Children and young people have many accidents and frights and this is a natural part of growing up. However, sometimes events can be more extreme and traumatic, when the child or young person’s physical or emotional well being is threatened or even harmed. These kinds of traumatic events can include severe accidents, natural disasters, war, car accidents, fires, etc. It can be traumatic for a child or young person to witness another person come to harm or die; it does not necessarily have to happen to themselves. Of course being physically or sexually abused can also be traumatic, but this is covered in a different section.
Reactions to a traumatic experience can differ greatly from person to person. It is important to understand that just because a child or young person has experienced a traumatic event, this does not mean that they will inevitably suffer severe emotional consequences as a result. Factors that influence how much children and young people react to a traumatic event include the age of the child and their ability to understand the event, the nature of the event itself, the level of exposure, whether it happened to themselves or to others, the gender of the child, their personality and functioning prior to the event, how quickly they can return to a normal lifestyle after the event, their support network and people around them, and whether they have experienced a traumatic event in the past.
Experiencing or witnessing a traumatic event can make a child think that the world around them is no longer a safe and predictable place. This is very frightening, and they are worried that the event will happen again and that they or someone in their family will come to harm or even die. The event itself can be hard to understand for children, and this alone can sometimes lead to a lot of fear and anxiety as a result of the traumatic event.
Specific reactions to a traumatic event can differ greatly from person to person, and also with the age of the child. Quite often, reactions to a traumatic event consist of a seemingly contradictory cycle of trying to avoid any reminders of the event (such as denial, not wanting to talk about it, or even physically avoiding the place where it happened or things that remind the child or young person of the event, etc.) but at the same time re-experiencing the event in many ways over and over again (nightmares, re-enacting the event, distressing reactions towards any reminders of the event, etc).
At the same time, reactions to traumatic events are often accompanied by being in a general state of heightened arousal, such as agitation, nervousness, poor concentration, changes in appetite, irritability, crying, worry and anxiety as well as being easily startled.
Of course the ways in which children and young people respond to a traumatic event can be very different depending on the age of the child. Younger children may start behaviours again that they had grown out of, such as tantrums, thumb-sucking or bed-wetting. They may start to cry more often than they used to, become frightened easily and start being excessively clingy. Young children (under the age of 5) also sometimes re-enact the event repeatedly.
School-aged children may become moody, blame themselves for the event, become more aggressive and angry, withdraw from their friends and school, and worry about not being taken care of, as well as being frightened and tearful. They might deny that the event occurred but at the same time asking a lot of questions about it. At this age, children often feel angry and sad about the event, and feel guilty that it happened to them. Sometimes they show a deep desire to help others in need, and worry greatly about the safety of their loved ones.
Teenagers may also become more angry and upset, and withdraw from their friends and other important social activities. They may also become more moody and show signs of feeling depressed, and are anxious about the future. Their appetite and sleeping patterns can change as well. Sometimes teenagers start using alcohol and drugs after a traumatic event, or engage in other high-risk or illegal behaviours.
It is important to understand that coping with traumatic experiences is a complex challenge, and therefore the reactions to the event can be very different and unpredictable.
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Many children and young people will experience or witness a potentially traumatic event at some point in their lives. This does not automatically mean that they will suffer serious emotional consequences as a result. In fact, sometimes traumatic experiences can even function as 'eye-openers', leading individuals to appreciate their lives and time with their loved ones more than before.
However, it is also not unnatural to feel afraid and stressed after a traumatic event, and often these reactions do not last for very long. However, it can be the case that severe reactions to a traumatic event can last for a long time, even months and years, and in this case a specialist should of course be involved.
Remember that the specific reactions to a traumatic event or experience can differ greatly. And to some degree these reactions are completely normal. After all, traumatic events can be very severe, so an initial strong reaction should not be entirely unexpected. Reactions to a traumatic event only become problematic if they are very severe, last for a long time, or result in the child or young person not living their life the way they did before the event, e.g. withdrawing from their friends.
It is also possible for a child or young person to only show emotional reactions to a traumatic event after some time has passed.
It is often helpful to children and young people to talk about the traumatic event, or to just express their feelings about it. This can help with understand the event, and to feel less alone and scared about it. However, this is not always the case, and some people prefer not to talk about it at all. It is important not to be pushy and simply to respect this.
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Your own experiences of how you or others have coped with trauma will have a bearing on how you respond. Being aware of these biases and responding to the individual child and their specific situation is the best way to be helpful. For example, if you have had a similar traumatic experience, or their experience provokes strong emotions in yourself, you may not be the right person to talk to at this time. Being aware of your own ability to cope with discussing issues of trauma is important, so that you do not deter a young person from talking about a traumatic event in their life.
For more information, see section on being aware of yourself and your own response.
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- Be reassuring and comforting. Recovering from a traumatic event can be difficult, so try to pay extra attention to them and be considerate. Children and young people need to you at this time, so try to be extra loving towards them.
- Try to stick to routines as much as possible. Routines help the child return to their normal lives, and make the child or young person feel safe and secure. Make sure you stick to the routines and the limits that you set.
- Encourage the child or young person to express their feelings. For young children you can encourage them to express how they are feeling through play, art, or storytelling, and for young people be available to talk to them. At the same time it is very important that you do not force them in any way to talk about their experiences, or make the child or young person feel like they should talk to you. This is very personal and entirely up to them, so respect their wishes. For more information, see section on counselling techniques.
- When listening to a child or young person talk about their experiences or emotion, remain calm and just listen to them. Do not try to bring your own experiences into the conversation.
- When asked questions about the event, give simple but honest answers. Make sure that your answer will help the child understand the event better, and not confuse them more about it.
- If possible, try to avoid extra stress in the child or young person’s life, such as big lifestyle changes, etc.
- Encourage getting back to a normal life (school and recreational activities) as soon as possible.
- Encourage the young person to take part in physical activities, such as sports or relaxation.
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- If your attempt to help the child or young person has uncovered issues that you are inexperienced in dealing with, such as sexual abuse.
- If the specific behaviour that the child or young person is showing as a result is very extreme, or occurs together with other worrying behaviours, e.g. self-harming behaviours.
- If the child starts having problems in other areas of their lives, such as not wanting to go to school or withdrawing from friends.
- If as a result of a traumatic event the child or young person shows severe reactions and changes in behaviour for a long time.
- If the child or young person experiences frequent nightmares or other problems with their sleep after the traumatic event.
- If the child or young person starts having alcohol- or drug-related problems, or engages in dangerous risk-taking behaviours.
You should get in touch with your local health centre or hospital to obtain a contact number for the appropriate children and young people's mental health specialists.
Remember - you can contact your local mental health specialists for a number of reasons, for example:
- For advice on how to make a referral about a named child.
- For advice about whether or not to make a referral (it is normal practice to seek this advice without naming the child in the first instance).
- For advice about what to do (once again there should be no necessity to name the child).
By not naming the child you are protecting their right to confidentiality. This method of seeking advice also has the advantage that you do not need to get anyone’s consent in advance of your contact phone call.