, so his method is available there.
This information leaflet is for parents whose child is admitted to the hospital, yet it can be helpful to recognize stress reactions in general.
Click to access eng-in.original.pdf
There is more information (in Dutch) on stressreactions after a hospital admission on the website:
These infromation leaflets on stressreactions and tips are also available in Arab and Turkish
Click to access arab-in.original.pdf
Click to access trk-in.original.pdf
Hi Amanda, Maria, and Madelon,
Thanks for these links! In a few days I will make an overview.
Yesterday I also received this helpful information from Scott Sevin (7-Dippity):
” My organization and I collaborated with Dr. La Greca in developing materials to support children and families with the 9/11 terrorist attacks and fears and worries about future terrorist attacks. The materials are available for free download on my company’s website.
The link to “Helping Children Cope With The Challenges of War and Terrorism” is: http://www.7-dippity.com/other/op_hcc.html. There is a supplement for educators or counselors working with groups of children with this material as well.
The link to “Helping America Cope” – our 9/11 material for children and families (similar concept to the War and Terrorism” book) is: http://www.7-dippity.com/other/op_freedownloads.html.
Perhaps this material will be of comfort to some of the families.
In addition, we developed materials to help first responders (law enforcement, fire, etc.) cope with the 9/11 terrorist attacks. You can find one of the peer guides at: http://www.7-dippity.com/other/op_responses.html.”
Thanks for the useful resources, I will be forwarding them to people I know who have suffered by traumatic event(s) themselves.
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