Professor Brett McDermott writes about helping children after the event.
Children and adolescents often experience emotional or behavioural challenges after natural disasters, yet their treatment is not the usual business of mental-health teams or many counsellors. After a major bushfire devastated Sydney's Sutherland Shire in 1994, I conducted a program to screen and identify students with post-disaster emotional distress. Nearly 20 years later, the work continues.
After Cyclone Larry hit Far North Queensland in 2006, clinical psychologist Associate Professor Vanessa Cobham joined the screening program, bringing extensive expertise in treatments for anxious children. The program offers a multi-layered model of care, with a first level involving community forums, podcasts and tip-sheets; a second level assisting and skilling parents, teachers and counsellors; and a third providing therapy for children with established needs.
The approach was used during the 2010/2011 Queensland floods, and according to Cobham proved very effective. About one-third of students at one of the affected primary schools experienced post-traumatic stress disorder. "Several months later, after completing the trauma-focused, cognitive-behaviour-therapy program, an evaluation found the affected students had improved markedly to the stage where they were classified as having mild or no symptoms," says Cobham.
Despite these advances – and Cobham and me lecturing and consulting in Australia, New Zealand and South Korea – knowledge of post-disaster child, adolescent and parent interventions remains relatively limited. This is why Cobham and I published the book A Road Less Travelled: A Guide to Children, Emotions and Disasters. This resource, recently made available free of charge from beyondblue, is for counsellors, teachers and parents.
The book recognises that when the spotlight leaves a disaster-affected area, the emotional recovery may have only just begun, and it can take many years for communities and families to get back on their feet. Chapters explain why some children and adolescents develop post-traumatic mental-health conditions (such as phobias, traumatic grief and depression), and how they manifest themselves. This includes important distinctions such as the different symptoms and signs in a four year old compared with a 14 year old.
But there is more to understanding a child's response to trauma than medical categorisation. The book considers the role of parents, who are generally the most important 'counsellors' in a child's life. It discusses research on altered parenting, and why initial post-disaster overprotection and hyper-vigilance is normal. However, overprotection six months later can be a problem, and may impede the normal process of a child developing independence. The importance of parents looking after their own emotional health is also addressed.
While there should never be an expectation that teachers should deliver therapy, the book provides information on how they can identify traumatised children and help them access assistance. Like parents, teachers also need to be mindful of looking after their own emotional wellbeing while working in a post-disaster setting. The book also looks at trauma-focused cognitive-behavioural therapy and the major processes and strategies used in these interventions. For a copy of the book contact beyondblue on (03) 9810 6100, visit www.beyondblue.org.au or email your contact details and request to email@example.com.
Professor Brett McDermott (pictured) is a psychiatrist at Brisbane's Mater Children's Hospital and board member of beyondblue.