Supporting Students in the Aftermath of Crisis

A school response to a crisis is not the same as a clinical approach applied to every child in the school. There is a need to shift from exclusively relying on a medical model – characterized by screening, evaluation, diagnosis, referral and treatment for individual children with symptoms of mental illness – toward universal support (Tier 1 services) as the primary response to major crisis events, with a focus on building resilience rather than delivering treatment. This would be coupled with incorporating school- and community-based mental health professionals to provide additional support to children requiring more assistance.
 
Psychological first aid is one model of offering such universal support. The National Center for School Crisis and Bereavement (NCSCB) has recently developed a new model, “Practical Strategies for Educators to Support Students after a Death or Other School/Community Crisis – The ‘5 E’ Model.” It provides practical examples of how to engage, empathize, explore, educate and empower students after a crisis. Rather than focus only on how adults can support students, it offers strategies to empower students to take a more active role in their own coping and subsequent recovery.
 
Some students, though, will benefit from Tier 2 or 3 services. Since children often hide or minimize their distress, it’s important to reach out to students who have experienced major losses or likely traumatic experiences, even in the absence of symptoms.
 

Student Reactions

School counselors can look for these common adjustment reactions in students after a crisis:

• Fears and anxiety – This may include separation anxiety and school avoidance, even if the crisis happened outside of the school. Identify children’s unique fears and concerns. Don’t tell children they shouldn’t be worried or minimize their concerns. Share with them strategies to deal with distressing feelings rather than pretend they don’t or shouldn’t exist.
• Difficulties with concentration and academics – At least temporary academic challenges are common after a crisis. Offer academic support proactively, rather than waiting for students to demonstrate academic challenges or failure. Assist students in identifying the nature and level of academic work that feels appropriate and achievable. Consider modifications in classroom lessons to minimize likely trauma or grief triggers (e.g., “Fahrenheit 451” following a wildfire). Offer academic accommodations; reschedule or adapt tests.
• Sadness, depression, anger or irritability – Although sadness is expected after a crisis, school counselors can help identify when students need more support.
• Sleep problems – Help children adopt good sleep habits and learn self-calming and relaxation techniques.
• Alcohol and other substance use – Substance abuse evaluation and treatment services should be part of the recovery plan after a crisis.
• Physical symptoms – These may include headache, stomachache or fatigue. Psychological distress can present as physical symptoms; stress hormones can also contribute to physical illness.
• Post-traumatic symptoms and disorders such as PTSD
• Grief – Bereavement or grief from non-death-related losses is common and often insufficiently addressed.
• Guilt – Individuals may adopt an illusion of guilt to help cope with anxiety of a recurrence of the crisis. It may seem easier to feel responsible for something you did, didn’t do or should have done to prevent a death or crisis, rather than to accept it might have nothing to do with you. Because if it had nothing to do with you, that means it could happen again to you or someone else you care about and there may be nothing you can do to prevent it.

School counselors should remain introspective of their own personal and professional reactions to the crisis. They may be faced with a larger and more complicated caseload of students, numerous informal requests for assistance from staff, and the impact of the crisis on themselves and family and friends. School counselors should accept and seek assistance and take active steps to minimize the risks of vicarious traumatization, compassion fatigue and moral injury.
 

Schools and districts don’t have to do this alone.

The National Center for School Crisis and Bereavement (NCSCB) offers free advice, technical support and consultation to school professionals and schools in the aftermath of crisis and loss. Visit the NCSCB’s website at www.schoolcrisiscenter.org or call 1-877-53-NCSCB for immediate assistance at any time.
 
The NCSCB partnered with the New York Life Foundation to convene the 10 leading school professional organizations to create the Coalition to Support Grieving Students, which now includes over 150 professional organizations. ASCA is one of the Coalition’s 10 Founding Members.
 
The Coalition created a free school-practitioner-oriented website, www.grievingstudents.org, that houses more than 20 video training modules for self-directed professional development, most only 10–15 minutes in length. Free print materials, such as the parent booklet “After a Loved One Dies” (available for download in 10 languages and free print copies in English and Spanish) and a wide range of other free resources are available through the website.
 
Resources for more detailed information:

• Supporting the Grieving Student: A Guide for Schools
• The School Crisis Planning Guide: How to Build, Prepare, and Sustain an Effective Crisis Response Team

David J. Schonfeld, MD, is director of the National Center for School Crisis and Bereavement at Children’s Hospital Los Angeles and a professor of clinical pediatrics at the USC Keck School of Medicine. Contact him at schonfel@usc.edu.