The Community Trauma Toolkit: helping adults and children before, during and after trauma

Exposure to disaster is unfortunately common for children. To help children and young people affected before, during and after these events, Emerging Minds and the Australian National University developed resources that provide information and activities to help people work with children during traumatic times.

In 2007, Save the Children estimated that during 2008–2018 there would be 175 million children per year affected by disasters relating to climate change.1 In Australia, the past summer of 2019–2020 saw large numbers of people—even entire communities—acutely affected by drought, bushfires, flooding and tropical storms. The increase in unstable weather patterns, and the likelihood that these patterns will continue to increase in severity and frequency means the number of children and families who will experience disaster events is likely to increase within Australia and abroad.

Children are one of the most vulnerable groups during and after disaster events and they comprise approximately 30–50 per cent of all disaster-related mortalities.2 Children are among the worst affected for a number of reasons. They are dependent on adults for safety and protection, are in formative periods of physical and psychological development and may be unable to recognise hazards on their own.3 Further, children are less likely to have cognitive capacities and emotional maturity to effectively manage challenges that may arise after a disaster and usually require adult help to deal with their responses.4 As such, the functioning of the family unit and the wellbeing of adults in children’s lives are of paramount importance.

Exposure to traumatic events such as emergencies and disasters increases the risk of serious and long-term consequences for the social, psychological, emotional, cognitive and physical development of children. Depending on their age and circumstances, experiences of anxiety or depression, behavioural problems, declines in academic performance, social or interpersonal difficulties, extreme clinginess or other traumatic response symptoms may develop. Additionally, children may experience mental health difficulties such as Post-traumatic stress disorder or Acute stress disorder. However, unlike adults, children will need different approaches to treatment and care. Even children not personally exposed to the disaster may feel distress or fear when confronted with news footage or hearing people talk about the event.

Research on childhood stress has shown that while exposure to trauma can have long-term effects, these can be mediated by parent availability, care, support and family functioning.5 Children may display symptoms of distress during and immediately after a disaster event, but these symptoms will usually lessen and resolve themselves over time. The research indicates that a majority of children experiencing a disaster will not develop mental health difficulties severe enough to require clinical intervention.

The significant fire and flood events experienced in Australia this past summer means that the number of children who may need intervention could be a large cohort. While children can be naturally resilient and most will overcome any initial distress over time, all children (regardless of circumstance) will need increased care and assistance from family and other adults.

With appropriate support and guidance from adults, children can be active agents in their preparedness and recovery. Labelling children as a ‘vulnerable population’ without acknowledging their potential for agency can disregard their capacity to take active roles in their family’s and community’s disaster preparation and recovery work. Studies have identified children as a ‘community motivational reservoir’6, whose actions, in some instances, have saved lives. Children should be included in preparation and recovery activities. They can encourage and teach others, they have energy and creativity and they can learn good preparedness habits. These activities must be developmentally appropriate to the needs and responses of children so they can be actively involved.

Upskilling workforces and communities

Children rely on the important adults in their lives to support their recovery after a traumatic event. However, this may be difficult when these adults have experienced the same event and may be overwhelmed. Researchers have described a ‘chain of losses’ that can occur after a disaster event, with a series of negative events triggered by a disaster that stretches a family’s ability to cope.7 Therefore, upskilling workforces that work with children and families can improve their ability to identify, assess and support communities in need.

The Australian National University, in partnership with Emerging Minds and the University of Queensland, designed a Community Trauma Toolkit to assist individuals and workforces involved with children, families and communities before, during and after a disaster. The toolkit’s purpose is to provide support to children to mitigate negative effects of disasters, support families who may be experiencing difficulty and promote long-term recovery.

Toolkit development

The toolkit was co-designed with input from various workforces and community members who had lived experience of disasters. Interviews were conducted with relevant workforces and community members. These interviews reinforced the importance of a coordinated approach to community preparation, and recovery where organisations, workforces and the community work together to support children and families. The interviews exposed knowledge and practice gaps. For example, participants indicated they were uncertain how to engage with and support children who had experienced trauma and some recognised that experiences of vicarious trauma symptoms had an impact on their role as parents. The toolkit addresses these gaps by including training and resources specifically tailored to and designed for individuals, groups and organisations.

The toolkit is informed by Bronfrenbrenner’s ecological model of child development, which places the child at the centre of an interconnected support network spreading out from the family to other environments such as schools, sporting groups and the local community. It also draws on the theory that healthy children and families are supported by a cohesive network of social relationships. Combining lived experience and evidence-based research, the toolkit offers foundational information and practical ways to support children and families.

Toolkit content

The toolkit is designed to be accessible at all stages of people’s experiences. It is predicated on the idea that every community is, at some time, either preparing for, experiencing or recovering from disaster—or, as witnessed this summer, experiencing an overlap of severe fire and flood events.

The toolkit includes written guides, podcasts, videos, tip sheets, infographics and a series of train-the-trainer-style workshop modules. It is designed for flexibility, with capacity to select a package of resources suited to meet the community or workforce needs.

The toolkit is available online and resources are divided in a user-centric way (e.g. parents and carers, educators, first responders, general practitioners, health and social service providers and community members). Content is also structured by timeframe (e.g. preparedness, immediate response and short-term recovery, long-term recovery as well as ongoing that covers cumulative or slow-onset disasters such as drought).

Conclusion

Communities support the wellbeing of children who have experienced a disaster, however, appropriate information and training has not always been freely available. Plans designed for disaster preparation or recovery traditionally have focused on groups of people, sometimes failing to incorporate the needs of infants and children. The Community Trauma Toolkit addresses this need and provides the information and targeted actions to use. It encourages all adults, including people who do not have children or interact directly with them, to think about the indirect ripple effect of their actions when they work with communities experiencing disaster. Giving communities and workforces the skills to recognise and support reactions to trauma contributes to the resilience and recovery potential of individuals, businesses and communities and mediates the effects of disaster events on children and families.

The Community Trauma Toolkit is available at: https://emergingminds.com.au/resources/toolkits/community-trauma-toolkit/.

The Community Trauma Toolkit was co-developed by the Australian National University and Emerging Minds for the National Workforce Centre for Child Mental Health. The National Workforce Centre is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.

 
Footnotes

  1. Save the Children 2007, Legacy of disasters: the impact of climate change on children. Retrieved 25 February 2020. At: https://resourcecentre.savethechildren.net/node/3986/pdf/3986.pdf.
  2. World Health Organization 2017, Health Emergency and Disaster Risk Management: Child Health. Retrieved 25 February 2020. At: www.who.int/hac/techguidance/preparedness/risk-management-child-health-december2017.pdf.
  3. Grindlay J & Breeze K 2016, Planning for disasters involving children in Australia: A practical guide. Journal of Paediatrics and Child Health, vol. 2, no. 2, pp.204–212; Pechtel P, Lyons-Ruth K, Anderson C & Teicher M 2014, Sensitive periods of amygdala development: The role of maltreatment in preadolescence. NeuroImage vol. 97, pp.236–244.
  4. McDermott BM & Cobham VE 2012, Family functioning in the aftermath of a natural disaster. BMC Psychiatry, vol. 12, no. 55, pp.1–7.
  5. Masten AS & Narayan A 2012, Child Development in the Context of Disaster, War, and Terrorism: Pathways of Risk and Resilience. Annual Review of Psychology, vol. 63, no. 1, pp.227–257.
  6. Webb M, & Ronan K 2014, Interactive Hazards Education Program for Youth in a Low SES Community: A Quasi-Experimental Pilot Study. Risk Analysis, vol. 34, no. 10, pp.1882–1893; Peek L 2008, Children and disasters: Understanding vulnerability, developing capacities, and promoting resilience—An introduction. Children, Youth and Environments, vol. 18, pp.1–29.
  7. McDermott BM & Cobham VE 2012, Family functioning in the aftermath of a natural disaster. BMC Psychiatry, vol. 12, no. 55, pp.1–7.