1. Coping in Today’s World
Psychological First Aid and Resilience
for Families, Friends and Neighbors
Copyright © March 2010 by The American National Red Cross

2. Helping Children in Times of Stress
SEGMENT FOUR
Helping Children in Times of Stress

3. “Sometimes the questions are complicated and the answers are simple
“Sometimes the questions are complicated and the answers are simple.” Dr. Suess 3

4. Developmental Considerations That Can Affect Children’s Coping
 Ability to Reason
 Effects of Uncertainty
 Impact of Change
 Worldview
 Time Orientation
 Limited Life Experience
 Expression of Thoughts and Feelings 4

5. Psychological Resilience
Psychological resilience is the ability to
effectively “bounce back” from stressful
situations, including crises and disasters.
 Everyone has resilience.
 Resilience is learned.
 Resilience can be enhanced and strengthened.
 It helps us adapt to changes and challenges in
our lives. 5

6. Building Resilience in Children and Teens
1. Make connections with others. 2. Help children and teens help others. 3. Maintain a daily routine. 4. Take a break. 5. Teach children self-care. 6

7. Building Resilience in Children and Teens (Continued)
6. Help children and teens move toward their goals 7. Nurture a positive self-view. 8. Keep things in perspective and maintain a hopeful outlook. 9. Look for opportunities for self-discovery. 10. Help children accept that change is a part of living. 7

8. Stress
 Stress is a common and expected part of our lives.  When challenging, difficult or even dangerous situations arise, stress can motivate us to act.  When stress is extreme, or prolonged, people often have stress reactions. 8

9. Recognizing Symptoms of Stress in Children
 Feelings
 Thoughts
 Behaviors
 Physical Conditions
 Spiritual Life 9

10. Recognizing Symptoms of Stress in Children 3 to 5
Have changes in behavior (more irritability, temper tantrums, crying)
Become more clingy or withdrawn
Regress in skills
Repeatedly ask questions, as they may not fully understand what happened, including experiences of loss
Demand more attention from others 10

11. Recognizing Symptoms of Stress in Children 6 to 10
Regress in skills
Demand more attention from others
Have problems with attention and/or concentration
Have more behavior problems
Have problems with homework/schoolwork, chores
Feel helpless and guilty about what happened
Fear going to school 11

12. Recognizing Symptoms of Stress in Children 11 to 18
Withdraw into silence and isolation (including depression)
Become more irritable with peers and family, often starting arguments
Have feelings of guilt and shame about the event
Express physical pains with no medical cause
Have a brief decline in school performance
Engage in high-risk behaviors such as alcohol or drug use 12

13. Psychological First Aid (PFA)
Psychological first aid (PFA) is a set of actions that can offer immediate support to people in need of help. 13

14. Psychological First Aid (PFA)
PFA aims to reduce stress symptoms and assist in a healthy recovery following a traumatic event, natural disaster, public health emergency, or even a personal crisis.
Anyone that interacts with children can be a potential source of assistance and support – if unprepared, they can be a source of further distress 14

15. The Limits of Psychological First Aid
Psychological first aid is not:
 A substitute for counseling or therapy.
 A cure-all.
 Treatment for serious conditions.
 A guaranteed means for solving problems that cause distress.

16. Adapting PFA for Children
PFA considerations related to children:
 Children are sensitive to your non-verbal behaviors.
 Adults need to be sensitive to children’s non-verbal behaviors.
 Adjust your actions to the child’s ability to understand.
 Be patient.
 Repeat your reassurance. 16

17. PFA Actions with Children
1. Observe and be aware. 2. Make a connection. 3. Assist with basic needs. 4. Listen. 5. Give realistic reassurance. 17

18. PFA Actions with Children (Continued)
6. Encourage positive coping. 7. Help children connect with others. 8. Give accurate and timely information. 9. Use referral resources for extra support. 10. End the conversation. 18

19. Tips on How Parents and Caregivers Can Help
Find out what they know about the event— what are they hearing or seeing on television and the Internet and from friends?
Allow children and youth to ask questions, answering honestly at a level they can understand.
Most children and youth want to talk about their experience. Let them talk, and listen to them. 19

20. Tips on How Parents and Caregivers Can Help
Accept their feelings, letting them know that all feelings are okay and that crying is just one way to help express feelings.
Help children and youth express their emotions through conversation, writing, drawing, music, and body movement such as running, playing, dancing, and yoga. 20

21. Actively Engage Children and Youth
Balance talk of the event with the important routine of school and home activities.
Take a break and do something relaxing or fun together.
Let them know it’s okay to laugh and have fun even in the aftermath of a traumatic event.
Let them know that you care about them.
Provide extra attention and patience.
Check back in on a regular basis. 21

22. Moving Forward
Most children and youth are quite resilient and get back to feeling “okay” soon after a trauma.
With good support from others around them including parents, caregivers, teachers, and peers, they can thrive and recover.
The most important ways to help are to make sure children and youth feel connected, cared about, and loved. 22

23. “Half of knowledge is knowing where to find it.” Unknown
Instructor: Read the quote: “Half of knowledge is knowing where to find it” –Goethe
Ask participants why they think this is especially important to remember when providing PFA. Bring out if they do not:
--People may need more than you have to give
--There are many resources that can provide what they need, and meeting such needs reduces stress
--There are some very serious circumstances under which it is critical that they get in touch with the appropriate resource 23

24. Resources and Making Referrals
 General Information and Resources  Mental Health Information and Referrals  Mental Health Emergencies 24

25. Information About Mental Health Topics
Consider:
 American Academy of Pediatrics (AAP).
 American Psychological Association (APA).
 Centers for Disease Control and Prevention (CDC).
 State and local mental health associations.
 Substance Abuse and Mental Health Services Administration (SAMHSA). 25

26. Mental Health Emergencies
It is always okay to ask for help. 26