Providing Post-Trauma Psychosocial Support

Importance of Providing Psychosocial Support after Crisis and Trauma​

Psychosocial support refers to the continuum of actions and interventions that help to support psychological and emotional healing and recovery in individuals (and their family members) after a crisis event. This includes assessing of needs and linking families up to relevant resources, ensuring that families are connected with sources of social support, strengthening coping strategies, or providing intervention and therapy.

As helping professionals working with children and adolescents, you are likely to occasionally come across situations where a child or young person has experienced a crisis or a traumatic event. In these situations, the support that children receive from their caregivers and supportive adults around them (including professionals!), can go a long way in helping them to cope and bounce back from the experience.

The provision of psychosocial support can be broken down into two phases: 1) Early Psychosocial Support and 2) Specialised Support. Navigate the tabs on the side to find out more about each of these phases.

Early Psychosocial Support

Immediately after a crisis or traumatic event, it is expected that children will present with some distress because of the devastating and unsettling nature of the crisis event. Early psychosocial support is support provided in the initial period (i.e. hours, days or weeks) after a crisis. Early psychosocial support is focused on ensuring that the child and family’s basic or practical needs (e.g. food, water, medical care) are met, reinforcing healthy coping strategies, and connecting the child to a social support network. This helps the child re-establish a sense of physical and emotional safety after a traumatic event, and can help to facilitate the natural recovery process, reducing the likelihood of distress symptoms persisting or escalating over time.

Early psychosocial support is not psychotherapy, and does not require the child to recount or process details of the crisis or trauma event. The key tasks that any professional providing early psychosocial support to children and teenagers in times of crisis are:

1. Ensure physical and psychological safety

Strategies to ensure this include:

• Introducing yourself and explaining your role to the child and the family
• Adjusting the complexity of the language used to the developmental age of the child
• Reconnecting the child to supportive caregivers, safe adults, and sources of social support
• Ensuring that the child and their caregivers are brought to a place of safety, especially if there is danger in their environment
• Creating spaces that help the child feel secure

2. Ensure basic and practical needs are met

You can do so by linking children and their families up with services that can help them meet these needs. Some examples of immediate basic and practical needs include:

• Medical care
• Financial needs
• Water, food, shelter
• Means of communication (e.g. WiFi, mobile phone reception)
• Access to accurate information about the event
• Protection from further harm/danger

3. Encourage coping strategies

When a child’s safety concerns and basic needs are addressed, psychosocial support can focus on reinforcing or teaching healthy coping skills. Strategies that may help promote coping include:

• Encouraging the child and their caregivers to return to basic routines (i.e. bed, meal, or play times, school routine)
• Encouraging the child to use their existing adaptive coping strategies, and/or teach them new strategies (e.g. deep breathing, grounding techniques, progressive muscle relaxation, mindfulness strategies, etc.)
• Teaching problem-solving skills
  Applying these skills allows the child to experience a greater sense of control, thus decreasing the level of distress they may feel

You can find out more about these coping strategies from our Coping with Trauma for Caregivers brochure on the Resources page.

4. Providing information and normalising of emotions

Providing accurate information about the trauma event, and psychoeducation about the expected reactions that the child may experience after crisis events, can help caregivers and the child understand what they are going through and normalise these reactions. By doing so, their distress levels are reduced, and the family knows what reactions to expect and look out for. Ways to do so include:

• Providing caregivers and children with brochures or tip sheets about trauma reactions (see the Coping with Trauma for Child/Teen/Caregivers brochures on the Resources page), and ways to soothe and cope with these reactions. Understanding their reactions, and knowing ways to cope helps individuals feel more empowered, and instills a sense of hope.
• Directing children and caregivers to reliable sources of information where they can obtain accurate updates about the event. Informing caregivers to be aware of their child’s exposure to crisis-related content on media platforms, and to check in with how their child is thinking or feeling about what they learn from media sources.
• Providing caregivers with information about the impact of the media on children, and how to mitigate this
  

5. Strengthen social and community support and connectedness

Strategies for this include:

• Helping the child and their family identify and utilise their existing strengths
• Ensuring that families can access the available resources and services (e.g. financial assistance, healthcare, housing, appropriate children's services) that can help them resume their normal day-to-day living
• Encouraging the continuation of activities that are typically held in the community (e.g. religious gatherings, meetings) where feasible
• Ensuring the continuation of play, recreation or school–based activities, including both formal and informal programmes
• Identifying individuals who are at risk of not receiving adequate social support

When to Refer a Child for Further Mental Health Services (i.e. Specialised Psychosocial Support)

Most children may just require early psychosocial support and be able to overcome signs of early distress within 4 to 6 weeks, after they have had some time to adjust. However, it is still important to keep a look out for children at risk of developing mental health difficulties after experiencing a traumatic event.

This includes children who experience high levels of distress that make it difficult for them to carry out their usual activities. Children should be referred for further mental health services if they develop the following symptoms and reactions at any point after a traumatic event:

• Dissociative symptoms (i.e. appearing confused, distant, daydreaming, aloof)
• Extreme confusion or difficulties focusing and making simple decisions
• Intense or uncontrollable emotional experiences
• Extreme intrusive thoughts
• Significant physical complaints (e.g. headaches, stomachaches, nausea, fainting)
• Significant drop in self-care (i.e. personal hygiene or grooming)
• Risky behaviours (e.g. self-harm, suicidal ideation, or being a risk to others)
• Substance use (e.g. alcohol, smoking, drugs)

In addition to the above, children who experience distress reactions that persist beyond 4 to 6 weeks after the event may also benefit from a referral to a professional trained in providing specialised psychosocial support or mental health interventions.

Helping professionals may also use relevant screening tools to obtain information from both the child and caregivers, to help distinguish when a child may need specialised support. An example of a quick screening tool for trauma-related difficulties after exposure to a traumatic event is the Child Trauma Screening Questionnaire.

References

Hobfoll, S. E., Watson, P., Bell, C. C., Bryant, R. A., Brymer, M. J., Friedman, M. J., … Ursano, R. J. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry. https://doi.org/10.1521/psyc.2007.70.4.283

Spee, I. (n.d.). If a Disaster Befalls the School - Coping with disasters in an educational setting, (Third revised edition). Retrieved from https://www.schoolenveiligheid.nl/wp-content/uploads/sites/2/2017/10/If-a-disaster-befalls-the-school.pdf

Sargent, J. (2009). Traumatic Stress in Children and Adolescents Eight Steps to Treatment. Psychiatric Times.

Specialised Psychosocial support

Specialised Psychosocial support refers to mental health interventions that are provided when distress reactions start affecting the child’s daily functioning at any point after the crisis event (see “When to refer a child for further mental health services” section in Early Psychosocial Support tab), or if the distress reactions do not reduce with early psychosocial support and persists beyond 4 to 6 weeks after the event. Children who experience higher levels or persistent distress usually do have exposure to more risk factors such as previous exposure to traumatic experiences, lack of social support, or prior history of behavioural or emotional difficulties. As such, it is beneficial for them to receive Specialised Psychosocial Support.

This form of support is usually provided by trained professionals, who will assess the child by gathering information from the child and caregiver, to determine what psychological interventions would be best suited for the child. Examples of evidence-based psychological interventions for children who present with trauma-related concerns are Trauma Focused Cognitive Behavioural Therapy (TFCBT), or Eye Movement Desensitization and Reprocessing (EMDR).