Monday, December 17, 2012

Tips for Talking to Children about the Connecticut School Shooting

By David Fassler, M.D.
Parents and teachers are faced with the challenge of discussing the recent tragic school shooting in Newtown, Connecticut with young children. Although these may be difficult conversations, they are also important.

There are no "right" or "wrong" ways to talk with children about such traumatic events. However, here are some suggestions that may be helpful:
  • Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready.
  • Give children honest answers and information. Children will usually know, or eventually find out, if you're “making things up.” It may affect their ability to trust you or your reassurances in the future.
  • Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.
  • Be prepared to repeat information and explanations several times. Some information may be hard for them to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.
  • Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate.
  • Remember that children tend to personalize situations. For example, they may worry about their own safety or the safety of friends or siblings when going to school.
  • Let children know that lots of people are helping the families affected by the recent shooting.
  • Don't let children watch too much news coverage with frightening images. The repetition of such scenes can be disturbing and confusing.  
Children learn from watching their parents. They are very interested in how you respond to local and national events. They also learn from listening to your conversations with other adults.

Children who have experienced trauma or losses in the past are particularly vulnerable to prolonged or intense reactions to news or images of violent incidents. These children may need extra support and attention.

Children who are preoccupied with ongoing questions or concerns about safety should be evaluated by a trained and qualified mental health professional
. Other signs that a child may need additional help include sleep disturbances, intrusive thoughts or worries, or recurring fears about death, leaving parents or going to school. If these behaviors persist, ask your child's pediatrician, family physician, or school counselor to help arrange an appropriate referral.

Although parents may follow the news with close scrutiny, most children just want to be children. They may not want to think about or discuss violent events. They'd rather play ball, climb trees, or ride bikes.

Senseless, violent crime is not easy for anyone to comprehend or accept. Understandably, some young children may feel frightened or confused. As parents, teachers and caring adults, we can best help by listening and responding in an honest, consistent, and supportive manner.

Fortunately, most children -- even those exposed to trauma -- are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences, and reduce the risk of lasting emotional difficulties.

David Fassler, M.D., is a child and adolescent psychiatrist practicing in Burlington, Vermont. He is also a clinical professor in the Department of Psychiatry at the University of Vermont, College of Medicine.

Monday, December 10, 2012

Grief and Loss Never Take a Holiday

By Joshua Reiher, Medical Student

The holiday season is in full swing. This time of year is meant to celebrate life, love, family, and friends. However, the holidays can also be difficult, especially if you or someone you know has lost a loved one. Maybe you are grieving the loss of a grandparent, parent, child, sibling, spouse, friend, or pet. Loss is a normal part of being human, and we will all face it at some point. Other causes of grief that you may not have considered:
  • A loved one suffering from severe mental illness
  • Divorce or breakup after a long term relationship
  • Miscarriage during pregnancy
When a person experiences loss, he or she is said to be grieving. Grief is a natural emotional and physical response to any loss.
  • People feel a wide range of emotions such as sadness, anger, disbelief, denial, guilt, loneliness, regret, anxiety, acceptance, and many others.
  • Physically, people may undergo weight and/or appetite changes, decreased energy, lack of concentration, disturbances in sleep, loss of interest in sex, headaches, and so on.
Grief is a personal and individual experience—no two people grieve the same way. There is no one right or wrong way of grieving as long as it does not lead to behaviors that harm yourself or others. Bereavement is the period of time a person goes through grief following the loss of a loved one. Bereavement varies in duration and intensity, but it can last a year or longer in some cases.

Everyone is different, and reactions to loss are influenced by many factors such as:  
  • Cultural beliefs and religious traditions
  • Access to support and community resources
  • Relationship with the person who left / passed away
  • Personality and mental health history  
When to ask for help
While coping after a loss is painful and challenging, most people eventually find effective ways to heal and return to their daily life activities such as school or work. Some people, however, have more difficulty with recovering from a loss, and their emotional and physical symptoms do not improve. They may develop a psychiatric illness called depression. If you are concerned about yourself or someone you know, there are many treatments available including:  
  • Talk therapy
  • Community support groups with other people who have similar experiences
  • Medications such as antidepressants
Additional resources to consider: