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A natural disaster can affect anyone, anytime, anyplace. A natural disaster is defined as a sudden and terrible event such as a hurricane, wildfire, mudslide, tornado, or flood that result in major damage or loss of life (Merium-Webster.com). In the last decade, a 70% increase in natural disasters have occurred in the United States (Baggerly, 2006); affecting at least two million people annually (Jordan et al, 2013).
Natural disasters affect everyone; however, children are one of the most vulnerable populations following a disaster (Baggerly, 2006).
“Because young children have limited coping skills, they are particularly at risk for negative outcomes associated with traumatic events” (Dugan, Snow, & Crowe, 2010, p.52). Children’s “neuro-physiological systems are subject to permanent changes and their coping skills are not developed enough to manage catastrophic events” (p. 80). A child who has been through a natural disaster has experienced their world being destroyed. The child has experienced loss of personal possessions, loss of school routine, and may be temporarily separated from friends and family (Jordan, Perryman, & Anderson, 2013).
Children look to their parent or caregiver who may now be overwhelmed and in shock (Kousky, 2016).
“Many children exposed to traumatic events meet the criteria for posttraumatic stress disorder, acute stress disorder, depression, and generalized anxiety disorder (Jorden et al, 2013, p. 222). Young children who have been exposed to the trauma of a natural disaster experience symptoms which include flashbacks, nightmares, sleep disturbance, anxiety, and generalized fear. The child may lose interest in school, blame themselves for loss, and develop aggressive behaviors that were not previously present (Jorden et al, 2013). Play themes related to control and safety. Sorting behaviors, fixing play, broken play and instability play. Control, power, aggression.
Indicators of childhood PTSD include the following symptoms that persist longer than 30 days after the event: persistent re-experiencing of the event through intrusive memories, frightening dreams with or without recognizable content, repetitive play in which themes or aspect of the disaster are expressed, increased arousal such as irritability, and avoidance of things related to the disaster (Baggerly, 2008, p. 81). Lieberman and Knorr (2007), outlined the behaviors often seen resulting from traumatic events: increased clinginess, crying and whining; greater fear of separation from parents of primary guardians, increased aggressive behavior, more withdrawn and harder to engage; play that acts out scary events; changes in sleeping and eating behaviors; more easily frustrated and harder to comfort; return to earlier behaviors like frequent nighttime awakenings and thumb sucking; new fears not preset before trauma (Dugan et al, 2009, p. 53).
Following a natural disaster, children can suffer a myriad of problems. Physical issues arise as hospitals, doctors, and medications are not available or sparse. Kousky (2016) notes after Hurricane Katrina, many children suffering from asthma did not have access to their medication. In addition, half of the children who had a pediatrician before Katrina, no longer had a doctor after Katrina. Children’s health makes them physically more vulnerable to illnesses as they are still undergoing rapid growth and development and their immune systems are less mature. Following a storm like Katrina, clean water sources are sparse and overall hygiene levels are reduces resulting in increased sickness in the child population.
Schooling is important to a child’s developmental process not only from a cognitive perspective but also from a social perspective. After a natural disaster, the school may be completely destroyed or temporarily closed. Both circumstances could result in delay of education and lower grades after the event. In addition, if the child is not able to see or communicate with peers, added stress could compound to result in anxiety or another related disorder. Interestingly, after Hurricane Katrina, Louisiana found that moving displaced school children from the destroyed poor performing schools to non-effected higher performing schools mitigated the hurricanes negative effects on academic outcome. However, negative effects were seen for students who were not placed in higher performing schools or had complicated re-entry process. (Kousky, 2016)
Research indicates that play therapy is a developmentally appropriate treatment for young children. Play conducted in a safe and therapeutic environment allows the distressed child to achieve a sense of catharsis, abreaction, and mastery over the traumatic event (Dugan et al, 2009). Trauma often remains stuck in the nonverbal parts of the brain – amygdala, thalamus, hippocampus, or brain stem. Meanwhile the ability to think through life events and the ability to process these events takes place in the frontal lobes of the brain. Play provides physical activity so that playing out the event assists the brain in moving the memory from the nonverbal parts of the brain to the frontal lobes (Homeyer & Morrison, 2008, p.211).
Play is often thought to be the most effective approach to trauma resolution for children (Herbert et al, 2007, p. 140). The goal of play therapy is to help children and families recover from the trauma in a safe and trusting environment (Herbert). During play, children are able to play out negative life experiences by breaking them into smaller parts, releasing feelings that accompany each part, assimilating each experience back into the view they have of themselves, and obtaining a new level of mastery (Homeyer & Morrison, 2008).
After a natural disaster, play therapists can maximize their efforts by training teachers and parents to provide supportive responses and basic interventions for their children. Since young children may not be able to effectively communicate their feelings verbally, playing, drawing, or singing may be more effective. Many states provide print out coloring books for natural disasters to help the child express their own story, thoughts, and feelings.
To maximize children’s sense of self-efficacy, parents and teachers should reassure children that nightmares and crying are normal in this situation and usually temporary. Provide psychoeducational handout to parents and teachers of what a typical child’s cognitive, emotional, physiological, behavioral, and spiritual symptoms look like. Focus on the normalcy of the child’s responses rather than seeing them as pathological. Other ways to help the self-efficacy of children affected by natural disasters are to quickly re-establish a routine. After a natural disaster, schools may be closed, and the family may be living without power or staying somewhere temporarily. Establishing a routine and structure helps the child feel more secure. When possible, the caretakers should re-establish dinner time, prayer time, homework time, and a chore schedule. Re-establishing structure in the child’s life helps the child feel more secure. The caregiver should also encourage children to participate in social activities as well as community rebuilding activities. (Baggerly, 2008)
Following a natural disaster, counselors may need to train teachers and caregivers on how to respond to a child’s nightmares about the natural disaster. Dahlen’s Traumatic Dream Defusing Process creates a safe sleeping environment and gives voice to the specific details, feelings, and thoughts from the child’s dreams. Parents or teachers help the child defuse the strength of the dream and regain sense of control by helping the child record the dream and a journal. (Baggerly, 2008)
Younger children can draw or color their dreams and then bury them in a structured ceremony. This symbolic burial gives children the power to bring end to the significance of the dreams. Another method is to ask the child to blow their fearful dreams into a balloon and then release be inflated balloon. This activity helps children feel more in control as they see their dreams disappear (Baggerly, 2008).
Traumatic memories tend to be stored in sensorimotor modalities, such as visual and auditory images, affective states, and somatic sensations. Play therapy allows children to access and process these memories in a safe environment (Dugan et al., 2010, p. 53). The use of play allows the child to reenact the traumatic experience until the experience has lost its power.
When children involved in a natural disaster are allowed a safe place to express themselves, as well as given access to support from caregivers, teachers, and counselors, they are able to feel secure enough to partake in releasing such emotions (Jordan et al., 2013). Researchers have concluded that children who experience traumatic events through repetitious play in the presence of a therapist are often able to desensitize themselves to the traumatic events. Symbolic play affords children the opportunity to restructure traumatic experiences holistically, that is, cognitively, affectively, and bodily. Traumatic memories tend to be stored in the sensorimotor modalities such as a visual and auditory images effective states in somatic sensations.
In a well-equipped playroom, the child can use specific toys to play out occurrences that are associated with traumatic events. Children who have been traumatized can use specific toys such as emergency vehicles, medical kits, and tools for creative expression to communicate their fears and anxieties regarding the terrifying event in a safe space. Therapeutic toys can allow children to indirectly express themselves using dolls, cars, puppets, and many other props to convey specific thoughts and feelings that maybe too threatening to deal with directly. Play therapy allows the child to shield themselves from the intensity of their own feelings because what they’re dealing with maybe too overwhelming to face on their own. Symbolic play allows children to remain a safe distance from the trauma and allows them to work at their own pace add approaching the events. Therapeutic nature of play therapy with traumatized children is positively fostered when counselors and play therapist strive to acknowledge children during symbolic moments, allowing them to recognize the negative thoughts and feelings regarding a traumatized event are acceptable (Jordan et al., 2013).
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