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Disaster Behavioral Health Frequently Asked Questions (FAQs)

What can I say to my children about their fear and anxiety related to the threat of terrorism?

In this time of heightened anxiety, our children are experiencing fear and anxiety, too. They see news reports on television and hear adults talk about war and threat levels. But unlike adults, children have little experience to help them put all this information into perspective. Whatever their age, children need to be able to express their feelings and concerns. As adults, we need to encourage them to talk, and we need to listen to them and answer any questions they may have. Whether tragic events touch your family personally or are brought into your home via television and newspapers, you can help your children cope with their fear and anxiety. Here are some things to remember for children of all ages.

  1. Acknowledge children’s worries and uncertainties. Reassure them their feelings are normal.
  2. Children’s reactions to terrorism may be heavily influenced by your own. Your reactions are key in helping them decide whether or not the world is a safe place.
  3. Children need comforting and frequent reassurance they are safe-make sure you give it to them.
  4. Provide activities for children which help them explore their feelings; such as, classroom discussion, informal play, community service projects, writing, music, art or drama projects.
  5. Maintain family routines; keep lines of communication open.
  6. Create a family plan in the event of an emergency.

Here are some tips on how to help children of specific age groups. Pre-school age children:

  1. Reassure preschoolers their homes and day care centers are safe. Provide extra comfort and contact by discussing their fears, staying in touch during the day, and giving lots of hugs. Spend extra time with your children especially at bedtime.
  2. Limit exposure to television when adults can be with them.
  3. Get a better understanding of their feelings about the war. Encourage them to draw pictures about the war and then discuss them. This offers insight into a child’s concerns or fears.
  4. Preschoolers often gauge their reactions to events based on what adults do around them. If they see worry and fear, they are more likely to become worried and afraid. If routine and calmness are the norm, however, they may equate terrorism as something occurring far away from their world.
  5. Certain behaviors may reappear or intensify in pre-school age children. They may return to bed wetting, thumb sucking, baby talk or fear of sleeping alone. They may complain of stomachaches or headaches and state they don’t want to leave the house. They are simply expressing their fear.

Grade-school age children:

  1. Expect questions about the war from this age group. Try to answer them in simple and clear language. Don’t get too technical or complicated. Explain police and others are working hard to keep us safe.
  2. Be honest. False reassurance does not work with this age group. Don’t say terrorism is gone forever but rather “ I will always be here to keep you safe” or “ Our President and others are working hard to make things safe for all of us.”
  3. Focus on the positive. Reinforce the fact most people are kind and caring.
  4. Monitor their television viewing. Limit the amount of hours of coverage regarding “the war on terrorism.” Consider scheduling an alternative activity during the news hour without calling attention to your concerns.
  5. Don’t be afraid to say, “I don’t know.” Part of keeping an open dialogue with your children is not being afraid to say you don’t have all the answers. When you don’t have all the answers, explain wars are very complicated and things happen which even adults don’t understand.

Middle and High school age youth:

  1. Plan for shared time in front of a reliable national newscast. Because terrorism is discussed in school every day, your teen may be more ready to talk when he or she gets home than you may guess. This is a good opportunity for conversation.
  2. Discussing history with this age group can help put terrorism and related politics in context.
  3. Get teens to open up about what they have heard about terrorism. Allow them to express their fears and concerns. Listen. Don’t judge. Validate their feelings. Use the opportunity to correct any misinformation they may have acquired.
  4. This age group may ask very technical or even grisly questions which may seem off the wall to you. Take each question seriously, and do the best you can to answer it.
  5. Encourage them to work out their own positions on war and terrorism, even if it differs from your own. This is an age when kids are developing personal ethics and morals, a process you can support with open discussion and debate.
  6. Create a family plan to follow in the event of an emergency. Make sure that each family member has everyone’s phone/cell numbers and knows where to meet. This will make teens feel safer and may help reduce panic if an emergency does occur.

What are the symptoms of post-traumatic stress disorder? (PTSD)

Symptoms include emotional numbness; sleep disturbances, depression, anxiety, irritability, angry outbursts, and feelings of guilt. PTSD is an extremely debilitating condition often occurring after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened.

Many people with PTSD repeatedly re-experience the ordeal in the form of flashback episodes, memories, nightmares or frightening thoughts, especially when they are exposed to events or objects reminiscent of the trauma. Anniversaries of the event can also trigger symptoms. Most people with PTSD try to avoid any reminders or thoughts of the ordeal.

PTSD is diagnosed when symptoms last more than one month. Once PTSD occurs, the severity and duration of the illness varies. Some people recover within six months, while others may not do so for much longer.

Helpful Web sites:

National Center for PTSD

International Society for Traumatic Stress Studies

What are the common reactions to loss and how can I help someone through the grief process?

The death of a loved one is always difficult. When the death results from a war or a disaster, it can be even more troubling given the sudden and potentially violent nature of the event. A wide range of emotions may be experienced, including: denial, disbelief, confusion, shock, sadness, anger, humiliation, despair and guilt.

These feelings are common reactions to loss. Many people also report physical symptoms of acute grief such as stomach pain, loss of appetite, intestinal upsets, sleep disturbances, or loss of energy. Profound emotional reactions can include anxiety attacks, chronic fatigue, depression, and thoughts of suicide.

There are several things you can do to assist someone you care about who is grieving. First is simply to be available to the person if they want to share their feelings. Listening is an important gift you can provide. Allow the person to talk about his feelings and to share memories of the deceased. Offer practical help such as babysitting, cooking, or running errands. Find out about available support groups and share this information. Don’t hesitate to recommend professional help when you feel someone is experiencing too much pain to cope alone. Chaplains trained in pastoral counseling are available in most communities. Community mental health centers offer short term, professional counseling. Seeking professional assistance is a sign of strength not weakness. Encourage the grieving person to take care of his health. Have the person make an appointment with his family Physician. Don’t underestimate the value of eating properly, getting regular exercise, and getting plenty of rest.

Contact your local community mental health center by calling 1-800-852-3345.

What is Critical Incident Stress Management?

CISM is an integrated system of interventions, designed to prevent or mitigate the adverse psychological reactions accompanying a critical incident or crisis event. A component of the CISM is the Critical Incident Stress Debriefing (CISD). CISD is a group meeting or process using both intervention and education to mitigate or resolve the psychological distress associated with a critical incident. To maximize effectiveness, a debriefing should occur 24 to 72 hours after an event. CISD usually uses all team members. It is not therapy even though mental health professionals are part of the team.

The goal of CISM is to return the affected group or individual to normal levels of functioning. CISM is a proven means to assist personnel in dealing with the symptoms of critical incident stress. The intervention process utilizes trained peers, chaplains, and mental health professionals. It is managed by CISM Team Coordinators. CISM programs are intended to assist those affected by traumatic events to cope with stress effectively. CISM includes pre-incident training and post-incident services to help those who have suffered a catastrophic experience.

What are Disaster Behavioral Health Response Teams?

Disaster Behavioral Response Teams are New Hampshire's effort to address the emotional/behavioral needs of our citizens, first responders, and volunteers resulting from a disaster. These teams consist of trained behavioral health professionals who can be mobilized and deployed to offer such services as crisis counseling, brief supportive counseling, assessment and referral, public education, grief counseling psychological first aid and critical incident stress management.

Teams have been formed in five regions of the state; training is free. Team members receive training in: concepts of disasters, roles of key agencies, critical incident stress management, assessment and triage, basic crisis counseling and the incident command system among other topics. Upon completion of the training, team members receive official identification recognizing them as Disaster Behavioral Health Responders.

Response teams work collaboratively with local, state and federal emergency response agencies, as well as with organizations such as the American Red Cross and the Community Mental Health Centers. If you would like more information about the Disaster Behavioral Health Response Program, or would like to receive educational materials, please contact the Disaster Behavioral Health Coordinator at (603) 271-9454 or (800) 852-3345 ext. 9454

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