Psycholgical First Aid - Children
Psychological First Aid is a term used like physical first aid, to describe things you can do following this very distressing event. Psychological first aid is recommended and supported by the World Health Organisation, which has developed specific guidelines for use across the world following traumatic events. Special guidelines have also been developed for children and young people by both by the World Health Organisation and the National Child Traumatic Stress Network (details at end of information sheet).
Children who have been involved with or near to Grenfell Tower will naturally feel very frightened. This is a normal response so soon after this type of disaster. Children view fires as very uncontrollable and they may also have witnessed or heard many distressing things. How children react and recover from the fire depends on their personal experience of the fire, age, previous experiences, and other life circumstances. It is very likely for most children close to this very upsetting event that they are going to be afraid and highly anxious.
The shock and fear can cause a range of different reactions, behaviours and feelings such as:
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a feeling of being stuck and being less aware of what is going on around them;
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becoming very alert and on edge, constantly scanning for more danger;
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may be over - aware of some details which can become really big in their minds;
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intense physical reactions such as heart racing, feeling short of breath, feeling unwell;
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intense crying or outbursts of anger;
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they may have sleep problems and nightmares;
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they may feel guilty and irritable;
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they may feel confused and unsure;
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in younger children you may notice that they are bedwetting or having more tantrums;
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a fear and worry about their safety or the safety of others, including pets;
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a fear of separation from family members;
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they may show changes in appetite or activity levels;
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older children may get angry want to drink or act out more.
Although all children and young people can react differently, most children and young people will have an overwhelming need to feel the protection, safety and comfort of the most important and familiar people in their lives. The key principles of psychological first aid are always safety, survival, shelter and to protect life. The words used to inform Psychological First Aid for children in a disaster such as this are:
Listen; Protect; and Connect
These three first aid steps can really help your child recover. Listen to them; protect them by having shelter; help them connect with others. It can make a big difference if you can help your child have a sense of emotional and physical safety where they feel protected as far as possible from the traumatic event. You are bound to feel upset and distressed too, but a child will respond well if they are comforted and see that you are being calm. You may feel very helpless but simple things can really help your child cope. Therapy and counselling too soon after an event can be very unhelpful. Children and young people can learn to cope with simple strategies and routines.
This is what your child needs for psychological first aid:
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To be with their parents/ carers as much as possible
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Keep a calm and safe environment where at all possible
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Take steps where you can to get basic health needs including shelter, warmth, healthy food and rest
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Explain what has happened and, if possible, what will happen next
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Make sure you look after your own safety and wellbeing
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Distract your child and yourself as much as possible from the sight, sounds, smells of the fire
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Tell your child that they are safe that you are with them and that you will look after them
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Limit media exposure. Protect your child from graphic depictions of the fire or trauma, particularly those on television, the radio, the Internet
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Spend extra time with your children, playing games outside, reading together indoors, or just cuddling
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Take care of your children's health. Help them get enough rest, exercise, water, and healthy food.
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Return to regular daily life as soon as possible. Children will feel more secure with structure and routine. If you can, keep to regular mealtimes and bedtimes.
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Stick to your family rules about good behavior. Give them normal daily tasks. Children cope better and recover sooner if they feel they are being helpful and things are as normal as possible
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Give lots of support and more time at bedtime. Children may be more anxious at such as bedtime. Spend a little more time than usual talking, cuddling, or reading
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Help with boredom. The fire may have disrupted the family's daily activities. Help children think of things they can do and get others to help you support them with child-friendly activities.
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Try to keep children away from people who are very upset or other people’s conversations about the fire
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Just listen in a non judging way and accept how the child reacts and feels. Try not to say things like ‘stop being silly’ or ‘be brave’
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Answer any questions clearly and without lots of detail. If you do not have information, say so.
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Reassure them that their reactions are normal and will pass in time
Ask for further help if...
All of these things can really help your child. If your child still has real difficulties more than six weeks after the fire then you should seek professional help from your local GP or a mental health professional particularly if:
1) the child's upset feelings and behaviour seem to be getting worse
2) the signs of extreme stress last for longer than about one month to six weeks
3) worries prevent you, your child or your family getting on with normal, everyday life after 4-6 weeks
If a professional recommends help please keep in mind that cognitive behavioral therapy (CBT) and EMDR (Eye Movement Desensitisaton and Reporcessing) can be the best therapies for helping children recover from a disaster.
As a parents you may be struggling too...
It can be easy to forget about your own needs during a crisis. You cannot help your child if you do not look after yourself. They need you to be healthy and calm so you can support them. It is usually better to admit to your children that you are feeling sad and upset. At the same time, you need to make it clear that you don't expect them to look after you. Try and make sure you have the support of family, friends and community supports. Here are some things you should try and think about:
1) Take care of yourself. Eat healthily, get enough sleep, and get the care that you feel you need.
2) Avoid making any big decisions during this stressful post fire period.
3) Take time to talk to adults you trust away from your child and get support as needed.
4) Do not be hard on yourself if you are struggling too. Cry, get a hug, take time out...do what you feel you need to help you feel able to cope.
Remember...
...that everyone reacts differently after traumatic events such as this. It can take children (and adults too) different amounts of time to cope with what has happened. In the few weeks after this event it is totally normal to experience feelings of fear, sadness, worry, anger and frustration. These are common and normal feelings for your child too. They will just show this in different ways to adults.
Most children will slowly adjust after about a month of this tragic event if you can help them by listening to them, protecting them and helping them connect with others. This will help you too... and if you find you or your child is still not coping well after about a month seek professional help.
Free Poster PDF: Click Here
Web Resources:
Apps:
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Help Kids Cope" recommended by the child trauma network equips parents:
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Know what to say “in the moment” to support your kids of all ages.
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Understand how kids commonly respond during and after disasters.
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Find tips on caring for yourself as you care for your family.
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Connect to activities, children’s books, tip sheets, and more!
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Smiling Mind" is a not-for-profit organisation that works to make mindfulness accessible to all. This is an activity that can really help when feeling stressed or upset. It can help reduce distress, help with a sense of calm and help the mind focus on other things. It has age appropriate exercise that work well for all ages - parents too.
Dr Lynne Taylor is Consultant Clinical Psychologist and Lead Consultant Psychologist CAMHS within the NHS.
Dr Lynne Taylor-Consultant Psychologist CAMHS NHS, 20/06/2017