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All Posts Tagged: Posttraumatic stress disorder

How Parents Can Help Children Through Traumatic Events

By Rise VanFleet Guest Blogger. Rise VanFleet, PhD, RPT-S, CDBC
Child/Family Psychologist
Registered Play Therapist-Supervisor
Certified Dog Behavior Consultant
In practice for nearly 40 years, with specialties in traumatic events, chronic medical illness, strenghening parent-child relationships (esp. Filial Therapy), and Animal Assisted Play Therapy. Author of dozens of books, manuals, chapters, and articles on play therapy, Filial Therapy, AAPT, and canine behavior.

Too often our world is shaken by traumatic events such as natural disasters (e.g., tornadoes, hurricanes, earthquakes, tsunamis, floods), war, school and community violence, acts of terrorism, accidents, housefires, life-threatening illness, separations, loss of a pet, kidnappings, and so on. Such events can leave all of us feeling helpless, and children may be particularly reactive to events that make them feel unsafe. Children who are directly exposed to such events can become traumatized, and the emotional impact of trauma can last a very long time if it goes unnoticed. Some children are exposed to trauma indirectly through sensationalized or repetitive newscasts or by hearing and seeing others‘ emotional reactions, and there’s evidence that children can be traumatized by this indirect contact with trauma as well. It’s important that parents have information about trauma, its impact on children, and how to help their children understand and cope with these events.

When something traumatic occurs, it’s important to give children an honest but simple explanation of what happened. They are bound to hear about it through television, schoolmates, or overheard adult conversations, so it’s best if their parents or primary caregivers play an active role in helping them understand the event. It’s also important to reassure children that you, their parents, will do everything you can to keep them safe. Some children blame themselves when bad things happen, so parents need to tell them firmly that it’s not their fault.

Caregivers should limit children’s exposure to newscasts about traumatic events. Broadcasts are geared toward adults, and children may not have the reasoning abilities or coping mechanisms to deal with repeated views of people crying, buildings on fire, and so on. Although children’s programs often portray violence, the emotional tone of the news conveys its “reality” and children and adolescents can become extremely frightened, whether or not they show it. You need not restrict their exposure entirely, but screen carefully what they do see!

Children who are roughly 3 to 12 years of age, given the opportunity, will often play out scenes from a traumatic event. Sometimes older children will, too. For example, following a car accident, parents might see their children playing out car crashes and rescues with their toys. When parents see this, they might worry that it’s damaging somehow for the child to play out the traumatic situation. Actually, it’s often just the opposite: it can help the child cope better. Just as we adults need to talk with others after experiencing something frightening, sad, or devastating, children need to play through their feelings and reactions to the trauma. It can be very beneficial if parents allow their children to play this way while showing acceptance of the child’s feelings. To stop such play can cut off the child’s primary means of coping. Of course, children should be distracted to some other activity if they are playing in ways that are actually dangerous to themselves or others, or if the child is becoming obviously upset by the play. If a child constantly plays out the traumatic event and seems unable to think about anything else, then limits should be set on the amount of time spent playing out the traumatic events. (If children’s play appears to be upsetting the child further or if they seem “obsessed” with their trauma play, parents should consider a consult with a mental health professional, as these behaviors might signal that the child is already traumatized. If children’s play appears robotic and the child seems “not there” while playing, a consult is warranted as well.)

It’s important to permit children to talk about their reactions to a traumatic event when they want to. Although such conversations can be difficult, especially if we’re experiencing our own reactions to the trauma, they do help all of us in the long run. One of the worst things we can do is say to our children, “Don’t play that way.” or “Don’t talk about it–it’s over–let’s get on with things.” Denial of the child’s reactions can lead to larger problems later. While it’s important to let children express themselves, including their feelings of anger, sadness, or helplessness, it’s also important to help them focus on the positive aspects of trauma situations.   In the wake of many disasters, there are many amazing, touching stories of selfless acts, heroic deeds, and the very best of human caring coming from the most horrible of conditions.  Although we see some of the worst of humanity after traumatic events, we also see vastly more of the very best.  It’s important for our children to hear about them because it adds to children‘s sense of security, connections to other people, and hope for the future.

The natural tendency of children to play out the things that are happening around them is their way of trying to understand. Because they are PLAYING, it feels safer to them, and this is very important. Too much TALKING about scary events can actually scare children more. Some talking is important to give children some basic information and to answer their questions, but it is through their play that children, especially those under 12, have a real opportunity to understand what is going on. Throughout the world, children in war zones are seen “playing war.” Children play doctor or medical scenes when they or someone in their family has been ill or hospitalized. Aid workers noticed that children directly affected by the Oklahoma City Bombing were playing with small plastic dogs sniffing around in piles of blocks, much as real dogs were used to find survivors in the actual rubble. After September 11, children throughout the world were reported to be playing scenes of planes hitting buildings, firefighters and rescue, buildings crashing down, and even funeral themes. A boy in the U.K. played scenes of police officers arresting “bad guys” after the terrorist bombing of the London Underground. A girl from New Orleans who had been moved to a shelter after Hurricane Katrina involved several other children in play where she was the “Mama Alligator” who was trying to save her babies (the other children) from the “Cane” (hurricane).

Long after a traumatic event has occurred, parents should remain alert to any signs of trauma in their children. When children are traumatized, the effects may occur much later than expected. Sometimes traumatized children look quite “normal” on the surface after the event, and then experience post-traumatic symptoms weeks, months, or even years later. It’s fine for parents to ask their children what they’re thinking and feeling about the event from time to time, and then really listen to what they say. On the other hand, it’s best not to “bombard” children with questions about how they’re feeling or to hold lengthy discussions with them, as this might actually raise the children’s anxiety levels. It’s good for parents to share their own feelings of fear, sadness, anger about an event because it helps children see that these reactions are normal and can provide good coping models. (A caution, though: be sure that you share your feelings simply and don’t elaborate to a point that could frighten the child further. Always reassure them that you’ll keep them safe.)

One of the most beneficial things for children after a traumatic event is for their day-to-day environment to return to “normal” as quickly as possible. Getting back to some sort of daily “routine” can help kids feel safer and keep the traumatic event from becoming the only focus of their lives. This can be challenging following some disasters, but working toward as normal an environment as possible under the circumstances can help. Parents can help children find a balance between playing/talking about the event and doing daily tasks and other types of activities.

When trauma has been caused by humans, as in terrorism, it is important for children and adults alike to remember that we gain strength from our human connections and that most people are good. Broad, angry statements about other ethnic groups can add to children’s sense of insecurity and promote prejudice and uninformed backlash effects. People throughout the world have struggled for a long time with our “differences,” and that struggle continues. Acts of terror are intended to divide us, and we can resist this and help our children feel much safer by teaching them that these bad deeds are the work of individuals (or small groups of individuals) and not of any broad ethnic, racial, religious, or other group.

Many children are quite resilient when dealing with traumatic events, but it’s good for parents to know what to look for when their child might be struggling. Here are some signs that your child might be experiencing post-traumatic problems:

  • anxious, “edgy”, nervous, agitated
  • difficulty concentrating
  • refuses to go to school; difficulty with schoolwork
  • becomes angry quickly
  • aggressive, either verbally or physically
  • nightmares, or repetitive nightmares
  • won’t sleep in his/her own bed; sleeps on floor or wants to sleep with parents
  • easily startled by noises or situations similar to the traumatic event
  • reverts to “younger-age” behaviors like bedwetting, nail biting, thumbsucking
  • won’t talk about what happened
  • talks excessively about what happened
  • becomes very dependent–clings to parents or other caretakers; fears separations
  • problems with friendships and siblings–seems aloof or argues
  • seems “different” than he/she did before; personality seems a bit different

Although these signs might be related to other things, if the signs persist, are intense, are different following the trauma, or if several occur for your child, it could be a sign of a traumatic reaction. If you or your children experience continuing distress that interferes with your day-to-day work, school, and family life, you might consider consulting with a therapist.  The sooner a post-traumatic reaction is determined and treated, the better the outcome is likely to be for the child (or adults, too). A qualified mental health professional can help the child and the parents.

Play therapy can be very effective with traumatized children. The play gives them some “distance” from which to explore and deal with their feelings. Even teens and adults can benefit from treatments which involve play and art or other expressive interventions. Words can fail us when we experience intensely frightening events, and other means of expressing ourselves become necessary. Sometimes family play interventions can be very helpful. If you have questions or concerns about your child, contact a local mental health professional. Make sure that he or she has experience with trauma, and having a background in play therapy can be a big plus.

For information on finding play therapists who specialize in children please visit The Association for Play Therapy director at

Or contact your local and state psychological, social work, mental health counseling, crisis, medical, or school counseling associations or professionals can make referrals to adult therapists.

Please visit Rise VanFleet visit her web site “Family Enrichment & Play Therapy Center” for more great parenting articles and great resources.

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Invisible Wounds of Deeply Hurting Children

Guest Blogger—Dr. David A. Crenshaw, is a highly credentialed and respected clinical psychologist who for more than 30 years has dedicated his career, Center, books, videotape, projective techniques, and leadership to helping defiant, oppositional, aggressive children.


By Dr. David A. Crenshaw, PhD

A fawn at the edge of the woods watches with a wary eye. Any sudden movement is likely to startle and send the fawn scurrying into the woods. If, however, you don’t approach and be still the fawn may cautiously move a step closer. Children who are hurting deep inside from invisible, but very real wounds are like a fawn on the edge of the woods. They fear being hurt again. They don’t dare approach because they fear that you will add to their pain. As much as they desire the contact, it will not be easy to convince them. Basic trust in some of these children was never established. They did not experience early in life what all children need to develop a sense of security, safety, and trust. They did not experience being cared for, loved, protected and nurtured. Some children do not get this at all, others unpredictably and inconsistently. The moments of nurture and love may be interspersed with anger or cold indifference.

A small group of children experience life as a horror show.  These are the repeatedly abused, often deprived and severely traumatized children who undergo multiple out-of-home placements. Their sense of trust is shattered. These are the children who typically make up the population of today’s residential treatment centers. For these children allowing a modicum of closeness with even the most warm and friendly adult is taking a monumental risk.

Sociocultural Trauma

The work of Kenneth V. Hardy, Director of the Eikenberg Institute for Relationships and Professor of Marriage and Family Therapy at Syracuse University and of James Garbarino at Loyola University advocate for a more  complex understanding of severely aggressive children; not to simply view them as “bad kids.”   When the layers are peeled away what emerges are glimpses of deeply hurting children, who have suffered multiple, profound losses, and all too frequently traumatic losses.  Hardy1 stated that the complex underlying emotional process that is at the core of the child’s aggressive acting-out needs to be appreciated. Unless the losses, the trauma events are faced, the treatment will consist of putting balm on the wounds, but there will be no healing.

Dehumanized Loss

The invisible wounds2,3 so often unrecognized by others and unacknowledged even by the child are thus trivialized and devalued.  The disenfranchised grief of children4 is a result of the cumulative effect of multiple losses never attended to and the unexpressed, buried grief of children that is not recognized, supported or facilitated by the care taking adults.  The end result of such ignored and unsupported grief is often loss of capacity to feel; what Hardy2 refers to as dehumanized loss.  Dehumanized loss plays a central role in the cycle of violence since the inability to feel one’s own pain can result in extreme cases in the child’s loss of the capacity to feel for the pain inflicted on others.

The Emotionally Focused Therapeutic Work

To restore a child’s capacity for empathy with his or her own pain and for the pain of others requires intense, in-depth emotionally focused work.1,2,3,5 This is not short-term work and there are no quick fixes. It involves engaging all the relevant systems impacting on the child and family. It will not be enough to engage the family. The larger systems of school, community, social service, and courts, will all have to be integrated in the provision of services in order for meaningful intervention to occur. Without a safety net of support, regular and reliable communication between service providers, the child and/or family will fall through the cracks. The pressures on these systems to meet an ever expanding level of need, to serve more seriously impaired individuals and families, and the human and emotional toll that this work can exact poses the risk that the systems designed to provide care becomes dehumanized as well.

The Traumatized Child Within

Garbarino6 reminds us that whenever he has interviewed a youth who has committed a violent crime he almost always finds an untreated traumatized child. To provide the intensive treatment that these children and families need, as many studies5 have indicated, will in the long run result in huge cost savings to society.  Furthermore, by making this commitment to providing the intensive services needed to the most vulnerable of our citizens it will be a step towards reversing the insidious devaluing process that results from making the mental health treatment of socioculturally traumatized children in our society a low priority.

The art of healing fawns in gorilla suits requires not taking their anger personally, but realizing anger is how they protect themselves.  They hurt deep inside from invisible, yet very real wounds.  To help such children feel safe, become trusting, and deal with intense emotions, Dr. Crenshaw developed special play therapy techniques.  He teaches his techniques to clinicians, school personnel, and others who work with angry children.


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  1. Hardy, K.V. (2003). Working with aggressive and violent youth. Psychotherapy Networker Symposium. Washington, DC
  2. Hardy, K. V. & Laszloffy, T. (2005). Teens who hurt: Clinical interventions to break the cycle of violence. New York: Guilford Press.Crenshaw, D.A. & Mordock, J.B. (2005a). Handbook of play therapy with aggressive children. Northvale, NJ: Jason Aronson.
  3. Crenshaw, D.A. & Hardy, K.V. (2005). Understanding and treating the aggression and violence of traumatized youth in out-of-home care. In N. Boyd-Webb (ed.),Traumatized youth in child welfare, pp. 171-195. New York: Guilford Press.
  4. Crenshaw, D. A. (2002). Disenfranchised grief of children. In K. J. Doka (ed.), Disenfranchised grief: New directions, challenges and strategies for practice (pp. 293-306). Champaign, IL: Research Press.
  5. Crenshaw, D.A. & Mordock, J.B. (2005b). Understanding and treating the aggression of children: Fawns in gorilla suits.  Northvale, NJ: Jason Aronson.
  6. Garbarino, J. (1999). Lost boys: Why our sons turn violent and how we can save them. New York: Anchor Books, A Division of Random House.
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