Crisis Response Manual RUAMRUDEE INTERNATIONAL SCHOOL SWISS SCHOOL
RUAMRUDEE INTERNATIONAL SCHOOL
SWISS SCHOOL
Crisis Response Manual
Revised: August 2014
Table of Contents
Section I
Section II
Section III
Section IV
Crisis Response Manual
Crisis Phone Tree
Emergency Telephone Number
Road Map for Nearby Hospitals
Crisis Phone Number
Procedures
Bomb Threat
Violent Situation on Campus
Kidnapping
Suicide or Death on Campus
Suicide or Death off Campus
Accident / Death on Field Trip
Building Evacuation for Fire
Lock Down
Earthquake
Revision RIS Lightning Procedures
Emergency School Closure Procedures
Decision Making Guidelines
Checklist
Head of School/Deputy Head of School
Crisis Response Team Coordinator
Principals
Faculty/Staff
Head of School/Principals
School Manager/HR Manager
School Clinic
Security Liaison
Montri Transportation
Facilities Support
First Aid Kit Supply Checklist
First Aid Kit List
First Aid Kit Location Map
School Personnel with CPR/First Aid/AED Training
After School Supervision
Appendix
Appendix A: Information from National Association of School Psychologist (NASP)
& Resources Concerning Grief & Suicide Prevention
Stress in Children and Adolescents
Death and Grief in the Family: Providing Support at School
Death and Grief in the Family: Tips for Parents
Crisis Teams to Support School Safety: The PREPaRE Model
Crisis Prevention, Response, and Recovery: Helping Children with Special Needs
Crisis: Helping Children Cope with Grief and Loss
Responding to Natural Disaster: Helping Children and Families
Classroom-Based Crisi Intervention
Traumatized Children: Tips for Educators
Suicidal Student: Intervening at School
Suicide Risk Assessment
Suicide Prevention: Information and Strategies for Educators
Suicide: Postvention Strategies for School Personnel
Save a Friend: Tips for Teens to Prevent Suicide
Crisis Caregivers: Taking Care of Ourselves
Trauma Reactions in Children: Information for Parents and Caregivers
Trama Victims and Psychological Triage: Considerations for
School Mental Health Professionals
Memorial Activities and Traumatic Events: Guidelines for Educators
Copy Powerpoint of ―A Cry for Help‖
Appendix B: Bomb Threat Procedures (English)
Bomb Threat Procedures (Thai)
1
2
3-6
7
8-9
10
11
12
13
14
15
16
17
18
19-21
22
23
24-25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44-46
47-49
50-52
53-56
57-59
60-62
63-67
68-70
71-73
74-76
77-80
81-84
85-87
88-89
90-92
93-96
97-99
100-103
104-106
107
108
Crisis Response Manual
The purpose of the Crisis Response Manual is to provide emergency information in an accessible
easy to read format for administrators, faculty and staff. The information in the Crisis Response
Manual is consistent with the Emergency Procedures of the Policy and Procedure Manual for RIS.
Crisis Response Team is composed of the following members:
Administrative Council
Swiss School Head
In the event of an emergency or crisis, the Head of School or his designee determines the need for a
Crisis Response Team (CRT) meeting.
The Head of School convenes and chairs the meeting. The Crisis Response Team members have the
responsibility to disseminate information to the faculty and staff of their section.
After the initial meeting, the CRT may determine that a working task force, may be a more efficient
means to respond to a crisis.
The CRT Manual is an annual document that needs to be reviewed by all Crisis Response
Team members at the beginning and end of each academic school year.
Crisis Response Team Members Responsibilities:
Assume primary responsibility for initiating communication (one spokesperson only)
Assume or delegate all ongoing communication duties
Ensure communication with all groups in the school community or those groups deemed
necessary
Be alert for rumors/unsubstantiated information in the community
Coach and support teachers and staff in their role
Keep contact with Thai Ministry of Education, Thai Police and US Embassy for updates
regarding security matter in Thailand
1
Crisis Phone Tree
RIS School Director
Fr. Apisit Kritsaralam
081 751 3668
Assistant Director
Fr. Jetana Kitcharoen
080 8139020
Director of Strategic
Initiatives & Thai Studies
Sudarat Tanattanawin
087 9049955
School Manager
Fr. Yuthana Sriprapha
090 9717545
Head of School
Dr. Peter M. Toscano
089 6862808
Minburi Police Chief
02 540 7300,
02540 7215
Deputy Head of School
Sudha Maroli
084 6441836
089 6862808
School Security Liaison
Charoen Saengdej
089 778 4241
ES Principal
Antonia Boush
083 0783844
MS Principal
Gretchen DePoint
095 8608211
HS Principal
Eric Monson
086 3453114
Swiss School Principal
Dominic Tellenbach
086 3520940
ES Assistant
Principal
Daryl Imanishi
090 9894741
MS Assistant
Principal
Timothy Fitzgerald
092 5259616
HS Assistant
Principal
Sara Ghorayeb
089 7478747
Director of
Pupil Services
Rob Conley
089 2252062
2
Emergency Telephone Number
Minburi Police Station
Minburi Fire Department
Minburi Electricity Authority
Minburi Water Supply
02 540-7212-3
02 517-2919
02 543-8404
02 543-8398-9
Metropolitan Mobile Police
191
Thai Tourist Police
1155
General Emergency
1669
Hospitals
Nearby Hospitals
Kasemrad Hospital
Ramkhamhaeng Hospital
Vejthani Hospital
Samitivej Hospital (Srinakin)
Samitivej Hospital (Srinakin) Ambulance
Synphaet Hospital
Seriruk Hospital
Telecare Clinic
Telecare Ambulance
02 729-3000
02 374-0200
02 734-0000
02 731-7000
02 378-3090
02 948-5380
02 918-9888
02 3087170-71
1719
Bangkok Hospitals
Bangkok General
B Care Medical Center
Bamrungraj
Bangkok-Prapadaeng
Bangkok Christian
Bangkok Nursing Home
Bangna 1
Bangna 2
Bangna 3
Bangpakok 1
Bangpakok 2
Bangpakok 3
Bangpo
Bangkapi
Bhumipol
Buddhist‘s Monks
Camillion
Central General
Chaophraya
Charoen Krung Pracharak
Children
Chularat
Chulalongkorn
Deja
02 318-0066, 02 310-3000
02 523-3359-71
02 667-1000
02 815-7141
02 233-6981-9
02 632-0550
02 746-8630-8
02 740-1800-6
02 750-1060-3
02 428-4525-9
02 451-0357-61
02 818-7500-55
02 587-0136-55
02 377-7306
02 534-7000
02 640-9537
02 391-0136, 02 391-8311
02 552-88801-10
02 8847-000-49
02 289-7001
02 354-8333
02 769-2900
02 256-4000
02 246-1685-93
3
Bangkok Hospitals (Cont.)
Daokhanong
Ekachon Bangchak
Karunapitak
Kasemrad Bangkhae
Kasemrad Prachachuen
Kasemrad Ratanatibet
Kasemrad Sukapibal 3
Kluaynamthai
Kluaynamthai 2
Krungdhon
Ladprao
Lert Sin
Mahachai 2
Mayo
Mission
Mongkuwattana
Muangsamuth - Bangpoo
Nakornthon
Navamint
Navanakorn General
Nontavej
Nopparat Ratchatani
Pakkred Vejchakarn
Paolo Memorial
Petchravej
Phaet Punya
Phyathai 1
Phyathai 2
Phyathai 3
Phra Mongkutklao
Piyamint
Piyavej
Police
Praram 9
Prasart
Prommitr
Ratchaburana
Rajanukul
Ramatibodee
Ramkhamhaeng
Ratchawithi
Ruamchaipracharak
Samitivej Sukhumvit
Samitivej Srinakarin
Samrong
Seriruk
Synphaet
St. Louis
Sukhumvit
Thainakarin
02 468-4221
02 463-2941
02 287-3974-6
02 454-0033
02 910-1600
02 594-0020
02 729-3000
02 381-2006-20
02 399-4260-3
02 438-0040
02 530-2556-69
02 353-9798-9
02 431-0054
02 579-1770
02 282-1100
02 574-5000
02 323-4081
02 416-5454
02 918-7604-8
02 529-4533-41
02 589-0102
02 517-4270-9
02 960-9655
02 279-7001-8
02 318-0080
02 314-0726
02 642-7373
02 617-2444
02 869-1220-2
02 354-7600
02 316-0026-42
02 641-4499, 02 625-6500
02 252-8111
02 248-8020, 02 202-9999
02 354-7007
02 259-0373-8
02 427-0175-9
02 245-4601
02 354 7308
02 374-0200
02 354-8108-9
02 708-7500-9
02 392-0011
02 731-7000
02 361-0070
02 918-9888
02 948-5380
02 675-9300
02 391-0011
02 361-2727
4
Bangkok Hospitals (Cont.)
Theptarin
Thonburi 1
Thonburi 2
Vejthani
Vibhavadi
Vidhavadi 2
Vibhavadi-Rangsi
02 240-2727
02 412-0020
02 448-3858
02 734-0000
02 561-1260-7
02 722-2500
02 531-0420
Embassies
Apostolic Nunciature (Vatican)
Argentine Embassy
Australian Embassy
Austrain Embassy
Bangladesh Embassy
Belgium Embassy
Brazilian Embassy
Canadian Embassy
Chilie Embassy
The people‘s Republic of China Embassy
Czechoslovakian Embassy
Danish Embassy
Dominan Republic Embassy
Egyptian Embassy
The Federal Republic of Germany Embassy
Finnish Embassy
French Embassy
Greece Embassy
The Hungarian People‘s Republic Embassy
Indian Embassy
Indonesia Embassy
Iranian Embassy
Israeli Embassy
Italian Embassy
Japanese Embassy
Korean Embassy (North)
Korean Embassy (South)
Laotian Embassy
Malaysian Embassy
Negera Brunei Darussalam of Embassy
Nepalese Embassy
New Zealand Embassy
Norwegian Embassy
Pakistan Embassy
The People‘s Republic of Bulgaria Embassy
Peru Embassy
Philippine Embassy
Polish Embassy
Portuguese Embassy
02 212-5853
02 259-0401-2
02 287-2680, 02 287-3485
02 287-3970-2
02 253-0288-9
02 679-5454
02 679-8567-8
02 636-0540
02 260-3870-2
02 245-7043-4
02 255-4978, 02 255-3027
02 689-5958
02 552-0675
02 661-7184
02 287-9000
02 256-9306-9
02 266-8250-6
02 679-1462
02 661-1150-2
02 258-0300-6
02 252-3135-9
02 259-0611-3
02 204-9200
02 285-4090-3
02 252-6151-9
02 319-2686
02 247-7537-41
02 539-6667-8
02 679-2190-9
02 204-1476-9
02 391-7240, 02 390-2985
02 254-2530
02 261-0230-5
02 253-0288-90
02 259-0139-40
02 314-2099
02 259-0139-40
02 251-8891-2
02 234-7436
5
Embassies (Cont.)
The Republic of Irag Embassy
Royal Netherlands Embassy
Russia Embassy
The Socialist Republic of Romania Embassy
Saudi Arabia Embassy
Singapore Embassy
Spanish Embassy
Sri Lanka Embassy
Swedish Embassy
Switzerland Embassy
Taiwan Embassy
Turkish Embassy
Union of Myanmar, Embassy
The United Kingdom of Great Britain Embassy
The United States of America Embassy
Vietnames Embassy
Yugoslav Embassy
6
02 237-1443
02 254-7701-5
02 268-1169, 02 268-1167
02 617-1551
02 639-2999
02 286-2111, 02 213-1261
02 252-6112, 02 252-8368
02 333-1149
02 263-7200
02 253-0156-60
02 670-0200-9
02 274-7262-3
02 234-0278, 02 234-4698
02 305-8333
02 205-4000
02 251-7202, 02 251-3551
02 391-9090-1
ROAD MAP FOR NEARBY HOSPITALS
No. 1
Kasemrad Hospital (Ramkhamhaeng Road) Tel. 02 729 3000
No. 2
Ramkhamhaeng Hospital (Ramkhamhaeng Road) Tel. 02 374 0216
No. 3
Seriruk Hospital (Sereethai Road) Tel. 02 918 9888
No. 4
Samittivej Hospital (Srinakarin Road) Tel. 02 731 7000, 02 378 9110
No. 5
Vejthanee Hospital (Ladphrao Road) Tel. 02 734 0000
No. 6
Synphat Hospital (Ramintra Road) Tel. 02 948 5380, 02 793 5000
7
Crisis Phone Number
School Director / Head of School & Deputy Head of School
Fr. Apisit Kritsaralam
(School Director)
02 791-8900 ext. 119
081 751 3668
Fr. Jetana Kitcharoen
(Assistant Director)
02 791-8900 ext 119
080 8139020
Fr. Yuthana Sriprapha
(School Manager)
02 791-8900 ext 4105
090 9717545
Fr. Leo Travis
(Campus Ministry)
02 791-8900 ext. 111
Dr. Peter M. Toscano
(Head of School)
02 791-8900 ext. 321
089 686 2808
Sudha Maroli
(Deputy Head of School)
02 791-8900 ext 115
084 644 1836
Principals & Assistant Principals
Ms. Antonia Boush (Toni)
(ES Principal)
02 791-8900 ext. 255
083 0783844
Mr. Daryl Roger Imanishi
(ES Assistant Principal)
02 791-8900 ext. 256
090 9894741
Mrs. Gretchen DePoint
(MS Assistant Principal)
02 791-8900 ext. 108
095 8608211
Mr. Timothy Fitzgerald
(MS Assistant Principal)
02 7978900 ext. 106
092 5259616
Mr. Eric Monson
(HS Principal)
02 791-8900 ext. 229
086 3453144
Ms. Sara Ghorayeb
(HS Assistant Principal)
02 791-8900 ext. 231
089 7478747
Mr. Dominique Tellenbach
(Swiss School Principal)
02 791-8900 ext. 273
086 3520940
8
Counselors/Psychologist
Mr. Robert Conley
(Director of Pupil Services)
02 791-8900 ext. 123
089 225 2062
Dr. Michelle Meskin
(School Psychologist)
02 791-8900 ext. 127
096 1722327
Ms. Crystal Ellis
(ES Counselor)
02 791-8900 ext. 259
081 7495323
Mr. Terry Shuster
(MS Counselor)
02 791-8900 ext. 238
087 827 6400
Mr. Brett Arnold
(HS Counselor)
02 791-8900 ext. 233
088 012 6153
Mrs. Nancy Sousa
(HS Counselor)
02 791-8900 ext. 265
086 765 2304
Mr. Gregory Bishop
(HS Counselor)
02 791-8900 ext. 306
081 927 4085
Mr. Tawan Waengsothorn
(Thai College Counselor)
02 791-8900 ext. 362
081 590 1311
Health Personnel
Siripakorn Ryback
(School Clinic Coordinator)
02 791-8900 ext. 244
081 8189102
9
PROCEDURES
10
Bomb Threat
Person Receiving the Threat
By Phone
Listen carefully, take notes
Notify co-worker threat received
Complete Bomb Threat Call Form
(see Appendix B)
Immediately report to Section Principals,
Head of School, Deputy Head of School,
Security Liaison
By Mail
Handle letter as little as possible
Place in plastic folder
Immediately report to Section Principals,
Head of School, School Manager, Security
Liaison
Meeting Crisis Response Team
Head of School
School Manager
Section Principals
Pupil Services Director
Security Liaison
Swiss School
Notify
Minburi Police
Notify local hospitals – stand by
Head of School
Decision to evacuate
Decision not to evacuate
Alarm
Evacuate to Mooban Chokechai/or
Perfect Place. Most injuries in bomb
explosion caused by flying debris e.g.
glass, brick, plaster, etc.
11
Violent Situation on Campus
Person who comes upon Violent Situation
Notify security
Administrative Office learns of incident
Alert school clinic (x 244) to stand by
Notify Head of School’s office (x 321)
Notify School Principals (x 255, 108, 229, 274)
Call Minburi Police
Notify faculty with CPR certification. See CPR list in Appendix
School Health Office
Gather emergency kit and mobile
phone
Provide first aid as needed
Utilize CPR faculty as needed
Follow-up at hospital if needed
Head of School
Notify security guard house
Cordon off area
Close campus
Liaise with police/EMT
Initiate evacuation if ordered
Head of School
Confirm and gather facts
Decide if evacuation is necessary and if
so, notify operations director
Prepare statements for media, faculty,
staff, parents and students
Notify principals (x 255, 108, 229, 274)
Convene Crisis Response Team
Facilitate disposition of deceased
Principals
Confirm and gather facts
Notify parents of involved students
Notify counselors (see Emergency
Telephone Numbers)
Advise secretaries regarding response
to inquiries
Deputy Head of School
Disseminate statements for media,
faculty, staff, parents and students
Prepare receptionist and secretaries for
incoming calls
Notify PA
Liaise with media
Crisis Response Team
Confirm and gather facts
Devise communication plan for faculty,
staff, students and parents
Identify individuals in need of support
Review scheduled activities for
possible cancellation/suspension
Establish crisis counseling centers and
other necessary support systems
Set follow-up meetings to address
ongoing issues and evaluate
responsivenesses
12
Counselors
Review and service at-risk individuals
Follow-up with family/faculty/
students
Provide grief counseling and
inservices for faculty to assist students
Make referrals to outside agencies
Create plan for meeting ongoing
mental health needs of school
community
Kidnapping
School is notified that a student has been kidnapped
Alert Head of School
School is notified that a student has been kidnapped
o
Alert D
Head of School
Call CRTC to convene CRT meeting
Notify Minburi Police – relevant Embassy, family
Confirm and gather facts
Issue statement for community/parent
Crisis Response Team
Confirm and gather facts
Devise communication plan for faculty, staff, students and parents
Identify individuals in need of support
Review scheduled activities for possible cancellation/suspension
Establish crisis counseling centers and other necessary support systems
Set follow-up meetings to address ongoing issues and evaluate
Principals
Issue statement to faculty
Issue statement to student
Identify individuals in need of support
Review scheduled activities for possible cancellation/suspension
Establish crisis counseling centers and other necessary support systems
Set follow-up meetings to address ongoing issues and evaluate
13
Suicide or Death on Campus
Person who finds the victims
Offer basic first aid
Remain with victim
Send someone to report incident to the nearest
administrative office
Administrative Office learns of Incident
Alert school clinic
Call nearest emergency hospitals/Minburi Police
Notify faculty with CPR certification
Notify Head of School‘s office
School Clinic
Gather emergency kit and mobile phone
or walkie talkie
Attend to victim
Utilize faculty present as needed
Follow-up at hospital if needed
Head of School
Notify guard house
Restrict access to site
Close campus to media
Liaise with police
Principals
Confirm and gather facts
Notify parents or next of kin
Notify counselors (see Telephone
Emergency List)
Advise secretaries regarding calls
Secure victim‘s belongings
Head of School
Confirm and gather facts
Communicate with family
Prepare statements for media, faculty,
staff, parents and students
Notify principals (x 255, 106, 229, 274)
Convene Crisis Response Team
Notify legal counsel/insurance broker
Notify Board Chairperson
Deputy Head of School
Disseminate statements for media,
faculty, staff, parents and students
Prepare receptionists and secretaries for
incoming calls
Notify PA
Liaise with media
Crisis Response Team
Confirm and gather facts
Devise communication plan for faculty,
staff, students and parents
Identify individuals in need of support
Review scheduled activities for possible
cancellation/suspension
Establish crisis counseling centers and
other necessary support systems
Set follow-up meetings to address
ongoing issues and evaluate
responsiveness
Counselors
Review and service at-risk individuals
Follow-up with family/faculty/students
Provide grief counseling and inservices for
faculty to assist students
Make referrals to outside agencies
Create plan for meeting ongoing mental
health needs of school community
14
Suicide or Death off Campus
Administrative Office learns of Incident
Alert school clinic (x 244)
Notify Head of School’s Office (x 321)
School Clinic
Follow-up at hospital if needed
Head of School
Close campus to media
Liaise with police
Principals
Notify parents or next of kin
Notify counselors
Designate family support
Confirm and gather facts
Advise secretaries regarding calls
Gather victims belongings
Head of School
Notify principals (x 255, 108, 229, 274)
Convene CRT meeting
Confirm and gather facts
Deputy Head of School
Disseminate statements for media,
faculty, staff, parents and students
Prepare receptionists and secretaries for
incoming calls
Notify PA
Liaise with media
Provide memorial service information
Crisis Response Team
Confirm and gather facts
Devise communication plan for faculty,
staff, students and parents
Identify individuals in need of support
Review scheduled activities for possible
cancellation/suspension
Establish crisis counseling centers and
other necessary support systems
Set follow-up meetings to address
ongoing issues and evaluate
responsiveness
Counselors
Review and service at-risk individuals
Follow-up with family/faculty/students
Provide grief counseling and inservices for
faculty to assist students
Make referrals to outside agencies
Create plan for meeting ongoing mental
health needs of school community
15
Accident/Death on Field Trip
Faculty Chaperones
Attend to victim
Arrange for victim to be transported to hospital
Call principals (x 255, 108, 229, 274)
Provide information and comfort to other students
Principals
Confirm and gather facts
Notify Head of School
Notify parents or next of kin
Notify counselors (see Counselor Telephone)
Advise secretaries regarding calls
Secure victim‘s belongings
School Clinic
Gather emergency kit and mobile
phone/walkie talkie
Attend to victim
Utilize faculty present as needed
Follow-up at hospital if needed
Head of School
Confirm and gather facts
Communicate with family
Prepare statements for media, faculty,
staff, parents and students
Notify principals (x 255, 108, 229, 274)
Convene Crisis Response Team
Deputy Head of School
Disseminate statements for media,
faculty, staff, parents and students
Prepare receptionists and secretaries
for incoming calls
Notify PA
Liaise with media
Crisis Response Team
Confirm and gather facts
Devise communication plan for faculty,
staff, students and parents
Identify individuals in need of support
Review scheduled activities for
possible cancellation/suspension
Establish crisis counseling centers and
other necessary support systems
Set follow-up meetings to address
ongoing issues and evaluate
responsiveness
Counselors
Review and service at-risk individuals
Follow-up with family/faculty/
students
Provide grief counseling and
inservices for faculty to assist students
Make referrals to outside agencies
Create plan for meeting ongoing
mental health needs of school
community
16
Building Evacuation for Fire
Upon hearing a continuous ringing of the fire alarm bell
Teacher
Turn off gas valves
Turn off electrical items
Close windows and doors
Lead class to designated area via
evacuation route
Take attendance in assembly area
Classroom teacher to take
notebook/classlists to assembly area
Report any missing students to
principal/Assistant Principal
Keep students orderly and quiet
Principals
Assign non-teaching staff to sweep
building
Report names of any missing
student/staff to the command post
Head of School
Access situation
Decide to evacuate campus, move to
Mooban Chokechai, or return to
building
Sound all-clear or implement further
evacuation procedures
Guards
Sweep building for students/staff
Close campus, no vehicles or
pedestrians enter or leave grounds
Investigate area of alarm to determine
if there is a fire
Non-teaching Faculty/Staff
Go with section
School Manager
Report to guardhouses
Assist with communications
Organize search for any missing
student/staff
Free block students
Go to designated evacuation areas
Visitors/Guests
Go to assembly areas with faculty
17
Lock Down
Intruder on Campus
Upon hearing a continuous ‘beeping’ signal
Administrative Office learns of incident
Notify Head of School‘s office (x 321)
Notify School Principals (x 255, 108, 229, 274)
Principals
Assign floor janitor to check locked
door and report unlocked class doors
Teachers
Turn off electrical items
Close windows and doors
Lock windows and doors
On ground floor students and teachers
crouch under window panel indoor
Second floor and above students and
teachers crouch along inside wall cover
window panel on door
Students and teachers during PE to
move to Godbout Hall Phoenix Hall
and lock windows and doors
Students and teachers in Library to lock
down and move to upstairs area
All students ‗outside‘ classrooms to
move to nearest section office, clinic,
Administration Building, Godbout Hall
Head of School
Assess situation
Sound all-clear
Guards
Do not allow any more visitors on
campus
All guards not on gate duty to search
for children on campus and escort to
safe area
18
EARTHQUAKE
CRITICAL INFORMATION
An earthquake is a sudden, rapid shaking of the earth caused by the breaking and shifting of
rock beneath the earth's surface. Earthquakes generally occur without advance warning and
may cause minor to serious ground shaking, damage to buildings, and injuries. It is important
to note that even a mild tremor can create a potentially hazardous situation (broken gas and/or
water lines, exposed electrical wires) and the below procedures should be implemented in
response to all earthquakes regardless of magnitude.
To reduce the likelihood of injury and death during an earthquake one should immediately
"DROP, COVER and HOLD ON".
DROP down to the floor onto your hands and knees.
COVER your head and neck (and your entire body if possible) by crawling under a nearby
table or desk. Cover your eyes by leaning your face against your arms.
HOLD ON to the table or desk until the shaking stops.
If there isn't a table or desk nearby, cover your head, neck and face with your arms as best you
can and crouch in an inside corner of the building. Stay away from windows, outside doors
and walls, and anything that could fall, such as lighting fixtures or furniture.
Modifications for people with disabilities or access and functional needs: If a person(s)'
mobility is limited and they are unable to perform the. DROP, COVER and HOLD ON, it is
important that they do not try to move to a "safer place" or attempt to move outside during an
earthquake. Movement will be very difficult and the risk of injury by falling or being struck
by toppled and flying objects are great; instead, they should protect their head, neck and face
with a pillow or their arms, and bend over if able.
The main goal of "DROP, COVER and HOLD ON" is to afford protection from falling and
flyingdebris and increase the chance of surviving a building collapse. Studies of injuries and
deaths caused by earthquakes over the last several decades show that people are much more
likely to be injured by toppled, falling or flying objects (loose items on shelves and counters,
shattered window glass, unsecured bookcases and computers, etc) than die because of a
collapsed building.
19
In the event of an EARTHQUAKE:
If inside a building
Teachers/Staff
Upon the first indication of an earthquake, teachers/staff should direct students to
DROP down to the floor onto their hands and knees, seek COVER under a nearby
desk or table, and HOLD ON to the furniture legs. If they cannot find shelter beneath
furniture, have them cover their head, neck and face with their arms and crouch in an
inside corner of the building away from windows.
Remain covered until the shaking stops.
Check for injuries.
Account for all students.
Immediately report any missing, extra or injured students.
Continue to maintain control of students.
Wait for further instruction.
If evacuation of the building is initiated, perform a test run of the elevator
car(s) without passengers before using for the transportation of
passenger(s).
If outside a building
Teachers/Staff
Direct students to move away from buildings, trees, streetlights, signs, vehicles,
windows and overhead utility wires that could fall and cause serious injury.
Once in the open, students and staff should DROP to the ground onto their
hands and knees before the earthquake knocks them off their feet.
If students and staff are unable to safely move away from buildings, trees, streetlights,
signs, vehicles and overhead utility wires during the earthquake, then students and
staff should DROP down to the ground onto their hands and knees, COVER their
head, neck and face with their arms as best they can until the shaking stops. When the
shaking subsides move to an open area.
Check for injuries.
Account for all students.
Immediately report any missing, extra or injured students.
Continue to maintain control of students.
Wait for further instruction.
People with disabilities or access and functional needs
Teachers/Staff
If a student and/or staff member's mobility is limited and they are unable to perform
the DROP, COVER and HOLD ON, it is important that they do not try to move to a
"safer place" or attempt move outside during an earthquake. Movement will be very
difficult and the risk of injury by falling or being struck by toppled and flying objects
are great; instead, they should protect their head, neck and face with a pillow or with
their arms, and bend over if able.
20
Principal/Crisis Response Team (CRT)
Upon the first indication of an earthquake, personally execute the DROP,
COVER and HOLD ON procedures.
If appropriate and time permits, assign staff to assess the safety and accessibility of
evacuation routes and assembly sites before initiating an evacuation order. Avoid exit
routes with overhanging building facades, overhead utility wires, large trees and
expansive glass windows. Alter exit routes and assembly sites accordingly.
When the earthquake is over, initiate the evacuation of the building.
Communicate the need to evacuate the building by using plain language over the
public address system, bullhorn or messenger/runner. Do not use the fire alarm.
CALL local Police/Fire Station if your school experiences fire/explosion,
hazardous materials spill/release, medical emergency or extensive damage that
may have compromised the building's structural integrity.
provide emergency call taker with information about the emergency
Confirm address of school
Provide exact location of the emergency
Assign staff to meet with responding fire and police personnel
Weather conditions and special needs issues may necessitate the use of buses as
temporary shelters.
The First Aid Kit should be taken out of building.
Assign staff to inspect the building, if it can be done safely.
Contact the School Manager/Maintenance of facilities management to report damage
to masonry, electrical, plumbing, mechanical systems, and other structural issues.
Determine if circumstances require students and staff to be evacuated to a offsite
location.
Notify appropriate personnel/family by group SMS that an evacuation of the school
has occurred.
Monitor the situation and provide updates and additional instructions as needed.
Communicate when it is safe to re-enter the building i.e. bell system, radio
transmission, public address system or do not re-enter building until checked by
engineer.
Document all actions taken by staff.
21
RIS Lightning Procedures
The goal of having a lightning policy is safety for both students and staff. RIS is using the
SkyScan EWS-PRO lightning detector which measures the distance away from lightning
strikes. The display is a 4 color light system which denotes the distance of lightning strikes in
miles. It is important to note that you can hear thunder from a far distance but it may not be
close enough to cause an evacuation. Also, it may be raining without a lightning threat.
Lightning meters are to be used in the following locations:
Phoenix Field
Godbout Field
Alpha & Astra Pools
Staff in these locations will be instructed on:
How to operate the meters.
How to implement this policy and make notifications.
Level 1 Alert: Meter showing Yellow Light (between 3-8 miles away)
Red
Yellow
Blue
Green
Staff should observe the situation closely in order to make a prudent judgment.
They should ensure that:
All students are out of the swimming pools and under cover
There are no students on the fields, nor any other exposed outside areas
Section offices have been notified that students are safe & that the lightning policy is
being followed during regular school hours.
For afterschool activities, the Athletics Director has been notified. If unavailable,
contact Assistant HS Principal.
Level 2 Alert: Meter showing RED LIGHT (between 0-3 miles) or SEVERE
THUNDERSTORM ALERT LIGHT.
All students and staff are to be inside buildings
There are no students on the fields, nor any other exposed outside areas
Section offices have been notified that students are safe & that the lightening policy is
being followed during regular school hours.
For afterschool activities, the Athletics Director has been notified. If unavailable,
contact Assistant HS Principal.
When the storm is moving away students can return to the water or field
15 minutes after the last Yellow alarm has sounded.
Emergency School Closure
22
Emergency School Closure
Procedures
Policy (5750 from RIS faculty Handbook)
The Head of School is empowered to order the closure of school whenever the health or
safety of pupils and staff are threatened. School may be closed for a temporary period,
indefinitely, or even permanently in case of an emergency arising out of inclement weather,
fire, flood, the failure of an essential utility, or a public emergency endangering the health,
welfare or safety of children. An emergency shall be for a stated period which may be
shortened or extended by the Head of School or his designee, and may be declared by the
Thai Government.
Procedures (5750 from Faculty Handbook)
Head of School informs members of the Administrative Council.
School Manager informs Montri Transport, classified staff, workers, canteens and security
guards.
Head of School informs radio stations, (FM 88.0, 95.5, 100, 105, and 107). Update website
regularly/daily
Deputy Head of School updates school website daily, informs parents through SMS,
facebook, email, twitter, etc.
Section Principals & Directors informs teachers and staff in respective sections; telephone
trees go into effect.
DUTIES on the first day of school closure, specific personnel duties are as follows:
Administrators report to school so that meetings can be called and decisions made.
Teachers remain available for further information/announcements from school.
Staff Designated staff report to work to help with telephone calls and the general running of
the school since some students will be unaware of the school closure and come to school.
(Final decision on which staff will report will be made by Head of School in consultation with
Admin. Council, if possible. )
Workers All workers report to help with general clean-up if needed; Tasks might include,
putting up signs to inform parents and students who show up at school, ensuring ongoing
maintenance, etc.(Designation of staff needed for this will be made by Head of School and,
School Manager)
23
Decision Making Guidelines
The following are procedural recommendations to consider when making a decision to close
the school.
I. During the school day:
1. Call an emergency meeting of the Admin Council.
2. Continually check Bangkok Nation (http://www.nationmultimedia.com/), Bangkok
Post (http://www.bangkokpost.com), facebook and other reliable sources for recent
updates.
3. Contact ISAT to find out if they know of other schools that have made closure
decisions.
4. Contact other international schools in our general area to determine if they have made
a decision; if they have not, please let us know as soon as they have. (Bangkok-Patana,
ISB, NIST)
5. Consult with and consider the directions given by the Bangkok Metropolitan
Authority, Thai Ministry of Education and US embassy security updates.
6. Contact Montri Bus Company to verify that they are running on schedule.
7. Make a decision based on the information from # 1-6.
If the decision is to close school immediately:
a. Contact Montri to determine what the earliest time is that they can take
students home.
b. Make logistics decisions:
i. when will school close,
ii. for how long,
iii. continuation or cancellation of after-school activities, etc.
iv. which faculty, staff and/or workers should report on closed days
c. Determine how the closing will be communicated to teachers and students.
d. Send out an all school SMS and email explaining the reason why school is
closing, including supporting documentation (e.g. Ministry of Education
directives) and the logistics of the closing. The SMS include parents and
faculty
e. Compose a letter explaining the closing and post it on the website.
f. Determine necessary administrative duties in clearing the campus and where
students will be until they are picked up or go home on the bus.
g. Establish times for follow-up Admin Council meetings as needed.
If the decision is to close school at the end of the school day:
a. Contact Montri to verify that they can take students home at the regular time.
b. Make logistics decisions: when, for how long, afternoon activities, etc.
c. Determine necessary administrative duties in clearing the campus and where
students will be until they are picked up or go home on the bus.
d. Send out an all school SMS and email explaining the reason why school is
closing, including supporting documentation (e.g. ministry of education
directives) and the logistics of the closing. The SMS include parents and
faculty
e. Compose a letter explaining the closing and post it on the website.
f. Establish times for follow-up Admin Council meetings as needed.
24
II. During an evening or weekend/holiday:
1. The Head of School check the latest news from a reliable source and consults with
Crisis Response Team.
2. If the decision is to cancel school on Monday:
a. An all school email and SMS should be sent with the announcement and an
explanation.
b. A message, update blog should be written and posted on the school website,
Head of School blog.
c. The Section Principals begin their section emergency faculty phone tree, SMS
from Head of School.
d. Classified Staff will be notified as to whether or not they need to report for
work on Monday.
e. If needed, the Admin Council will meet during the weekend or on Monday to
discuss the length of the closure and provide further direction and information
to the community. In the event that this is not possible, the Head of School
will continue to arrange communications with the community via email, SMS,
and the website, until such a time when the Admin Council can reconvene.
3. If the decision is not to cancel school on Monday or After a Holiday:
a. Under certain circumstances, the Head of School may decide to send an email
and SMS message to the school community stating that school will be in
session on Monday.
b. Section Principals will use their emergency phone trees and SMS messages to
ensure accurate transmission of the information.
25
CHECKLIST
26
Head of School/School Manager
August
Meet with Crisis Response Team Coordinator to review preparedness, training
procedures and development of protocols
Confirm that the Crisis Response Plan is communicated to the faculty, staff, students,
parents and community
Communicate a plan with administrative team for back up procedures to secure and
store all updated records on disks) in case of closure or damage of school
Confirm that a person meets with a representative from each organization that utilizes
or shares the facility in order to ensure clear communication of all procedures and
protocols.
Quarterly
Meet with Crisis Response Team Coordinator
27
Crisis Response Team Coordinator
(Head of School & Director of Pupil Services)
August
Update Crisis Response Manual
Review Emergency Procedures
Ensure that the Administration is familiar with Crisis Response Manual
Set up meeting in August
Quarterly
Ensure that the Crisis Response Team Telephone Tree is updated monthly
End of the Year
Evaluate update and change procedures
28
Principals
August
Review Emergency Procedures with Crisis Response Team
Meet with faculty
Carry out crisis response inservice for faculty
Assist with creating faculty & parent telephone tree and all parents/guardians mobile
telephone numbers for group SMS service
Review emergency procedures:
telephone tree – teachers, and parents
differences in crisis (i.e. bomb threat, evacuation)
field trip emergency
student accident/suicide
Review procedures with office staff
Review/add numbers when needed
Walk through of the emergency procedure (fire drills, lock down, etc.) for faculty
(handout evacuation plan and walk through routes)
Conduct:
Fire drill
Evacuation drill
Lock down drill
Prepare pack for all teachers to take with them in all emergencies
Class list
Phone numbers
Emergency phone numbers (hospitals, etc.)
Distribute telephone tree lists - two per person (one for home and one for emergency
pack)
Communicate emergency procedures to parents at the beginning of the year
Quarterly
Conduct:
Fire drill
Lock down
Year End
Evaluate procedures with Crisis Response Team Coordinator and Administrative
Council
29
Faculty/Staff
Faculty: August
Learn procedures for crisis outlined in the Crisis Response Manual
New faculty / staff.- participate in crisis response training
Have Telephone Tree at home next to telephone
Register passport at Embassy or Consulate (optional)
Give emergency contact name and number in home country to Human
Resources
Ongoing
Participate in drills and exercises to reinforce procedures
Review emergency procedures with students
Keep current class list and contact numbers readily available
30
Head of School/Principals
August
Ascertain that student contact information is correct
Include summary of Crisis Response Procedures in Student Admissions Package
Ensure that school telephone emergency message works
Ensure that CRT is familiar with their roles during a crisis
Identify media sources to liaise with in the event of a crisis
31
School Manager/HR Manager
Beginning of August
Inservice new teachers and substitute teachers about emergency procedures
Communicate emergency preparedness to new teachers during new teacher
Orientation
Communicate hospital procedure, telephone tree procedures, registration embassy to
new teachers. Give lists of phone numbers of hospitals, Emergency Phone Number
list to all teachers
Communicate emergency preparedness to RIS staff
Compile all contact information for faculty and staff
Issue parking stickers
Prepare telephone tree for Human Resource office / classified staff
August
Distribute telephone tree lists – 2 for each person, one for home and one to use on
school trips, etc.
Review telephone procedures
Communicate emergency preparedness
Issue ID cards for teachers, students, parents
Issue parking stickers
Include faculty & staff mobile numbers for group SMS service
Monthly
Update all contact information
Periodically
Review procedures at end of each year
32
School Clinic
August
Check first aid kits throughout school and replenish supplies
Update first aid kit maps (where they are located)
First Aid Kits should be placed
In every section office and every department office e.g. Pupil Services,
Curriculum, etc.
Every section, ES, MS, HS, Swiss School
PE offices
Guard House – Gate 6
Give CRT information / maps on where First Aid Kits are placed
Update clinic / hospital / doctors / ambulance emergency telephone number lists and
maps and place in:
every first aid kit
each office
guard house
faculty room
PE office
Identify personnel with CPR/First Aid training/Certification maintain list and give to
Administration Team and Crisis Response Team. Organise annual training health
program
Inservice bus drivers and bus monitors on all students with medical alert needs
Inservice Homeroom teachers
Semesterly
Do check of medical conditions for Medical History lists and distribute to ES, MS,
HS, and Swiss
Check and resupply emergency medical supplies (first aid kits) or when needed
33
Security Liaison
(Charoen Saendej, RIS ext. 349)
August
Review campus security plans and policies with administration and guards
Post list of emergency numbers in guard house
Carry out inservice training for all security guards
Review traffic and gate security plans for emergency situations and evacuation of
campus
Check grounds and fencing around the property and all locks on gates, doors
Maintain a liaison with local police
Monthly
Check grounds, fencing, locks around property
Train any new staff for all emergency procedure
Periodically
Security reviewed by specialists security company
Ongoing
Communicating with other agencies
34
Montri Transportation
(Khun Suchada/Khun Somjit, RIS ext. 267)
Daily
Check buses for safety
Check emergency doors
July/August
Inservice training on emergency response
lnservice training on first aid
Check two way communication
Check busses for safety repairs
August
Alert drivers and bus monitors about student's medical conditions. Have nurses
communicate emergency health plan (i.e. diabetes)
Cyclic (depending on mileage)
Check fire extinguishers
Check and replenish first aid kits
35
Facilities Support
Daily:
Check alarms and fire extinguisher
July
Check all fire extinguishers, watch taps, electrical / distribution boards, fire hydrants,
building grounds, emergency exits, structure for school opening
Update campus maps for location of fire hydrants, fire extinguishers, exit doors,
electrical/ distribution boards, evacuation routes and give to administration team and
Crisis Response Team
Put evacuation routes in each classroom
Check emergency supplies. (Make a list and check off)
Check alarms (fire alarm), emergency lights, generator
Coordinate training in the use of fire extinguishers for all maintenance, security and
faculty
(done by fire station)
Monthly
Check fire alarms
Check electrical boards
Check water pumps
Check emergency generator
Replenish any material needed for emergency supplies
Year End
Service any needed parts of the building
Replace any equipment needed
36
First Aid Kit Supply Checklist
(School Clinic, RIS ext. 244)
Alcohol 70%
Antiseptic Cream (Burnol Cream)
Antiseptic Solution (Betadine Solution)
Cotton Ball
Cottlon Bud
Elastic Bandage 3‖
Eye Drop (Eye Mo)
Gauze Pad 3‖ x 3‖
Eye Pad
Glove
Ammonia
0.9% N.S.S.
Paper Tape (Albupore)
Plastic Tape (Tensopore)
Scissor
Sling / Triangular Bandage
Stretch Bandage 3‖ (Conform or Tensofix)
Tensoplaster
Tensoplastic
Tensoplastic (Assorted)
Arm Board
Finger Board
No prescription medication kept on campus
37
First Aid Kit List
No.
Section
Room No.
Tel
Kit No.
E 111
254
1
Info office
101
2
1
ES Office
2
Reception Gate 6
3
HS Office
H 111
230
3
4
Redeemer Office
IS 102
241
4
5
Pupil Services
AD 305
125
6
6
Elizabeth Library
AD 212
122
7
7
Griffith Library
L 102
270
8
8
Godbout Hall
G 102
-
9
9
Curriculum Office
Fl. 3 (AD)
332
10
10
Guard Gate 6
-
226
11
11
Head of School Office
AD 204
118
12
12
Maintenance Office
-
261
13
13
Phoenix Hall
-
353
14
14
Swimming Pool Office (Phoenix)
-
351
15
15
Athletics Director Office
GH 106
337
16
16
Swiss School
-
273
17
17
Swiss School
-
273
18
18
Lab ES
AD 120
242
19
19
Lab MS
M 103
-
20
20
Lab HS
AD 111
110
21
21
Small Swimming Pool Office
-
-
22
22
MS Office
M 203
246
23
38
First Aid Kit Location
Map
39
School Personnel with CPR/First Aid and
Automatic External Defibrillators Training
Training period: August 25, 2012
1.
Sean McMahon
2.
Joseph Michael Scott
3.
Caroline Scott
4.
Raha Mortel
5.
Janjira Khaosa-ard
6.
Prapote Unpudsa
Training period: August 17, 2013
7.
Matthew Treinen
8.
Jennifer Treinen
9.
Laura Axtell
10.
Kim McDonald
11.
Daniel Hindler
Training period: October 5, 2013
12.
Matthew
13.
April Slagle
14.
Tim Pettine
15.
Pavla Poch
16.
Walter Koertge
17.
Chuan Feng Lee
18.
Charoen Saendej
40
After School Supervision
Coordinated by Head of Security (Ajarn Charoen) and Administrator on Duty
Supervised time between 2.30 and 5.00 (and later) from Monday through Friday
Details of Supervision
Ajarn Charoen controls traffic until 3.00
From 3.00 through 5.00 Khun Charoen patrols the grounds with Khun Onsa (ES PE
Assistant). Khun Onsa concentrates on ES and Church area and Ajarn Charoen
concentrates on the rest of the campus. Khun Onsa is responsible for checking the
female bathrooms while Ajarn Charoen is responsible for checking the male
bathrooms. They work together to escort unsupervised students who are not involved
in organized sports, supporting the sports program as spectators, EDP or other schoolsponsored activities to the Library/Covered Gym area.
Between 3.30 and 5.00 Charoen has three Security Guards patrolling the grounds.
They do not intervene with students but may contact Ajarn Charoen or Khun Onsa if
an issue arises (who are also patrolling at this time).
Ajarn Charoen patrols ‗trouble spots‘ outside school perimeter around Perfect Place,
Jiffy Petrol Station, etc
At present, if younger students are being supervised by nannies while playing, we do
not intervene.
No students are allowed in classrooms if not supervised by a teacher.
No teacher is to be alone with a student in a classroom.
Administration team members must have Ajarn Charoen‘s, Khun Onsa‘s and Khun
Siripakorn‘s mobile number in their mobile phones.
Gates are closed at 6.00. Students still waiting to be collected stay just outside Gate 6
from 5.00 and are watched by a female security guard until 6.00. After 6.00 Ajarn
Charoen moves the students to near Gate 7 and stays with them until collected.
The After School Duty list should be kept on display in each admin office, The Clinic,
the PE and Sports Offices, EDP Office, etc. All faculty and staff involved in after
school activities must be aware who is on duty (or can find out quickly). PE and
Athletics and Aquatics Heads should have all Administrator‘s numbers in their
phones.
All Administrators should print a hard copy of Crisis Response Manual in case
electricity goes down and retrieve emergency numbers cannot be retrieved.
We will encourage students to leave early on Wednesdays (particularly early release
days). However, for the time being Bob Kovac will be with a soccer group on
Wednesdays from 2.45-4.00 and from 1.15-2.45 on Early release days. We will let you
know when this ceases.
Please note that the administrator on duty will meet with Ajarn Charoen and Khun
Onsa at 3.00 every day between the back entrance to the Administration Building and
the Middle School.
The Administrator on After School duty will actively patrol the campus in cooperation
with Campus Security. It is the responsibility of these personnel to inform each other
of any inappropriate student behavior/security concerns immediately. Please have
charged mobile phones with you.
41
APPENDIX
42
Appendix A
A.
In this section we have included information from the National Association of School
Psychologist (NASP) which deals with;
B.
Stress in Children and Adolescents, 44-46
Death and Grief in the Family: Providing Support at School, 47-49
Death and Grief in the Family: Tips for Parents, 50-52
Crisis Teams to Support School Safety: The PREPaRE Model, 53-56
Crisis Prevention, Response, and Recovery: Helping Children with
Special Needs, 57-59
Crisis: Helping Children Cope with Grief and Loss, 60-62
Responding to Natural Disasters: Helping Children and Families, 63-67
Classroom-Based Crisis Intervention, 68-70
Traumatized Children: Tips for Educators, 71-73
Suicidal Student: Intervening at School, 74-76
Suicide Risk Assessment, 77-80
Suicide Prevention: Information and Strategies for Educators, 81-84
Suicide: Postvention Strategies for School Personnel, 85-87
Save a Friend: Tips for Teens to Prevent Suicide, 88-89
Crisis Caregivers: Taking Care of Ourselves, 90-92
Trauma Reactions in Children: Information for Parents and Caregivers, 93-96
Trauma Victims and Psychological Triage: Considerations for School
Mental Health Professionals, 97-99
Memorial Activities and Traumatic Events: Guidelines for Educators, 100-103
More resources concerning suicide prevention;
Copy powerpoint of ―A Cry for Help‖, 104-106
This information provides helpful, very practical information to help children, adolescents
and parents to deal with critical, stressful and tragic events.
It also gives some insight into our own reactions to these events which allow us to be
effective helpers.
Please familiarize yourselves with this material.
43
Stress in Children and Adolescents
BY ELLIS P. COPELAND, PHD, The Chicago Schoal of Professional Psychology, IL
The healthy development and well-being of children and adolescents can be affected by stressful life events.
Research shows that stress is a part of the development of child and adolescent psychopathology and
physiological disorders. However, not all stress is bad. Harmful stress is often referred to as distress, and while
distress can adversely affect our bodies, our minds, and/or our behaviors, some stress actually makes us feel good
by energizing us to solve problems and accomplish goals.
All children are affected by stress. In the early years, children seldom know what to call it, so they tell us in
interesting ways, such as "My stomach hurts," "my head hurts," "I can't go to school," and so on. Youth and
adolescents may know that a problem is stress-related, yet are often unable to identify exactly what has caused the
discomfort. To further complicate the stress response, every individual reacts to stressors (events in the
environment and/or perceptions that cause stress) and tells his or her story about stress in a different way.
Therefore, one single inquiry may not be sufficient to help the adult know if stress is the problem. For example, to
assume too much activity is stressful may not be true. Although many children are adversely affected by too much
activity, another child may be more adversely affected by understimulation. Perhaps the best definition is that
stress occurs when a child or adolescent is unable to cope and/or perceives that his or her resources are less than
sufficient to meet the challenge.
BASIC FACTS/CHARACTERISTICS
According to Hans Selye (1978), an early pioneer of stress research, our bodies are affected by stress in ways that
are often beyond our control.
Physical Response to Stress
Selye notes three stages in the physical response: alarm, resistance, and exhaustion. In the first stage, alarm, the body
goes into alert, with an increase in heart rate and breathing as the individual considers a course of action
(analogous to the fight-or-flight response). Resistance follows alarm, when the body attempts to slow down and
return to normal, or homeostasis. Back in the fight-or-flight days (when a person either ran from danger or fought
back), our bodies naturally made this change. Today, stress is typically more continuous. The body attempts to
adjust, but if the event continues or if the individual is unable to adapt to the situation, exhaustion may follow.
Exhaustion may mean aches and pains to the adult, yet children may show behavioral changes. Of critical
importance, however, is that the body does not need to get to the exhaustion phase for physical and psychological
problems to occur. So, colds or body aches and pains (on the physical side), fear of failure, test anxiety, and/or
not seeing oneself as smart enough (on the psychological side) may all be examples of too much stress.
Sources of Stress Across Development
The source of stress, an individual's vulnerability and resiliency, and available supports to deal with stressors vary
with developmental stage.
Infonts ond children. Initially, infants learn through their interactions with a primary caregiver how to organize
and regulate stress systems. Children who experience more family stressors in the preschool years are more
aggressive and anxious and less socially competent in kindergarten than their peers who were exposed to less
family stress in those same years. As children enter their school years, the major sources of stress expand to
include school, peers, and neighborhood variables. As children get older, normal events such as puberty, peer
relations, academics, and unresolved home issues can become significant stressors. This period represents a
particularly vulnerable time for youth and children. Those who encounter multiple simultaneous stressful life
changes are more likely to experience emotional and behavioral disturbances. Support from significant adults,
feelings of worth, and safe environments all become foundational for effective coping.
44
Adolescents. As the adolescent enters middle school
and high school, there is yet another transition from
dependence on the family to an increasing reliance
on one's friends and oneself. It is necessary that these
sources of social support be balanced between peer
and adult orientations. For example, young
adolescents who rely more heavily on peer-oriented
sources of support tend to have higher levels of
negative adjustment. For older adolescents, the
biological changes that impacted early adolescents
have largely subsided. They are developing increased
capacities for abstract thought and self-reflection,
which allows them to internalize sources of support
to build self-system resources. These changes allow
adolescents to exert greater control over their
perceptions of stress and to regulate their subsequent
actions, allowing for a broader range of coping
strategies, especially those directed toward problem
solving. Mindfulness and self-efficacy are now set to
become key components for future problem solving
and stress control.
COPING WITH STRESS: KEY STRATEGIES
The nature of stressful life events can vary in
duration, severity, and type of occurrence. For
example, cumulative life experiences and daily
hassles can include normal developmental
experiences (e.g., standardized testing, grade
transitions) as well as atypical events (e.g., death of a
family member) and chronic stressors (e.g., excessive
crowding or noise in a low-income neighborhood).
The experience of stress appears to be complex and
depends on the psychological resources and
contextual factors that interact with one another. At
times, there is little that practitioners and parents can
do to decrease the number of stressors experienced
by children and adolescents. Thus, a focus on
prevention and facilitating the management of stress
by children and adolescents becomes critical.
successfully solving a problem.
Teach and model emotional regulation. The earlier
a child learns to use emotions to faCilitate rather
than negate problem solving, the better his or her
response to stress will be.
Encourage your children to develop healthy
relationships by modeling positive interactions
with others. A network of friends for you and your
children builds buffers against negative stress.
Encourage physical activity as a means of
releasing stress.
Set realistic behavioral expectations for your
child's developmental level.
Keep your children informed of necessary and
anticipated changes within the family, such as a
job change that might require moving.
Interpret events positively in order to enhance
optimism.
Express positive emotions (praise, admiration,
gratitude).
Monitor peer relationships in middle and high
school.
Realize that your children will be exposed to drugs
and alcohol, probably sometime during middle
school. Let them know that self-medicating with
alcohol and drugs is a poor strategy to cope with
stress.
Managing Stress
How can adults help children cope once distress
occurs?
Ongoing activities can escalate and produce stress.
Evaluate children's schedules regularly and be
careful that they are not overextended. Encourage
children to maintain a schedule that is manageable.
Be aware of children's behaviors and emotions.
Helpthem find things that give them personal
pleasure. Encourage them to talk if there was a
problem during the day.
If the family is moving to a new neighborhood,
help your children feel a part of the move. You
might pay a visit to a nearby park or set up a rope
swing or swing set in the backyard.
Be selective in the television programs that young
children watch (including news broadcasts), which
can produce worries and anxiety. Pay particular
attention to and provide supervision for video
games, DVDs, and the use of the Internet.
When a child makes a poor decision, listen without
being critical and try to use encouragement and
natural consequences instead of punishment.
If a problem occurs at school, or if there is a
problem at home that may affect your children's
schoolwork, contact the teachers. Teachers want to
be informed and can help children to re-engage.
Prevention for Parents
How can parents help to inoculate children from the
harmful effects of stress?
Let your children know that they can trust you (be
honest and reliable, be on time), that their home
and neighborhood are safe, and that they are loved
and important members of your family.
Encourage the expression of feelings. Awareness
of feelings is one of the major building blocks to
selfawareness. When listening to your children
tell about the day's experiences, find out how they
felt about the day as well as what they did.
Help your children learn how to problem-solve.
Taking responsibility for their decisions helps
them feel that they can be in control. Children
who cope best haveexperienced the satisfaction of
45
Seek professional help or advice when signs of
stress do not decrease or disappear, or if a child
has been a victim of a traumatic experience.
RECOMMENDED RESOURCES Print
Hess, R. S., & Copeland, E. P. (2006). Stress. In G.
G. Bear & K. M. Minke (Eds.), Children's needs III:
Development, prevention, and intervention (pp. 255265). Bethesda, MD: National Association of
School Psychologists.
Maton, K. I., Schellenbach, C. J., Leadbeater, B. J., &
Solarz, A. L. (2003). Investing in children, youth,
families, and communities: Strengths-based research
and policy. Washington, DC: American
Psychological Association.
Sapolsky, R. M. (2004). Why zebras don't get ulcers
(3rd ed.). New York: Henry Holt.
What Can Children Do?
There are many strategies children can use to help
themselves alleviate stress. Read this section aloud
with your children.
Talk about your problems.
Learn strategies to manage your stress, such as
taking time out to relax, listening to relaxing
music, taking a warm bath, or watching the stars.
Laugh and playa little every day.
Engage in exercise/sports.
Pet your dog or cat. Watch your fish in the fish
tank.
Set realistic goals. Be honest with yourself and
remember that no one is perfect.
Love and respect yourself. Make friends who
accept
and respect you.
Respect your parents.
Accept others and be tolerant of differences.
Enjoy solving problems. Handle your emotions
before your emotions handle you.
Breathe deeply using your diaphragm.
Know that drugs and alcohol may appear to help
you to fit in, yet they never solve problems or
reduce the long-term effects of stress.
Online
These three noteworthy organizations promote
diverse yet interrelated competencies in youth and
communities on a school-wide or district-wide basis:
Character Education Program Network: http://www.
character.org
Collaborative for Academic, Social, and Emotional
Learning (CASEL): http://www.casel.org
The Search Institute: http://www.search-institute,org
Ellis P. Copeland, PhD, is Emeritus Professor of School Psychology at the
University of Northern Colorado and currently is on the faculty of the
Chicago School for Professional Psychology .
REFERENCE
Seyle, H. (1978). The stress of life (2nd ed.). New
York: McGraw Hill.
46
Death and Grief in the Family:
Providing Support at School
BY KELLY S. GRAYDON, PHD, Chapman University, Orange, CA
SHANE R. JIMERSON, PHD, NCSP, University of California, Santa Barbara
EMILY S. FISHER, PHD, Loyola Marymount University, Los Angeles
Loss is a natural and expected part of life. Before reaching adulthood, the majority of children and adolescents
will experience the loss of a close or special person. Therefore, it is very important for educators and staff at all
levels to have a strong understanding of the ways in which they can support grieving students. This includes
having a solid understanding of expected grief reactions as well as the ability to identify reactions or behaviors
that are indicative of unhealthy mourning. School personnel should be aware of the resources available for
bereaved students at their school sites as well as in their communities, and be ready and willing to direct both
students and families to needed support.
WHAT ARE TYPICAL GRIEF REACTIONS?
It is important to remember that there is no right or wrong way for children and adolescents to react to a loss, and
that no two children are expected to react in exactly the same way. Grief reactions among children and
adolescents can be highly variable and are influenced by several factors, including students' developmental level
and/or the presence of mental health challenges or disabilities. For example, children with exceptional needs may
possess fewer coping strategies, making their reactions similar to those expected in younger children. The nature
of the loss may also have a great impact on a child's reaction. Factors such as traumatic or unexpected deaths, the
loss of multiple family members, suicide, and homicide are associated with stronger negative grief reactions.
Additionally, children can be impacted by the variety of associated life changes that may occur as a result of the
loss, including a move, a change in the family's financial situation, or the impaired caregiving abilities of the
surviving parent or guardian.
While heterogeneity is expected in grief reactions, some general trends exist that can help teachers and other
school staff understand typical and atypical reactions of bereaved children. Sadness, confusion, and anxiety are
among the most the common grief responses and are likely to be observed in children of all ages and ability
levels. In contrast, the following reactions (listed with the ages most likely to exhibit them) may warrant further
attention:
Preschool Level
Young children are generally unable to directly express their emotions. Adults should be alert to the following
symptoms:
Decreased verbalization
Increased anxiety (e.g., c1inginess, fear of separation)
Regressive behaviors (e.g., bedwetting, thumb sucking)
Elementary School Level
Although more able to express feelings with words, school-age children more readily communicate grief
responses through changes in behavior including the following:
Difficulty concentrating or inattention
Somatic complaints (e.g., headaches, stomach problems)
Sleep disturbances (e.g., nightmares, fear of the dark)
Repeated telling and acting out of the event
47
Withdrawal
Increased irritability, disruptive behavior, or
aggressive behavior
Increased anxiety (e.g., clinging, whining)
Depression, guilt, or anger
A decrease in academic performance or school
attendance
mental health staff, including school
psychologists, counselors, and/or school social
workers with knowledge of grief counseling may
provide individual and/or group counseling.
Level 3. Support at this level is highly therapeutic
and provided for severely grief-impaired youth.
Treatment at this level will be conducted by those
with highly specialized training in this area and may
be provided outside of the school context. Care at
this level is often provided by school psychologists,
licensed clinical social workers, marriage and family
therapists, clinical psychologists, or psychiatrists.
Middle and High School Level
Teenagers exhibit grief symptoms more like those of
adults, with less experience and less developed
coping skills. Their symptoms might include:
Flashbacks
Emotional numbing or depression
Nightmares
Avoidance or withdrawal
Peer relationship problems
Substance abuse or other high-risk behaviors
A decrease in academic performance or school
attendance
Preparing to Assist When Needed
As grief and loss are natural and expected parts of
life, schools must expect that a percentage of their
students will be affected by the death of a loved one
each year. Schools can take several steps to ensure
they are prepared to assist children who experience a
loss.
Teach all staff basic information about grief and loss.
Make sure they understand that grief is a natural
and expected reaction to the loss of a loved one.
Inform them of the developmental stages
associated with grief responses. Encourage them
to view each child's grief and mourning as unique.
Provide information about cultural sensitivity to grief
reactions. School staff may need information that
takes into account the culture of the individual
family or the community. Give guidance when
needed regarding culturally appropriate responses
to death.
Prepare staff to answer questions. School staff
should be comfortable discussing death as a
normal and healthy part of life. Misinformation
(e.g., "She just fell asleep") is not helpful and can
confuse and scare children. Staff members who
interact with children experiencing grief should be
prepared to answer questions and encourage
children to express their feelings.
Teach staff to watch out for signs of intense, prolonged,
or unhealthy grief reactions. Teachers, school
psychologists, nurses, counselors, social workers,
and administrative staff are all in excellent
positions to identify children who may require
additional assistance
Inform teachers and staff that certain behaviors are
expected. Children may be distracted, tired, impatient,
forgetful, or have difficulty concentrating in the
classroom setting. These reactions, and others such as
recurring headaches or stomachaches, should be
viewed as a natural part of the grieving process and
children should not be punished for them. However,
if symptoms do not subside over time, a referral
HOW CAN SCHOOLS SUPPORT BEREAVED
CHILDREN?
In the event of a death in the family, children will
likely experience reactions of grief and loss that
affect their school success. Many of the reactions
noted above may have negative consequences on
classroom behaviors and academic achievement.
School personnel can help to support children during
these difficult times. After a loss, students will likely
need some support to help them cope with their
feelings, as well as to adjust back into the routine of
school.
Levels of Support
Fortunately, schools have many levels of support
available to children who have experienced a loss:
Level 7. Support at this level is based on caring,
supportive relationships or friendships and is not
therapeutic. Naturally occurring support systems
such as teachers, parents, friends, and community
members help students deal with their grief. School
counselors, school psychologists, and school nurses
can also provide assistance. School staff should be
made aware of healthy and unhealthy grief reactions
so students who require additional levels of
assistance may be identified.
Level 2. Support at this level contains
psychoeducational interventions and potentially
therapeutic interventions. While teachers can help
facilitate psychoeducational interventions, trained
48
should be made to a school-based mental health
professional who can provide the student with
additional support and resources.
Brock, S. E., Nickerson, A. B., Reeves, M. A.,
Jimerson, S. R, Lieberman, R. A., & Feinberg, T. A.
(2009).
School crisis prevention and intervention: The
PREPaRE model. Bethesda, MD: National
As'sociation ~f School Psychologists.
Brock, S. E., Lazarus, P. J., & Jimerson, S. R (Eds.).
(2002). Best practices in school crisis prevention and
intervention. Bethesda, MD: National Association
of School Psychologists.
Fiorini, J., & Mullen, J. (2006). Counseling children
and adolescents through grief and loss. Champaign,
IL: Research Press.
Lehmann, L., Jimerson, S. R., & Gaasch, A. (2001).
Mourning child grief support group curriculum.
Philadelphia: Brunner-Routledge. Available:
http:// www.routledge.com
Signs That Additional Help Is Needed
School personnel should be particularly alert to any
of the following as indicators that trained mental
health staff should be consulted for intervention and
possible referral:
Severe loss of interest in daily activities (e.g., play
and friends)
Disruption in ability to eat or sleep
School refusal
Fear of being alone
Repeated wish to join the deceased
Severe drop in school achievement
Preschool, early childhood, middle childhood,
and adolescent editions are available.
Murthy, R., & Smith, L. (2005). Grieving, sharing, and
healing: A guide for facilitating early adolescent
bereavement groups. Champaign, IL: Research
Press.
Individual Counseling
Upon returning to school after a loss in the family,
some children and adolescents may need intensive,
one-to-one counseling support. This may be
especially true if students display intense or
unhealthy grief reactions (such as those noted above)
or engage in high-risk behavior. Individual treatment
should focus on both the affective and the cognitive
aspects of the loss, as well as on promoting coping at
school and at home. It is important that, whenever
possible, parents or other family members be
included in grief counseling.
Online
National Association of School Psychologists, Crisis
resources: http://nasponline.org/resources/crisis_
safety/index.aspx
A source for multiple handouts including
"Helping Children Cope with Loss, Death, and
Grief."
Group Counseling
Group counseling can also help children and
adolescents cope more effectively with grief and
loss. It is important that school-based mental health
professionals identify students who have similar
needs and use developmentally appropriate activities
to help them understand and cope with feelings of
grief and loss. Several structured group curricula for
grief and loss are available. Many of these programs
have versions for multiple age levels, and most
provide outlines, routines, and activities for groups
lasting 10-12 weeks.
National Organization of Victim Assistance: http://
www.trynova.org
Project LOSS:
http://education.ucsb.edu/jimerson/loss. html
Kelly S. Graydon, PhD, is an Assistant Professor of School Psychology at
Chapman University in Orange, CA; Shane R. Jimerson, PhD, NCSP, is a
Professor in the Department of Counseling, Clinical, and School
Psychology at the University of California, Santa Barbara; and Emily S.
Fisher, PhD, is an Assistant Professor of School Psychology at Loyola
Marymount University in Los Angeles.
RECOMMENDED RESOURCES
Print
Auman, M. (2007). Bereavement support for
children.
Journal of School Nursing, 23(1), 34-39.
Black, S. (2005). When children grieve. American
School Board Journal, 192(8), 28-30.
49
Death and Grief in the Family:
Tips for Parents
BY KELLY S. GRAYDON, PHD, Chapman University, Orange, CA
SHANE R. JIMERSON, PHD, NCSP, University af California, Santa Barbara
EMILY S. FISHER, PHD, Loyola Marymount University, Los Angeles
Many children and adolescents will experience the loss of a dose relative or other special person before they
reach adulthood. As families are often the primary sources of support for youth in crisis, it is important for
parents to have a solid understanding of the reactions they may observe, and to be able to identify children or
adolescents who may require additional support. Parents and other caregivers should also understand how their
own grief reactions and responses to the loss may impact the experience of a child.
WHAT ARE TYPICAL GRIEF REACTIONS?
Grief reactions among children and adolescents vary and are influenced by their developmental level. No two
children will react to a loss in exactly the same way. There is no right or wrong way for children to react to a loss,
and reactions are influenced by many factors other than age. For example, children with a history of mental
health problems may be more likely to experience severe or prolonged negative reactions. Similarly, children
with exceptional needs possess fewer coping strategies, making their reactions more like those of younger
children.
Some general trends exist that can help parents and other caregivers understand typical and atypical reactions of
bereaved children. For example, sadness, confusion, and anxiety are among the most common grief responses and
are likely to be observed in children of all ages.
The Grief Process
There are common stages that children and adolescents may go through after the loss of a loved one. While many
adults are familiar with the stages of the grief process, common misconceptions assume that all children must
proceed through all stages in the same order or within a specified time limit. In reality, grief does not follow a
specified pattern. Children and youth may experience some or all of these stages in varying intensity and even
repeat stages.
The general stages of the grief process are:
Denial (unwillingness to discuss the loss)
Anger or guilt (blaming others for the loss)
Sorrow or depression (loss of energy, appetite, or interest in activities)
Bargaining (attempts to regain control by making promises or changes in one's life)
Acceptance or admission (acceptance that loss is final, real, significant, and painful)
Grief Reactions of Concern
The above behaviors are expected and natural reactions to a loss. However, the following behaviors may warrant
further attention:
Preschool Level:
Decreased verbalization
Increased anxiety (e.g., dinginess, fear of separation)
Regressive behaviors (e.g., bedwetting, thumb sucking)
50
Elementary school level:
Difficulty concentrating or inattention
Somatic complaints (e.g., headaches, stomach
problems)
Sleep disturbances (e.g., nightmares, fear of the
dark)
Repeated telling and acting out of the event
Withdrawal
Increased irritability, disruptive behavior, or
aggressive behavior
Increased anxiety (e.g., clinging, whining)
Depression, guilt, or anger
Myth: Children Should Be Protected From the
Mourning of Adults
Many adults try to shelter youth from their own grief
reactions, presuming that this may cause more pain
for the child. Children model the behavior that is
demonstrated to them. Those children who view
denied grief are likely to replicate this response,
whereas children whose loved ones are openly sad
will learn that mourning is natural and okay.
Myth: Children Should Not Attend Funerals
Many adults assume that exposing a child to a funeral
will only cause more pain. In reality, funerals and
other memorial services are a natural way to begin
the mourning process, providing structure and a sense
of commonality. Attendance should be encouraged as
developmentally appropriate.
Middle and high school level:
Flashbacks
Emotional numbing or depression
Nightmares
Avoidance or withdrawal
Peer relationship problems
Substance abuse or other high-risk behavior
Myth: Death Should Be Explained in Softer Terms
Death is a complicated concept that is beyond the range
of understanding for many young children (e.g., very
young children may lack the ability to understand the
permanence of the loss). However, speaking to children in
broad or vague terms may lead them to incorrect
assumptions. For example, a child who was told that the
deceased fell asleep may conclude that sleep is a risky
behavior and develop a fear of sleep.
Complicating Factors
Although grief is a process, and reactions are best
understood when considering the developmental
stage of the child, it is also very important to keep in
mind that reactions are also largely impacted by the
particular circumstances of the loss. Not surprisingly,
the closer the relationship a child had with the
deceased, the more severe the reaction.
HOW CAN FAMILIES SUPPORT BEREAVED
CHILDREN?
How family members grieve following a loss will
influence how children grieve. When family
members are able to talk about the loss, express their
feelings, and provide support for children in the
aftermath of a loss, children are better able to develop
healthy coping strategies. Family members are
encouraged to:
Other factors must also be considered. For example,
the loss of a parent can often be accompanied by
other losses, including a move, a change in the
family's financial situation, or the impaired
caregiving abilities of the surviving parent. Stronger
and more persistent grief reactions are more likely
when multiple losses have occurred. Additional
factors include sudden or traumatic losses,
homicides, or suicides.
Talk about the loss. This gives children permission to
talk about it, too.
Ask questions to find out how children are
understanding the loss, and to determine their
physical and emotional reactions. Listen patiently.
Remember that each child is unique and will
grieve in his or her own way.
Be prepared to discuss the loss repeatedly. Children
should be encouraged to talk about, play out, or
even act out the details of the loss as well as their
feelings about it, about the deceased person, and
about other changes that have occurred in their
lives as a result of the loss.
Give children important facts about the event at an
appropriate developmental level. This may
include helping children accurately understand
what death is. For younger children, this
explanation might include helping them to
COMMON MYTHS REGARDING GRIEF AND
LOSS
Many misconceptions exist about how children and
adolescents respond to the loss of a loved one. For
family members to help, they need to understand
how young people mourn. Following are some
common myths that may get in the way.
Myth: Grief Should Be Time-limited
Many adults, including some mental health
professionals, assume there are certain benchmarks
that define the grieving period. For example, after six
months, bereavement becomes "unhealthy." In
reality, healthy reactions to a loss may take years.
51
understand that the person's body has stopped
working and will never again work.
Help children understand the death and intervene to
correct false perceptions about the cause of the
event, ensuring that they do not blame themselves
for the situation.
Provide a model of healthy mourning by being open
about your own feelings of sadness and grief.
Create structure and routine for children so they
experience predictability and stability.
Take care of yourself so you can assist the children
and adolescents in your family. Prolonged, intense
grieving or unhealthy grief reactions (such as
substance abuse) will inhibit your ability to
provide adequate support.
Acknowledge that it will take time to mourn and that
bereavement is a process that occurs over months
and years. Be aware that normal grief reactions
often last longer than six months, depending on
the type of loss and proximity to the child.
Take advantage of community resources such as
counseling, especially if children and youth do not
seem to be coping well with grief and loss.
Online
American Academy of Child and Adolescent
Psychiatry, Facts for families, Children and grief:
http://www. aaca p.org/ cs/ root/facts_for _fa mil
ies/ ch i Id ren_a nd_ grief
Compassion Books:
http://www.compassionbooks.com/ store
National Association of School Psychologists, School
safety and crisis resources: http://nasponline.org/
resou rces/ crisis_safety /i ndex.aspx
Multiple handouts, including "Helping Children
Cope with Loss, Death, and Grief."
Project LOSS:
http://education.ucsb.edu/iimerson/loss. html
Wider Horizons, Resources for children and teens:
http://www.whyy.org/widerhorizons/childrensres
ources.html
A directory of resources on grief and loss.
Kelly S. Graydon, PhD, is an Assistant Professor of School Psychology at
Chapman University in Orange, CA; Shane R. Jimerson, PhD, NCSP, is a
Professor in the Department of Counseling, Clinical, and School
Psychology at the University of California, Santa Barbara; and Emily S.
Fisher, PhD, is an Assistant Professor of School Psychology at Loyola
Marymount University in Los Angeles.
RECOMMENDED RESOURCES
Print
Boyd Webb, N. (2002). Helping bereaved children: A
handbook for practitioners (2nd ed.). New York:
Guilford Press.
Brown, L. K. (1998). When dinosaurs die: A guide to
understanding death. Boston: Little, Brown Young
Readers.
Coloroso, B. (2001). Parenting through crisis: Helping
kids in times of loss, grief, and change. New York:
Collins Living.
Fiorini, J., & Mullen, J. (2006). Counseling children
and adolescents through grief and loss. Champaign,
IL: Research Press.
Grollman, E. A. (2006). A complete book about death
for kids. Omaha, NE: Centering Corporation.
Lehmann, L., Jimerson, S. R., & Gaasch, A. (2001).
Mourning child grief support group curriculum.
Philadelphia: Brunner-Routledge. (Preschool,
Early Childhood, Middle Childhood, and
Adolescent Editions.) Available online at
http://www.routledge. com
52
Crisis Teams to Support School Safety:
The PREPaRE Model
BY MELISSA A. REEVES, PHD, NCSP, Winthrop University, Rock Hill, SC
AMANDA B. NICKERSON, PHD, NCSP, University at Albany-State University of New York
Crisis teams are an integral part of responding to a school crisis. However, crisis teams also play an important
role in all phases of crisis prevention and intervention. This role includes establishing a safe and healthy school
climate; providing crisis interventions; and assisting students, families, and staff in recovery. The NASP
PREP~RE curriculum (Brock, Nickerson, Reeves, Jimerson, Lieberman, & Feinberg, 2009) advocates for
hierarchical levels of crisis teams that include the school/building team, district team, and a community/regional
team. All three levels are necessary to build the capacity to respond to a smallerscale or larger-scale event. In
addition, schools teams are essential to establishing a positive school culture on a daily basis. Key responsibilities
at each of the crisis phases, in addition to the multidisciplinary crisis team roles assigned, are explained in this
handout.
CRISIS TEAMS WITHIN THE PHASES OF CRISIS PREVENTION AND INTERVENTION
According to the U.S. Departments of Education (2007) and Homeland Security (2004) and other relevant
research, there are four phases of crisis management which span prevention through recovery.
Prevention/Mitigation
This first phase of crisis management includes activities that prevent a crisis from occurring in the first place or
minimize the need for response by reducing risks of negative effects associated with crises. This phase
emphasizes the importance of providing a continuum of services, including universal prevention,
targeted/selected interventions, and intensive/indicated interventions addressing both behavior and academics.
Other key components of prevention include:
Crisis teams, which help to establish a safe school climate. This is done by evaluating the school culture,
conducting a needs assessment to identify physical and psychological safety concerns, and implementing a
universal positive behavior support model to build and sustain a positive school climate and culture that
respects individual differences.
A continuum of academic courses, which help to ensure that the needs of all students are addressed, as well as
helping to promote school engagement.
A confidential reporting system, as providing the student or other individual with information about a potential
attack typically will thwart a threat of violence.
Preparedness
At this phase, crisis teams help prepare a safety/crisis plan and obtain the supplies and resources needed to
implement the plan in an emergency. The needs assessment conducted in the prevention phase guides this
process. The crisis team also:
Identifies the next steps to be taken in crisis planning and preparation
Assigns roles and responsibilities to staff members according to the Incident Command System (ICS; see page
3 for further explanation)
Continuously reflects on the crisis plan and updates the plan as necessary
Ensures that practice exercises and drills are conducted
53
Figure 1. Multidisciplinary crisis team structure utilizing the Incident Command System (lCS).
Emergency Operations Center Director/
School Incident Commander
District/school administrator (e.g., superintendent)
(In a unified command includes an emergency response chief
or administrator)
Crisis Management Team
Public information officer (e.g., media liaison)
Safety officer (e.g., school resource office)
Liaison officer (e.g., community liaison)
Mental health officer (e.g., school psychologist)
(Thinkers)
Planning/Intelligence
Section
(Doers)
Operations
Section
(Getters)
Logistics
Section
Security & Safety
(e.g., school resource offiecer)
Facilities
(e.g., building engineer)
Student Care
(e.g., school psychologist)
Supplies & Equip.
(e.g., building engineer)
Emergency Medical
(e.g., nurse)
Staff & Community
Volun. Assignment
(e.g., community liaison)
Translation
(e.g., community liaison)
Communications
(e.g., administration)
(Payers)
Finance/Admin.
Section
From Brock, S. E., Nickerson, A B., Reeves, M. A, Jimerson, S. R., Lieberman, R. A, EX Feinberg, T. A (2009). School crisis prevention and intervention: The
PREP~RE model (p. 26). Bethesda, MD: National Association of School Psychologists.
Response
At this phase, the crisis team is responsible for the
crisis response to ensure both physical and
psychological safety. Crisis team members carry out
their assigned roles. The mental health members of
the crisis team need to be prepared for immediate
and long-term response, including:
Evaluating for psychological trauma
Conducting psychological triage
Providing psychoeducation to students, staff,
and family members
Implementing individual and group
psychological firstaid
Recovery
Recovery can last days, months, and even years. The
crisis team is responsible for:
Working with administration to return to a
structured academic environment as soon as
possible with psychological supports in place for
as long as necessary.
Identifying the additional supports needed during
the recovery period. The recovery process can
include planning suitable memorials (e.g., not in
the case of suicide), communicating with parents
on strategies to help their child, potentially
rebuilding a school, and considering anniversary
dates and the impact on students and staff.
54
Evaluating which students and staff may need
more long-term interventions and making
referral for psychotherapeutic treatment when
indicated.
ESTABLISHMENT OF SCHOOL/DISTRICT
CRISIS TEAM
In order for a school and/or district team to function
well, it is important that it conform to the NIMS
(National Incident Management System) and its ICS
(Incident Command System), as this is a federal
mandate (U.S. Department of Homeland Security,
2004). This structure allows teams to communicate
through a common language with many other
agencies and response personnel involved in school
crises (see Nickerson, Brock, & Reeves, 2006).
The NIMS allows for a common set of concepts,
principles, terminology, and organizational
processes to be used in planning, preparing, and
responding to a crisis. Use of the ICS allows for
public health, mental health, law enforcement,
public safety, and local governments to collaborate
and communicate using the same organizational
system (U.S. Department of Education, 2007). As
shown in Figure 1, the ICS has five major functions:
Command, Planning/Intelligence, Operations,
Logistics, and Finance. It is important to note that
not only should roles be fulfilled by those who have
the training and experience in each area, but crisis
team members must also posses a calm demeanor in
a tense situation, be able to make good decisions
while considering many factors, and have the ability
to work well on a team. The following section
briefly describes the crisis team structure according
to the ICS. The publication School Crisis Prevention
and Intervention: The PREP£RE Model (Brock et aI.,
2009) provides more in-depth information on the
ICS and specific activities within the four phases of
crisis management.
Command
Command includes the Incident Commander, and if
necessary, a crisis management team comprised of a
Public Information Officer (PIO), Safety Officer
(SO), and Liaison Officer.
Incident Commander. The Incident Commander is the
person who coordinates the crisis response and
assigns responsibilities, which is often the principal
on a school crisis team. If the response entails
involvement from a local or federal agency (police,
fire, Department of Homeland Security), a
representative from that agency usually serves as the
Incident Commander and a unified command
structure with the schools is formed. In a unified
command, the Incident Commander from the school
district and the Incident Commander from the local
or federal agency work together in a unified fashion.
As crises create overwhelming demands, there is a
need for the commander(s)' to be highly directive and
decisive in responding. In addition, the Incident
Commander assesses the situation, engages appropriate crisis guidelines, monitors implementation,
assigns duties, approves requests for additional
resources, and approves funds.
Team officers. Within the command staff (which
report directly to the Incident Commander), the Public
Information Officer communicates relevant and
accurate crisis-related information to the public, the
media, and other agencies. The Safety Officer ensures
the safety of the response personnel, students, and
staff; conducts ongoing assessments of hazardous
environments; coordinates safety efforts among
different agencies; and advises the Incident
Commander on safety matters. The Liaison Officer is
the point of contact for representatives of other
government agencies, nongovernmental
organizations, and private entities. In addition to this
traditional command structure, the Los Angeles
County Office of Education (n.d.) suggests adding a
Mental Health Officer, who assesses and coordinates
mental health services for students, staff, and
families. The command staff members may also have
responsibilities within the function areas listed
below.
Planning/Intelligence
The intelligence function is comprised of "the
thinkers" (California Governor's OES, 1998) who
collect, evaluate, and disseminate information about
the crisis to the Incident Commander or unified
command. This may also include assigning a crisis
team chairperson who facilitates the crisis team
meetings and coordinates functioning of the team and
the specific roles. The planning/ intelligence section
staff provides input on how to link administration
into the crisis plan; leads the development of a
prevention, intervention, response, and recovery
plan; evaluates the effectiveness of response and
interventions; and communicates with district and/or
community level teams.
Operations
Referred to as "the doers" by the California
Governor's Office of Emergency Services (OES,
1998), operations is responsible for immediate
response needs, such as reducing immediate hazard,
saving lives, establishing situational control, and
restoring normal operations (U.S. Department of
Homeland Security, 2004). This function is most
55
relevant for school psychologists as it includes
immediate and long-term "student care" response
activities we consider to be "crisis interventions."
Other potential key roles included in the operations
section are school security and safety coordinators
(e.g., school resource officer, school security) which
help ensure physical safety, facilitate traffic flow and
manage media, and coordinate with local authorities.
The emergency medical coordinator (e.g., nurse)
provides first-aid and medical triage, while the
translation and cultural mediator coordinator
consider the cultural implications and barriers and
helps communicate information to the students and
parents.
Logistics
The logistics section or "getters" obtain all resources
needed to manage the crisis, (California Governor's
OES, 1998), such as personnel, equipment and
supplies, and services, including transportation. Key
roles to be fulfilled are facilities (e.g. building
engineer) which include locking entrances and exits;
securing building; being familiar with school floor
plan and being able to activate heating, air,
electrical, and gas systems; and helping to move
objects if necessary. Supplies and equipment (e.g.,
office personnel) are needed for duties such as
acquiring water and food and making photocopies.
A staff/ community volunteer coordinator would
also be subsumed under this section as they help
establish, coordinate, and activate a phone tree;
facilitate the dissemination of information to
community groups, professionals, and parents; and
screen and coordinate volunteers. Communications
(e.g., public information office) is also crucial to
verify information before being released; develop
press/media documents and statement to students,
staff, and parents; facilitate ongoing communication
with media, rescue agencies, and professional
support staff; and facilitate communication with
victims and families.
Finance
The finance section consists of "the payers"
(California Governor's OES, 1998), who develop a
budget for yearly planning and preparation,
authorize purchases, keep a record of all expenses,
and work with the logistics section to obtain needed
supplies.
PREPaRE CURRICULUM
The establishment of school, district, and
community crisis teams according to the NIMS/ICS
system is important in order to address the
multidisciplinary needs of establishing a safe school
climate and culture through crisis prevention/
mitigation, preparedness, response, and recovery. It
also facilitates effective collaboration and
communication with various response agencies. The
NASP PREPaRE Crisis Prevention and Intervention
Curriculum provides workshops specifically designed
for educators and school-based crisis team to further
their skills in all phases of crisis management. For
further information on the curriculum and to
schedule training, visit http://www.nasponline.org/
prepare/index.aspx.
REFERENCES
Brock, S. E., Nickerson, A B., Reeves, M. A,
Jimerson, S. R., Lieberman, R. A, & Feinberg, T. A
(2009). School crisis prevention and intervention: The
PREPg,RE model. Bethesda, MD: National
Association of School Psychologists.
California Governor's Office of Emergency Services.
(1998, June). School emergency response: Using SEMS
at districts and sites. Guidelines for planning and training
in compliance with the standardized emergency
management system. Sacramento, CA: Author.
Los Angeles County Office of Education, Safe
Schools Center, Division of Student Support
Services. (n.d.). Managing a school crisis using the
standardized emergency management system: An
administrator's guide to complying with California
government code 8607 (SEMS). Los Angeles: Author.
Nickerson, A B., Brock, S. E., & Reeves, M. A.
(2006). School crisis teams within an incident
command system. The California School Psychologist,
11, 63-72.
U.S. Department of Education, Office of Safe DrugFree Schools. (2007). Practical information on crisis
planning: A guide for schools and communities.
Washington, DC: Author. Retrieved September 30,
2009, from http://www.ed.gov/admins/lead/safety/
emergencyplan/ crisisplanning.pdf
U.S. Department of Homeland Security. (2004).
National incident management system. Retrieved on
September 30, 2009, from
http://www.fema.gov/pdf/nims/ nims_doc_full.pdf
RECOMMENDED RESOURCES Print
National Association of School Psychologists.
(2006).
PREPaRE crisis prevention, preparedness, and intervention training curriculum. Bethesda, MD: Author.
Training information available at http://www.
nasponl i ne.org/ prepare/i ndex.aspx
Online
National Association of School Psychologists, School
safety and violence prevention:
http://www.nasponline.org/ resources/ crisis_safety /
schoolsafety.aspx
56
Crisis Prevention, Response, and Recovery:
Helping Children With Special Needs
BY MELINDA K. SUSAN, MA, NCSP, Sonoma County Office of Education, Santa Rosa, CA
When planning for crisis events, school crisis teams must make sure to consider students with special needs,
particularly in the areas of preparedness and response. For example, school teams should logistically plan for the
safe evacuation of students who are in wheelchairs. Specialized classrooms must be included in the site crisis
plan, and coordination between teachers and service providers should occur both prior to and during a crisis
event. In terms of response, students with special needs may be either more vulnerable or significantly less
vulnerable than other students on campus, depending on their personal risk and protective factors. It is important
for school staff to be aware of these factors so they can determine how much intervention individual students will
require.
RISK AND PROTECTIVE FACTORS FOR SPECIAL EDUCATION STUDENTS
How a student responds to a crisis event depends on many variables including pretrauma factors (e.g., history of
abuse, emotional problems, learning disabilities, substance use), characteristics of the traumatic event (e.g.,
natural disaster, accidental fatalities, violence), and posttrauma factors (e.g., family support, coping strategies).
These variables, in concert with individual characteristics and the personal meaning a student ascribes to a
traumatic event, will ultimately determine how a student will respond and recover in the face of trauma. While the
range of responses will be broad, students with certain disabilities may be more at risk for developing
posttraumatic stress symptoms based on pretrauma factors.
Vulnerability Factors
When assessing risk, school staff should consider internal vulnerability factors (avoidance/denial coping style,
preexisting mental health conditions, difficulty regulating emotions, inflexibility and poor problem-solving skills,
trauma history) and external vulnerability factors (family dysfunction, history of domestic violence, child abuse,
family drug use, poverty, poor peer relationships, lack of social support). Individuals with poor resiliency and
self-efficacy may require additional support following a traumatic event. For example, students with emotional
disabilities may have a stronger response to an event based on internal and external vulnerability factors.
Protective Factors
Some types of disabilities may serve as protective factors following a crisis event. For example, students with
significant cognitive disabilities or who have an autism spectrum disorder may not fully understand the impact of
the event, thereby reducing the potential for a traumatic reaction. Like all students, they will be affected by the
behavior of the adults around them. If adults are overly stressed or anxious, students may experience traumatic
reactions.
STRATEGIES AND ACTIONS
The following are helpful strategies and actions for use before, during, and after a crisis.
Prepare Before a Crisis Occurs
School personnel can prepare for a crisis in several ways:
Ensure that all classrooms are part of the intercom system.
Ensure that all classrooms have doors that lock from the inside, for safety during a lockdown.
57
Map and practice an evacuation plan that will
accommodate wheelchairs and allow for swift and
unencumbered movement.
Ensure that there are enough individuals available
to move wheelchairs during an evacuation. If
student volunteers are utilized, a new list must be
generated yearly. Keep in mind that students may
not be entirely reliable because of their own
reactions to the traumatic event.
Keep 72 hours' worth of medication on hand for
any students taking prescription medication at
school to ensure it will be administered during a
potential lockdown or if students are unable to
leave the site for several hours. A list containing
the names of students and dosages should be
readily available. Staff should be trained at the
beginning of each school year on medication
administration.
Make sure classrooms include supplies (food,
water, toilet) and an additional power source or
battery backup. This is crucial for individuals who
need suctioning or medical care.
For students with autism or limited language
skills, develop a picture schedule showing duckand-cover or evacuation procedures that can be
used during practice drills as well as during a
crisis.
Maintain a list of community and school support
staff (case managers, social workers, therapists)
that work with specific students or have relevant
expertise. Following a crisis, they can be called on
to consult with school crisis team members or help
provide support to students and families.
Have specific comfort items known to calm
students (stuffed animals, favorite objects)
available in the classroom or ready for evacuation.
Actions Following a Crisis
Response and recovery following a crisis can be
supported by the following suggestions:
Closely monitor individuals with preexisting mental
health conditions. Pay attention to significant changes
in attendance, weight, and mood. Maintain contact
with mental health caseworkers. Refer to school or
community resources for additional support as
needed.
Provide students with cognitive disabilities with
developmentally appropriate activities (e.g., drawing,
writing, or dictating letters to the family of victims).
Review and adjust crisis response plans to address
concerns that surfaced during the crisis event.
SPECIAL CONSIDERATIONS FOR SPECIAL
POPULATIONS
Students with different types of disabilities may
require different support strategies. The following are
suggestions for school staff and caregivers to
consider.
Emotional Disturbance
Students with emotional disturbance may have poor
coping skills and limited social connectedness. They
may struggle with self-regulation or expression of
feelings. Following a crisis event, negative behaviors
including aggression, noncompliance, absenteeism,
and anger may increase. School teams should monitor
possible increases in high-risk behaviors, substance
abuse, regression, withdrawal, and suicidal ideation.
Many of these students may be reluctant to address
their feelings directly, particularly in front of a group.
They may be more comfortable with journal writing
or art projects. Maintaining the structure and
consistency of their school schedule will also support
their feelings of control. (This is also important for
students with ADHD.)
Strategies During a Crisis Event
School personnel can respond during a crisis with the
following actions:
Remove students from immediate danger.
Reunite students with support systems (parents,
peers) as soon as possible. For those students with
significant family dysfunction, call on other
familiar resources such as clergy, mentors, Big
Brothers/Big Sisters, and/or extended family. .
Minimize television exposure. Students with
cognitive disabilities may think the event is
recurring.
During a lockdown, routines will be disrupted
because students will be unable to leave the
classroom. Use indoor physical education
activities (stretching, quiet ball) to keep students
active. Provide students with extra
incentives and supports for varying their schedule
These students may also be at risk if they have a
history of abuse or poor attachment, or if their parents
have poor coping skills. Positive relationships with
adults at school sites will build self-esteem and foster
resilience. Assigning tasks that foster interaction with
school personnel will promote and increase feelings
of security. School staff can refer students for
therapeutic support if needed.
58
Above all, adults should not project their own
emotions onto these students. The students may be
coping well due to family support or because they
have less understanding of the situation. Constant
pressure for them to feel sad can increase feelings of
guilt or anxiety. However, these students do grieve,
and they should be provided with developmentally
appropriate activities to support this grief.
High-Functioning Autism Spectrum Disorders or
Asperger Syndrome
These students may have a difficult time relating to
peers. They may unwittingly make comments that
agitate or anger others. Peer education will help other
students to recognize that these students do not
intended to be hurtful.
Following a crisis, these students would benefit from
social scripts and practicing ways to approach a
grieving peer or staff member. They will also
respond well to structure and routine. Since these
students may be less affected by the crisis than
others, adults should take care not to project their
own feelings of fear or grief onto them. If a child
with autism or Asperger syndrome is demonstrating
appropriate coping behaviors, additional intervention
may not be needed.
Physical Limitations
Students with physical limitations who do not have
cognitive deficits will benefit greatly from practice
drills where they are assured oftheir safe and
respectful evacuation. Students in wheelchairs should
know that a trusted individual will be there to provide
support and comfort during a crisis event. This
individual should understand that a wheelchair is an
extension of the student's person.
Cognitive Disability
Some students with cognitive disabilities may not
fully understand the impact of the crisis event. These
students often benefit from the presence of positive,
familiar adults. Adults can help by saying, "I am
feeling sad, but this is what I am doing to feel
better." Additionally, some students may seek more
physical comfort and proximity than usual. They
may be particularly vulnerable to images on
television, and should be shielded from multiple
reenactments of the event because they may think
that the event is recurring.
Despite protective factors, individuals with significant cognitive disabilities may experience a wide
array of reactions to a crisis event that require a
structured response. Facilitators experienced in
working with individuals who have significant
cognitive disabilities can provide psychoeducational
activities and information, including facts about the
crisis and strategies for self-care. Facilitators should
avoid providing excessive details about the crisis
event, as this could be frightening and may create
stress. They should respond to students' questions
rather than providing too much detail, and give
concrete examples while helping students to
normalize crisis reactions.
Activities based on student response to the event,
and on developmental level rather than age, can
support the recovery process. If a fellow student or
adult has been hospitalized following an accident, it
is important that students not be led to believe that
their actions can somehow change the course of
events. For example, they should not be told that any
cards or letters will help someone to get better. It
might be more useful to encourage them to write to
the family of the victim because they are sad about
what happened.
SUMMARY
There are many factors that determine how a student
will respond to a crisis event. Recognizing these
factors can help staff plan ahead to ensure student
safety and appropriate support to address specific
needs. Crisis teams should prepare to appropriately
address the individual needs, risks, and strengths of
children with disabilities before, during, and after
crisis events.
RECOMMENDED RESOURCES Print
Brock, S., Nickerson, A., Reeves, M., Jimerson, S.,
Lieberman, R., & Feinberg, T., (2009). School crisis
prevention and intervention: The PREPaRE model.
Bethesda, MD: National Association of School
Psychologists.
Sandoval, J. (Ed.). (2002). Handbook of crisis counseling,
intervention,and prevention in the schools.
Philadelphia: Lawrence Erlbaum.
Online
Dayian, C. (2006). Working with students with disabilities
in a disaster. Safe Schools Center, Los Angeles County
Office of Education. Available: http://rems. ed .gov Ii
ndex.cfm ?event = resources#pd_1
Health and Human Services, Office on Disability,
Emergency preparedness toolkit for individuals with
disabilities: http://www.hhs.gov/od/disabilitytoolkit/
index.html
National Organization on Disability, Emergency
Preparedness Initiative (EPI): http://www.nod.org/
index.cfm ?fuseaction = Page. viewPage&pageld =
1564
National Organization on Disabilities, Emergency
Preparedness Initiative interactive map of disability &.
emergency preparedness resources: http://www.nod.
org/EPI Resources/i nteracti ve_map. html
59
Crisis: Helping Children Cope With
Grief and Loss
BY EMILY S. FISHER, PHD, Loyola Marymount University, Los Angeles
SHANE R. JIMERSON, PHD, NCSP, University of California, Santa Barbara
BRIANA N. BARRETT, BA, Loyola Marymount University, Los Angeles
KELLY S. GRAYDON, PHD, Chapman University, Orange, CA
Crises are, by their very nature, sudden, unpredictable, and uncontrollable events. They include acts of war and
terrorism, natural disasters, deaths, injuries, and accidents. It is understood that children will be affected by crises
and will need the support of the adults in their lives to cope effectively with feelings of grief and loss. By being
aware of the impact crises can have on children, understanding how children at different developmental levels
might respond to crises, and knowing some effective strategies to help children, family members and school
personnel can help mitigate the negative effects of crises.
WHAT ARE TYPICAL GRIEF REACTIONS FOLLOWING A CRISIS?
Grief reactions among children vary and are influenced by their developmental level. Although no two children
will react to trauma in exactly the same way, there are some general trends that can be expected. While sadness,
confusion, and anxiety are likely among most bereaved children, the following describes grief reactions at various
developmental levels that would typically warrant further attention:
Preschool Level
Young children display relatively global reactions to crises:
Decreased verbalization
Increased anxiety (e.g., c1inginess, fear of separation)
Regressive behaviors (e.g., bedwetting, thumb-sucking)
Elementary School Level
School-age children are more likely to display more specific symptoms:
Difficulty concentrating or inattention
Somatic complaints (e.g., headaches, stomach problems)
Sleep disturbances (e.g., nightmares, fear of the dark)
Repeated telling and acting out of the event
Withdrawal
Increased irritability, disruptive behavior, or aggressive behavior
Increased anxiety (e.g., clinging, whining)
Depression, guilt, or anger
Middle and High School Level
The responses of adolescents are more like those of adults, but adolescents lack the coping skills and experience
to deal with such symptoms as:
Flashbacks
Emotional numbing or depression
Nightmares
Avoidance or withdrawal
Peer relationship problems
60
It is important to note that there is no right or
wrong way for children to react to a loss, and
reactions are influenced by many factors other
than age. Children with a history of mental
health problems are particularly susceptible to
severe negative reactions to crises. Similarly,
children with special needs may have less
developed coping strategies and may react to
crises in ways similar to younger children. Not
surprisingly, severity of exposure to the event is
related to the impact on children, and children
who perceive that their lives were threatened
often have a stronger negative reaction.
HOW CAN FAMILIES SUPPORT
BEREAVED CHILDREN?
How family members grieve following a crisis
will influence how children grieve. When
family members are able to talk about the loss,
express their feelings, and provide support for
children in the aftermath of a crisis, children are
better able to develop healthy coping strategies.
Family members are encouraged to:
Talk about the loss. This gives children
permission to talk about it, too.
Give children important facts about the event at
an appropriate developmental level. This
may include helping children accurately
understand what death is. For younger
children, this explanation might include
helping them to understand that the person's
body has stopped working and that it will
never again work.
Ask questions to find out about children's
understanding of the event.
Be prepared to discuss the same details
repeatedly with children. Children should be
encouraged to talk about, play out, or even
act out the traumatic event.
Help children understand the death and prevent
false reasoning about the cause of the event,
ensuring that they do not blame themselves
for the situation.
Create structure and routine for children so they
experience predictability and stability.
Acknowledge that it will take time to mourn and
that bereavement is a process that occurs
over months and years. Be aware that normal
grief reactions often last longer than 6
months, depending on the severity of the
crisis and the meaning it has for children.
Take advantage of community resources, such as
counseling, especially if children do not
seem to be developing strategies to cope
with grief and loss.
HOW CAN SCHOOLS HELP BEREAVED
STUDENTS? Whether or not the crisis event is
directly related to school, children will likely
experience reactions of grief and loss that affect their
school success. Many of the reactions noted above
may have deleterious consequences on classroom
behaviors and academic achievement. School
personnel can take steps to help support children
during these difficult times.
General Characteristics of Effective Grief Support
After a crisis event, students will likely need some
support to help them cope with their feelings of grief
and loss. General characteristics of effective grief
counseling include:
Unconditional acceptance of the variation of grief
reactions
Discussions of thoughts and emotions
Strategies to promote coping in the future
Understanding of the grief within the context of
the family
When multiple students are affected, school psychologists and other education professionals may use
structured grief support group curricula to develop
school-based support groups. Classroom teachers
may use short-term instructional modifications to
support bereaved students (e.g., being certain that
homework instructions are written down and sent
home with the student; offering flexibility if
completion of assignments is delayed).
Immediate Crisis Response
If the crisis event was large-scale and/or impacted the
school community, school-wide crisis response will
be necessary. Following such events, some students
will need' immediate and highly directive
psychological firstaid interventions. These efforts are
aimed at helping students to reestablish perceptions of
safety and security, facilitate immediate coping, and
begin to address crisis-generated problems.
Group approaches (such as debriefing strategies)
typically attempt to help students feel less alone and
more connected to their classmates (considering their
shared experiences) and to normalize the crisis
reactions that they might be experiencing. Group
debriefing approaches are controversial (as some
participants may have minimal trauma exposure prior
to such sharing sessions) and should only be used
when embedded within a range of crisis interventions
that are appropriate for students with various
experiences and needs.
Group Counseling
Group counseling can help children and adolescents
cope more effectively with grief and loss following a
61
crisis. It is important that school-based mental
health professionals identify students who have
similar needs and use developmentally
appropriate activities to help them understand
and cope with feelings of grief and loss. There
are several structured group curricula for grief
and loss, and they most often include the
following types of activities over a 10-12 week
period:
Education about the group, about grief and
the grieving process, and about basic
concepts of death and trauma
Allowing the participants to tell their stories
about the event and share memories
Discussion of changes that have occurred
since the event-at home, at school, and with
friends
Helping participants identify the feelings
they are experiencing
Allowing participants to share any unfinished
business related to the crisis event (e.g.,
things they missed out on, things they did not
get to say or do, things that continue to
trouble them about the event)
Helping participants identify positive coping
strategies and teaching other strategies (e.g.,
relaxation techniques, health promoting
strategies)
Acknowledging the ending of the group and
the progress each participant has made, and
determining whether further individual or
group support is warranted
Individual Counseling
After a crisis, some children and adolescents
may need intensive, one-to-one counseling
support. This may be especially true if students
display more severe symptoms of trauma.
Individual treatment should focus on both the
affective and the cognitive aspects of the
trauma, as well as on promoting coping at
school and within the family.
Initially, counseling should focus on helping
students express their feelings about the event
in a developmentally appropriate manner (e.g.,
young children might use puppets, while
adolescents might use poems or songs). It is
also important to help students develop skills to
manage the stress they are experiencing related
to the trauma, which might be done by teaching
relaxation skills or helping them develop a list
of activities that help them relax (e.g., listening
to music or exercising).
During counseling, students should be
encouraged to tell their stories about the event,
focusing on the details of the trauma along with their
responses to it. Individual counseling should also
help students recognize the relationship among their
thoughts, feelings, and behaviors, and should address
any distorted thoughts they might have about the
event (e.g., thoughts of culpability).
It is important that, whenever possible, parents or
other family members are included in trauma
counseling. They should learn skills along with their
children so they can support their children at home
(e.g., parents can read a relaxation script at home
before bed to promote relaxation and better sleeping).
RECOMMENDED RESOURCES
Print
Brock, S. E., Lazarus, P. J., & Jimerson, S. R. (Eds.).
(2002). Best practices in school crisis prevention and
intervention. Bethesda, MD: National Association
of School Psychologists.
Brock, S. E., Nickerson, A. B., Reeves, M. A., &
Jimerson, S. R. (2008). Best practices for school
psychologists as members of crisis teams: The
PREP~RE Model. In A. Thomas & J. Grimes
(Eds.), Best practices in school psychology V (pp.
1487-1504). Bethesda, MD:
National Association of School Psychologists.
California Association of School Psychologists.
(1998, October). Schoolyard tragedies: Coping
with the aftermath. CASP Hot Sheet, 2(4).
Available: http:// www.casponline.org
Lehmann, L., Jimerson, S. R., & Gaasch, A. (2000).
Mourning child grief support group curriculum.
Philadelphia: Brunner-Routledge. Available:
http:// www.routledge.com
Available in preschool, early childhood, middle
childhood, and adolescent editions.
Online
National Association of School Psychologists, Crisis
resources: http://www.nasponline.org/resources/
crisis_safety Ii ndex.as px
A source for multiple handouts, including
"Helping Children Cope with Loss, Death, and
Grief."
National Organization for Victim Assistance: http://
www.trynova.org
Project LOSS:
http://www.education.ucsb.edu/jimerson/
loss.html
Emily S. Fisher, PhD, is an Assistant Professor of School Psychology at
Loyola Marymount University in Los Angeles; Shane R. Jimerson, PhD,
NCSP, is a Professor in the Department of Counseling, Clinical, and
School Psychology at the University of California, Santa Barbara; Briana
N. Barrett, BA, is a graduate student in the School Psychology program
at Loyola Marymount University; and Kelly S. Graydon, PhD, is an
Assistant Professor of School Psychology at Chapman University in
Orange, CA.
62
Responding to Natural Disasters:
Helping Children and Families
Information for School Crisis Teams
By Philip J. Lazarus, NCSP, Florida International University
Shane R. Jimerson, NCSP, University of California, Santa Barbara
Stephen E. Brock, NCSP, California State University, Sacramento
Natural disasters can be especially traumatic for children and youth. Experiencing a dangerous or violent flood,
storm, wildfire, or earthquake is frightening even for adults, and the devastation to the familiar environment (i.e.,
home and community) can be long lasting and distressing. Often an entire community is impacted, further
undermining a child‘s sense of security and normalcy. These factors present a variety of unique issues and
coping challenges, including issues associated with specific types of natural disasters, the need to relocate when
home and/or community have been destroyed, the role of the family in lessening or exacerbating the trauma,
emotional reactions, and coping techniques.
Children look to the significant adults in their lives for guidance on how to manage their reactions after the
immediate threat is over. Schools can help play an important role in this process by providing a stable, familiar
environment. Through the support of caring adults school personnel can help children return to normal activities
and routines (to the extent possible), and provide an opportunity to transform a frightening event into a learning
experience.
Immediate response efforts should emphasize teaching effective coping strategies, fostering supportive
relationships, and helping children understand the disaster event. Collaboration between the school crisis response
team and an assortment of community, state, and federal organizations and agencies is necessary to respond to the
many needs of children, families, and communities following a natural disaster. Healing in the aftermath of a
natural disaster takes time; however, advanced preparation and immediate response will facilitate subsequent
coping and healing.
Issues Associated with Specific Disasters
Hurricanes. Usually hurricanes are predicted days to weeks in advance, giving communities time to prepare.
These predictions give families time to gather supplies and prepare. At the same time, however, these activities
may generate fear and anxiety. Although communities can be made aware of potential danger, there is always
uncertainty about the exact location of where the hurricane will impact. When a hurricane strikes, victims
experience intense thunder, rain, lightning, and wind. Consequently, startle reactions to sounds may be acute in
the months that follow. Among a few children subsequent storms may trigger panic reactions. Immediate
reactions to hurricanes can include emotional and physical exhaustion. In some instances children may
experience survivor guilt (e.g., that they were not harmed, while others were killed or injured). Research
indicates that greater symptomatology in children is associated with more frightening experiences during the
storm and with greater levels of damage to their homes.
Earthquakes. Aftershocks differentiate earthquakes from other natural disasters. Since there is no clearly
defined endpoint, the disruptions caused by continued tremors may increase psychological distress. Unlike other
natural disasters (e.g., hurricanes and certain types of floods), earthquakes occur with virtually no warning. This
fact limits the ability of disaster victims to make the psychological adjustments that can facilitate coping. This
relative lack of predictability also significantly lessens feelings of controllability. While one can climb to higher
ground during a flood, or install storm shutters before a hurricane, there is usually no advance warning or
immediate preparation with earthquakes. Survivors may have to cope with reminders of the destruction (e.g.,
sounds of explosions, and the rumbling of aftershocks; smells of toxic fumes and smoke; and tastes of soot,
rubber, and smoke).
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Tornadoes. Like earthquakes, tornadoes can bring mass destruction in a matter of minutes, and individuals
typically have little time to prepare. Confusion and frustration often follow. Similar to a hurricane, people
experience sensations during tornadoes that may generate coping challenges. It can be difficult to cope with the
sights and smells of destruction. Given the capricious nature of tornadoes, survivor guilt has been observed to be
an especially common coping challenge. For instance, some children may express guilt that they still have a
house to live in while their friend next door does not. In addition, a study following a tornado that caused
considerable damage and loss of life revealed significant associations between children‘s disturbances and having
been in the impact zone, been injured, and having experienced the death of relatives.
Floods. These events are one of the most common natural disasters. Flash floods are the most dangerous as they
occur without warning; move at intense speeds; and can tear out trees, destroy roads and bridges, and wreck
buildings. In cases of dam failure the water can be especially destructive. Research has reported that many
children who survive a destructive flood experience psychological distress. The two most significant predictors
of impairment are the degree of disaster exposure and perceptions of family reactions. Sensations that may
generate coping challenges include desolation of the landscape, the smell of sludge and sodden property, coldness
and wetness, and vast amounts of mud. Most floods do not recede overnight, and many residents have to wait
days or weeks before they can begin the cleanup.
Wildfires. Unlike other natural disasters such as earthquakes, there is often some warning of an advancing
wildfire. However, depending upon the wind and terrain the direction and spread of a wildfire can change
abruptly. The amount of warning can vary from one neighborhood to the next. While some people may have
hours (or even days) to evacuate, others will have only a few minutes to gather their belongings and leave their
homes. Even if evacuation is not ultimately necessary, preparing for the possibility can be frightening for
children, particularly if they are seeing images of homes burning nearby on television.
Reactions immediately following a wildfire may include emotional and physical exhaustion. In some instances
children may experience survivor guilt (e.g., that their home was left unharmed, while others were completely
destroyed). In general it might be expected that greater symptomatology in children will be associated with more
frightening experiences during the wildfire and with greater levels of damage to their community and homes. The
sights, sounds, and smells of a wildfire often generate fear and anxiety. Consequently, similar sensations (e.g., the
smell of smoke) may generate distress among children in the months that follow. Given the scale of most
wildfires, individuals living outside the ravages of the fires may still feel exposed to the danger from drifting
clouds of smoke, flames on the horizon, and television reports. Some children may also react to follow-up news
coverage, and even weather reports that talk about dry fire conditions after the fact.
It is important to acknowledge that although a given natural disaster may last for only a short period, survivors
can be involved with the disaster aftermath for months or even years. In attempts to reconstruct their lives
following such a natural disaster, families are often required to deal with multiple people and agencies (e.g.,
insurance adjustors, contractors, electricians, roofers, the Red Cross, the Federal Emergency Management
Agency (FEMA), and the Salvation Army).
Possible Reactions of Children and Youth to Natural Disasters
Most children will be able to cope over time with the help of parents and other caring adults. However, some
children may be at risk of more extreme reactions. The severity of children‘s reactions will depend on their
specific risk factors. These include exposure to the actual event, personal injury or loss of a loved one, dislocation
from their home or community, level of parental support, the level of physical destruction, and pre-existing risks,
such as a previous traumatic experience or mental illness. Symptoms may differ depending on age but can
include:
Preschoolers—thumb sucking, bedwetting, clinging to parents, sleep disturbances, loss of appetite, fear
of the dark, regression in behavior, and withdrawal from friends and routines.
Elementary School Children—irritability, aggressiveness, clinginess, nightmares, school avoidance,
poor concentration, and withdrawal from activities and friends.
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Adolescents—sleeping and eating disturbances, agitation, increase in conflicts, physical complaints,
delinquent behavior, and poor concentration.
A minority of children may be at risk of post-traumatic stress disorder (PTSD). Symptoms can include those
listed above, exhibited over an extended period of time. Other symptoms may include re-experiencing the disaster
during play and/or dreams; anticipating or feeling that the disaster is happening again; avoiding reminders of the
disaster; general numbness to emotional topics; and increased arousal symptoms such as inability to concentrate
and startle reactions. Although rare, some adolescents may also be at increased risk of suicide if they suffer from
serious mental health problems like PTSD or depression. Students who exhibit these symptoms should be referred
for appropriate mental health evaluation and intervention.
Immediately Following a Natural Disaster: Information for School Crisis Teams
Identify children and youth who are high risk and plan interventions. Risk factors are outlined in the above
section on children‘s reactions. Interventions may include individual counseling, small group counseling, or
family therapy. From group crisis interventions, and by maintaining close contact with teachers and parents, the
school crisis response team can determine which students need supportive crisis intervention and counseling
services. A mechanism also needs to be in place for self-referral and parental-referral of students.
Support teachers and other school staff. Provide staff members with information on the symptoms of
children‘s stress reactions and guidance on how to handle class discussions and answer children‘s question. As
indicated, offer to help conduct a group discussion. Reinforce that teachers should pay attention to their own
needs and not feel compelled to do anything they are not comfortable doing. Suggest that administrators provide
time for staff to share their feelings and reactions on a voluntary basis as well as help staff develop support
groups. In addition, teachers who had property damage or personal injury to themselves or family members will
need leave time to attend to their needs.
Engage in post-disaster activities that facilitate healing. La Greca and colleagues have developed a manual for
professionals working with elementary school children following a natural disaster. Activities in this manual
emphasize three key components supported by the empirical literature: (a) exposure to discussion of disasterrelated events, (b) promotion of positive coping and problem-solving skills, and (c) strengthening of children‘s
friendship and peer support. Specifically:
Encourage children to talk about disaster-related events. Children need an opportunity to discuss
their experiences in a safe, accepting environment. Provide activities that enable children to discuss
their experiences. These may include a range of methods (both verbal and nonverbal) and incorporate
varying projects (e.g., drawing, stories, audio and video recording). Again provide teachers specific
suggestions or offer to help with an activity.
Promote positive coping and problem-solving skills. Activities should teach children how to apply
problem-solving skills to disaster-related stressors. Children should be encouraged to develop realistic
and positive methods of coping that increase their ability to manage their anxiety and to identify which
strategies fit with each situation.
Strengthen children’s friendship and peer support. Children with strong emotional support from
others are better able to cope with adversity. Children‘s relationships with peers can provide suggestions
for how to cope with difficulties and can help decrease isolation. In many disaster situations, friendships
may be disrupted because of family relocations. In some cases parents may be less available to provide
support to their children because of their own distress and their feelings of being overwhelmed. It is
important for children to develop supportive relationships with their teachers and classmates. Activities
may include asking children to work cooperatively in small groups in order to enhance peer support.
Emphasize children’s resiliency. Focus on their competencies in terms of their daily life and in other difficult
times. Help children identify what they have done in the past that helped them cope when they were frightened or
upset. Tell students about other communities that have experienced natural disasters and recovered (e.g., Miami,
FL and Charleston, SC).
65
Support all members of the crisis response team. All crisis response team members need an opportunity to
process the crisis response. Providing crisis intervention is emotionally draining. This is likely to include
teachers and other school staff if they have been serving as crisis caregivers for students.
Secure additional mental health support. Although more than enough caregivers are often willing to provide
support during the immediate aftermath of a natural disaster, long-term services may be lacking. School
psychologists and other school mental health professionals can help provide and coordinate mental health
services, but it is important to connect with community resources in order to provide such long-term assistance.
Ideally these relationships would be established in advance.
Important Influences on Coping Following a Natural Disaster
Relocation. The frequent need for disaster survivors to relocate creates unique crisis problems. For example, it
may contribute to the social, environmental, and psychological stress experienced by disaster survivors. Research
suggests that relocation is associated with higher levels of ecological stress, crowding, isolation, and social
disruption.
Parent’s Reactions and Family Support. Parents‘ adjustment is an important factor in children‘s adjustment,
and the adjustment of the child in turn contributes to the overall adjustment of the family. Altered family
functions, separation from parents after natural disaster, and ongoing maternal preoccupation with the trauma are
more predictive of trauma symptomatology in children than is the level of exposure. Thus, parents‘ reactions and
family support following a natural disaster are important considerations in helping children‘s cope.
Emotional Reactivity. Preliminary findings suggest that children who tend to be anxious are those most likely to
develop post-trauma symptomatology following a natural disaster. Research suggests that children who had a
preexisting anxiety disorder prior to a natural disaster are at greater risk of developing PTSD symptoms.
Coping Style. It is important to examine children‘s coping following a natural disaster because coping responses
appear to influence the process of adapting to traumatic events. Research suggests that the use of blame and
anger as a way of coping may create more distress for children following disasters.
Long-Term Effects
Research suggests that long term difficulties following a natural disaster (e.g., PTSD), are most likely to be seem
among children who experienced any of the following:
Had threats to their physical safety.
Thought they might die during the disaster.
Report that they were very upset during the disaster.
Lost their belongings or house as a result of the disaster.
Had to relocate in the aftermath.
Attended schools following the disaster that had multiple schedule changes, double sessions or a lot of
disruptions.
Consequently, crisis response team members need to identify students who experience these risk factors and
closely monitor their status. These students may require long-term coping assistance.
References
Asarnow, J., Glynn, S., Pynoos, R. S., Nahum, J., Gunthrie, D., Cantwell, D. P., & Franklin, B. (1999). When the earth stops shaking:
Earthquake sequelae among children diagnosed for pre-earthquake psychopathology. Journal of the American Academy of Child and
Adolescent Psychiatry, 38, 1016-1023.
Bolton, D., O‘Ryan, D., Udwin, O., Boyle, S., & Yule, W. (2000). The long-term psychological effects of a disaster experienced in
adolescence: II: General psychopathology. Journal of Child Psychology and Psychiatry and Allied Disciplines, 41, 513-523.
66
Brock, S. E., Lazarus, P. J., & Jimerson, S. R. (Eds.), Best practices in school crisis prevention and intervention. Bethesda, MD: National
Association of School Psychologists.
Feinberg, T. (1999). The midwest floods of 1993: Observations of a natural disaster. In A.S. Canter & S.A. Carroll (Eds.), Crisis prevention
& response: A collection of NASP resources (pp. 223-239). Bethesda, MD: National Association of School Psychologists.
Green, B. L., Korol, M., Grace, M. C., & Vary, M. G. (1991). Children and disaster: Age, gender and parental effects on PTSD
symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 945-951.
Goenjian, A .K., Molina, L., Steinberg, A. M., & Fairbanks, L. A. (2001). Post traumatic stress and depressive reactions among adolescents
after Hurricane Mitch. American Journal of Psychiatry, 158, 788-794.
Jones, R. T., Fray, R., Cunningham, J. D., & Kaiser, L. (2001). The psychological effects of hurricane Andrew on ethnic minority and
Caucasian children and adolescents: A case study. Cultural Diversity and Ethnic Minority Psychology, 7, 103-108.
La Greca, A .M., Vernberg, E. M. Silverman, W. K., Vogel, A. L.,& Prinstein, M. J. (1994). Helping children prepare for and cope with
natural disasters: A manual for professionals working with elementary age children. Department of Psychology, University of Miami.
Lazarus, P. J., & Jimerson, S. R., Brock, S. E. (2002). Natural disasters. In S. E. Brock, P. J. Lazarus, & S. R. Jimerson (Eds.), Best practices
in school crisis prevention and intervention (pp. 435-450). Bethesda, MD: National Association of School Psychologists.
Lazarus, P. J., & Gillespie, B. (1996). Critical actions in the aftermath of natural disasters. The School Administrator, 53(2), 35-36.
Lonigan, C. J., Shannon, M. P., Finch, A. J. Jr., & Daugherty, T. K. (1991). Children‘s reaction to a natural disaster: Symptoms severity and
degree of exposure. Advances in Behavioral Research and Therapy, 13, 135-154.
National Institute of Mental Health. (2000). Helping children and adolescents cope with disasters: Fact sheet [On-line]. Available:
http://www.nimh.nih.gov.
Prinstein, M. J., La Greca, A. M., Vernberg, E. M., & Silverman, W. K. (1996). Children‘s coping assistance: How parents, teachers, and
friends help children cope after a natural disaster. Journal of Clinical Child Psychology, 25, 463-475.
Young, M. A. (1997). The community crisis response team training manual (2nd ed.). Washington, DC: National Organization for Victim
Assistance.
Zenere, F. J., & Lazarus, P.J. (1999). Winds of terror. Children‘s responses to hurricane and tornado disasters. In A. S. Canter & S. A.
Carroll (Eds.), Crisis prevention and response: A collection of NASP resources (pp. 223-229). Bethesda, MD: National Association of School
Psychologists.
Adapted from Lazarus, P. J., & Jimerson, S. R., Brock, S. E. (2002). Natural disasters. In S. E. Brock, P. J. Lazarus, & S. R. Jimerson (Eds.),
Best Practices in School Crisis Prevention and Intervention (pp. 435-450). Bethesda, MD: National Association of School Psychologists.
For further information on helping children cope with crises, visit www.nasponline.org.
67
Classroom-Based Crisis Intervention
BY STEPHEN E. BROCK, PHD, NCSP, California State University, Sacramento
MELISSA A. REEVES, PHD, NCSP, Winthrop University, Rock Hill, SC
When a situational crisis occurs, school staff members can easily become overwhelmed by the need to provide
support to large numbers of students. After immediate physical safety and security have been ensured, staff
members need to begin the process of addressing psychological safety. These actions may include classroombased crisis intervention (CCI), formerly referred to as group psychological first-aid, which focuses on the
immediate response to a crisis event with groups of students (often naturally occurring classroom groupings). It is
important to note that CCI is a relatively sophisticated school crisis intervention response and should only be
implemented by a mental health professional with the necessary school crisis intervention training and
experience. The purpose of this handout is to provide school personnel with an introduction to CCI and resources
for more information, not to prepare them to actually implement the process.
Although mental health professionals must playa leadership role in CCI, it is not psychotherapy, nor is it a
substitute for professional mental health interventions. It is not designed to prevent the more serious
psychological consequences of crisis event exposure (e.g., posttraumatic stress disorder, or PTSD). Rather, it is
an immediate helping response for groups of students who have been indirectly exposed to a common stressor
(Brock et aI., 2009).
PLANNING ISSUES
Mental health personnel will be responsible for evaluating risk for trauma, determining which students are
appropriately served by CCI, and implementing procedures to meet the goals of CCI.
Evaluating Risk
Before CCI is conducted, a mental health professional must evaluate individual risk for psychological trauma
(see, for example, Brock & Reeves, 2010). This includes considering (a) crisis exposure, (b) personal
vulnerabilities, (c) threat perceptions, and (d) crisis reactions.
If these skills have not been learned in a graduate training program or through additional professional
development, it is important that the school-based mental health professional obtain additional training in how to
evaluate crisis exposure and how to conduct CCI, such as the NASP PREP~RE Crisis Intervention & Recovery
workshop.
Goals and Limitations of CCI
CCI groups are homogeneous in terms of developmental level and degree of traumatic event exposure. Goals
include helping students to (a) understand the trauma, (b) make sense of and normalize experiences/reactions, and
(c) learn how to cope with crisis-related stressors. By exploring crisis experiences/reactions, it is hoped that the
CCI session will help students feel less alone and more connected to classmates, and that it will identify specific
crisis-related problems and adaptive coping skills. In addition, CCI allows crisis interveners to identify students
who may be in need of mental health assistance.
CCI is not appropriate for all students. Those who were directly exposed to the crisis, were physically injured,
and/or have significant preexisting mental health problems should be offered individual crisis intervention and
may not be appropriate candidates for a group session (Brock et aI., 2009).
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GENERAL ISSUES IN IMPLEMENTATION:
FAQS
The following are frequently asked questions and
answers regarding CCI implementation:
What is the optimal size of the CCI group? Large
groups may limit sharing and interfere with the
expression of feelings. Thus, 15 to 30 students
is a typical size.
When should CCI be offered? If it is impossible or
inappropriate for CCI to be held right away,
school officials should acknowledge the
magnitude of the crisis and inform students as
to when CCI (or other supportive
interventions) will be offered. CCI should not
be initiated at the end of a school day.
Must all students participate? Not all students will
be ready to share crisis experiences/reactions
(nor hear others do so) at the same time. Thus,
no student should be required to participate.
Where should CCI be offered? Providing CCI in
the school environment, with its naturally
occurring social supports, is optimal.
Who are CCI facilitators? Ideally, at least one of
the facilitators is familiar to students. It is
recommended that two or more staff members
facilitate CCI. A ratio of at least one facilitator
for every 10 students is required. The lead
facilitator should be a mental health
professional who has training and experience
in school crisis intervention. The lead
facilitator is responsible for directing progress
through CCI. Support facilitators help identify
students in need of additional support, may
also provide emotional and practical support to
the lead facilitator, and attend to students who
unexpectedly leave the classroom and/ or are
unable to continue to participate in the session.
What is the role of the teacher? It is recommended
that teachers take an active role in CCI.
However, when teachers are having significant
difficulty coping with the crisis, crisis
interveners will need to take responsibility for
CCI. It is important to establish an
environment that makes it easy for teachers to
acknowledge limitations and ask for help.
How long is CCI? The length of CCI must be
tailored to students' developmental level. Older
students will be able to participate in sessions
for longer uninterrupted periods.
THE CCI MODEL
CCI is implemented as a series of six steps.
Introduction (10-15 Minutes)
The first step includes the identification of the
CCI leader and facilitators, and explanation of the purpose,
sequence, and rules of the session.
While students are told that they are not allowed
to leave the room without permission, they are also
informed that active participation is voluntary. Those who
do not want to be in the room during discussion should be
given an alternative activity. While students should be
given permission to discuss whatever they want, it will be
important to acknowledge that verbal or physical violence
or abuse will not be tolerated. Students may participate in
the creation of the rules to facilitate the sense that they are
capable problem solvers. Often, already established
classroom rules address these issues.
Providing Facts and Dispelling Rumors
(30 Minutes) The goal of this step is to help students
understand the crisis and dispel rumors. When providing
facts, it is important to be sensitive to developmental level.
For example, with intermediate-grade students, carefully
selected, well-written newspaper articles or fact sheets
about the trauma may be helpful. Younger students,
however, need more Simplistic descriptions. It is
important to remember that the novelty of the situation
will make it difficult for students to understand facts, and
facilitators should be prepared to repeat them frequently.
Sharing Stories (30-60 Minutes)
While everyone should be given a chance to share, no one
should be required to do so. Specific questions to facilitate
this step include (a) "Where were you when it happened?"
(b) "Who were you with?" (c) "What did you see, hear,
smell, taste, or touch?" (d) "What did you do?" and (e)
"How did you react?" Facilitators should validate
experiences and help students feel more connected to each
other by explicitly pointing out their common experiences.
Sharing Reactions (30 Minutes)
Approaches include (a) stating common reactions, (b)
asking those who have experienced each reaction to raise
their hand, (c) asking for individual examples, and (d)
anticipating reactions that may arise in the future.
Facilitators should state that initial trauma reactions are
typical. Crisis reactions can be very unsettling, and it is
not uncommon for students to fear that they are "going
crazy." Group sharing and facilitator anticipation of
trauma reactions helps normalize these frightening
symptoms.
Facilitators should also let students know that, with time,
for most people, reactions will go away. However,
students should be informed of what to do if they feel that
they are unable to manage reactions. This is a natural time
to ensure that students are aware of selfreferral procedures
for obtaining one-on-one crisis intervention. As this step
ends, asking future-focused questions helps students to
predict experiences they will have and coping skills they
may need.
69
Empowerment (Up to 60 Minutes)
The primary goal of this step is to help students
begin to participate in activities that help them
regain a sense of control. Important to the
attainment of this goal is the identification of both
prior successful coping strategies as well as the
identification of new coping strategies. The
facilitator should reinforce those that are adaptive
and offer alternatives when maladaptive strategies
are proposed.
During this step facilitators might review basic
stress management techniques (e.g., getting needed
sleep, food, and exercise, and talking to friends and
family). Alternatively, they might encourage
students to work together on developing strategies
to gradually desensitize each other to traumarelated fears; instruct them on how to reply to
intrusive thoughts and images; or ask students to
brainstorm strategies to prevent reoccurrence of the
traumatic event.
Closing (Up to 30 Minutes)
Closing activities may include the development of
memorials; preparation for attending or
participating in funerals; the writing of get-well
cards and letters to victims; and, if the class has
experienced the death of a classmate or teacher,
discussion of what to do with the deceased's desk
and belongings. In concluding CCI, facilitators
should answer any remaining questions.
In their closing comments, facilitators should
remind students that they are experiencing common
reactions to abnormal circumstances. Facilitators
should acknowledge that, for some students, it
might be some time before they are truly able to
integrate the crisis event into their life experiences
and move forward with their lives. They should
also acknowledge that, for some students, life
might never be the same. It is important to stress
tolerance and acceptance of various expressions of
emotions and grief. At the same time, facilitators
should be positive about the future and remind
students that, while memories will remain, with
time, crisis reactions will typically lessen. Finally,
the facilitators should reassure students that
additional crisis intervention services are available
and reiterate self-referral procedures.
Reassure your child that he or she is safe
Offer assistance with everyday tasks and chores
Respect your child's privacy
Do not take anger or other reactions personally
Continued Availability
After CCI has ended, facilitators should be available to
students throughout the remainder of the school day.
This gives students additional opportunities to seek out
support and to have questions answered. It also gives
facilitators additional opportunities to assess how
individual students are coping.
Debriefing
Finally, as soon as possible after CCI, facilitators should
debrief the session. This debriefing typically occurs at
the end of the school day and serves two important
purposes. First, it allows for discussion of student
reactions and decisions regarding who will need
additional crisis intervention. Second, it gives facilitators
the chance to focus on their own reactions and coping.
Special attention should be directed toward the teacher.
If needed, crisis intervention services should be made
available to the teacher and other CCI team members.
REFERENCE
Brock, S. E., Nickerson, A. B., Reeves, M. A., Jimerson,
S. R., Feinberg, T., & Lieberman, R. (2009). School crisis
prevention and intervention: The PREP[!RE model. Bethesda,
MD: National Association of School Psychologists.
RECOMMENDED RESOURCES
Brock, S. E. (2002). Group crisis intervention. In S. E.
Brock, P. J. Lazarus, & S. R. Jimerson (Eds.), Best
practices in school crisis prevention and intervention (pp.
385-403). Bethesda, MD: National Association of
School Psychologists.
Brock, S. E., & Reeves, M. A. (2010). Trauma victims
and psychological triage: Considerations for school
mental health professionals. In A. Canter, L. Z. Paige,
& S. Shaw (Eds.), Helping children at home and school
III: Handouts for families and educators (S9H43).
Bethesda, MD: National Association of School
Psychologists.
National Association of School Psychologists, School
safety and violence prevention resources: http://www.
nasponli ne.org/ resou rces/ crisis_safety /
schoolsafety. aspx
POST -CCI ACTIVITIES
Following the CCI session, all caregivers need to
be informed about how they can help students
cope. Recommendations, which should be provided
to the families of all CCI participants, include:
Listen to and spend time with your child
Offer, but do not force, discussion about the
trauma
70
Traumatized Children: Tips for Educators
BY KATHY SIEVERINGr MAr NCSP, Jefferson County School District, Golden, CO
Psychological trauma refers to emotional and/or physical reactions caused by an extremely distressing experience
that is painful, terrorizing, and shocking. A normal response to an extreme event, such trauma may result in
lasting mental and physical effects. A traumatic event involves a single experience or repeated events that
completely overwhelm the child's ability to cope. In some cases, the sense of being overwhelmed is delayed by
weeks or months, while the child struggles to cope with immediate danger.
Childhood trauma may be caused by a wide range of events including, but not limited to, physical and sexual
abuse, natural disasters, ,or witnessing/experiencing extreme threat or violence. Traumatized children feel
complete helplessness due to real or perceived threats to their own lives or the lives of loved ones. In general, the
more direct the exposure to the traumatic event, the higher the risk of emotional harm. This handout provides
educators with an overview of childhood trauma and tips for supporting children who are trauma victims.
RESPONSES TO TRAUMA: A DEVELOPMENTAL PERSPECTIVE
While trauma causes immediate and acute feelings of confusion, disorientation, and terror in many children,
there are developmental differences in response based on a child's age and previous experiences. Below are
descriptions of symptoms and reactions children might display following one or a series of traumatic events.
Symptoms and reactions surface in varying degrees and time periods. For example, some children might display
minimal separation anxiety following a traumatic event, while others may develop immediate and exaggerated
anxiety symptoms for longer periods of time. When significant changes in personality persist for more than 3
months, mental health services may be warranted.
The following descriptions include both positive and negative reactions noted in children following traumatic
events. Although many resources address only negative responses, especially those pertaining to large-scale
traumatic events, many children demonstrate bravery, courage, and a desire to help others.
Primary School-Age Children (Ages 5-8)
Separation anxiety: c1inginess, difficulty separating from parents, sense of powerlessness
Sleep disturbances: increased nightmares, disrupted sleep patterns, night terrors, irritability and/or
oppositional behavior due to fatigue, sleeping in odd places (on the floor next to parent's bed) Anxiety:
increased worries or fears, jumpiness, avoidance of stress-provoking situations, repeated acting out of the
traumatic event (often through play), strong need for safety and security Regression: toileting problems,
thumb-sucking, baby talk, whining, clinging, tearfulness, hygiene issues (refusal to wash, brush teeth, or
dress oneself), breakdown in bedtime routine
Blunted emotions: numbness, lack of affect, not communicating with others, lack of interest, increased
daydreaming
Somatic concerns: headaches, stomachaches, bodily aches and pains, hyperventilating, trembling, racing heart
rate
High degree of agitation: more frequent and intense temper tantrums, heightened aggression, increased
peer/sibling conflicts, difficult to soothe, heightened impulsivity and/or hyperactivity
Heightened concerns for family members, friends, and peers: desire to help but uncertain how to be useful
Magical thinking: believing that one's thoughts cause actions, such as blaming himself or herself for the
trauma
71
Intermediate School-Age Children (Ages 9-11)
Heightened fears: phobias, repetitive
thoughts/worries about the event, sense of
powerlessness
Sleep disturbances: nightmares, night terrors,
irritability and/or oppositional behavior due to
fatigue, difficulty falling or staying asleep
Somatic concerns: headaches, stomachaches, bodily aches and pains, increased or decreased
appetite, hyperventilating, racing heart rate,
feeling faint
Blunted emotions: numbness, lack of affect, not
communicating with others, lack of interest,
staring into space, increased daydreaming
Increased anxiety: repetitive ideas, fears,
thoughts, memories
Behavioral regression: agitation, behaviors typical
of a child 2-3 years below chronological age
Social difficulties: increased arguments with
peers, more physical altercations
Desire to take positive action, need for
empowerment
Academic changes: poor concentration, increased
distractibility, heightened disorganization, lack of
motivation, "who cares" attitude, sloppy work, or
desire to do well academically but unable to keep
up with assignments and homework
Desire to understand why the traumatic event(s)
occurred
High School Youth (Ages 15-19)
Increased aggression, rebellion, and/or agitation:
increased arguments, rule-breaking, refusal to go
to school
'
Physical concerns: increased illness, excessive
absences/tardies, feeling overwhelmed and
exhausted, or excessive spurts of energy, recurring
intrusive thoughts or feelings, startle reactions
Changes in grades or attitudes towards school:
poor ability to focus or concentrate, refusal to
complete or turn in homework, disorganization,
lack of motivation, confusion, desire to do well in
school but trouble organizing thoughts and time
Personality changes: moodiness, increased tearful
episodes, helplessness, hopelessness, intense
desire to be alone or strong need to be with others
and discomfort being alone
Increased anxiety: loss of control and safety,
intense feelings of vulnerability
Increased creativity used as an outlet for intense
feelings: art, writing, music, movement
Desire to take positive action: need for
empowerment, need to improve the situation/make
it better/help others, need to connect with others in
similar situations
Improved social bonds: stronger desire to be with
close friends
Desire to be near loved ones: family, friends,
spiritual community
Intense need to understand why the traumatic
incident occurred
Middle School-Age Children (Ages 12-14)
Increased conflicts: more arguments with peers,
moodiness, negative attitude
Academic failure: poor concentration, increased
distractibility, heightened disorganization, lack of
motivation, "who cares" attitude
Increased aggression, rebellion, and/or agitation:
increased arguments, rule-breaking, and arguing
Somatic complaints: headaches, stomachaches,
bodily aches and pains
Intense need to understand why the traumatic
incident occurred
Desire to be near loved ones: family, friends,
spiritual c'ommunity
Social difficulties: increased arguments with
peers, more physical altercations
Improved social bonds: stronger desire to be with
close friends
Desire to help others in similar situations, make a
difference, improve the situation
Increased creativity used as an outlet for intense
feelings: art, writing, music, movement
Heightened anxiety: sense of powerlessness,
increased fears, phobias, loss of safety and
security
HOW EDUCATORS CAN SUPPORT
TRAUMATIZED CHILDREN
While most educators don't receive training in how to
help traumatized children, students often turn to their
teachers for emotional support following a crisis or
traumatic event. Finding a balance between teaching
core subjects and helping students with their
emotional and social needs is difficult. Given the
pressure to improve state achievement test scores,
teachers and administrators feel torn. They are
expected to increase their students' achievement
scores no matter what the circumstances. Even if
students recently lost a parent or experienced a school
shooting, they must attend to assignments,
homework, and standards tests. Educators can help
alleviate traumatic stress through the following:
Move towards resumption of classroom/school
routines following a large-scale event.
Maintain structure and expectations but allow
movement and social breaks.
72
Offer opportunities to draw or write about experiences. Don't ask children to share pictures in a
group because explanations may unknowingly
impact others.
Involve students in activities that encourage
empowerment by helping others.
Repeat teaching of main concepts and offer extra
academic support.
Allow traumatized children to use quiet places in
the classroom; incorporate quiet time, play
calming music, and refrain from yelling or using a
loud voice.
Realize that students might attend memorial or
funeral services. Don't expect make-up work from
those times.
Give students choices and control during the day.
Note noises or situations that trigger feelings
related to the event. Eliminate them if possible.
Read or offer books to students that reinforce
hope and resilience.
Maintain close communication with parents as a
student might display different reactions at home
versus school.
RECOMMENDED RESOURCES
Print
Goldman, L. (2004). Raising our children to be
resilient: A guide to helping children cope' with trauma
in today's world. New York: Brunner-Routledge.
Muldaff, S. J., & Pillo, C. (2000). A terrible thing
happened: A story for children who have witnessed
violence or trauma. Washington, DC: Magination
Press.
Singleton, D. M. (2008). The aftermath of Hurricane
Katrina: Educating traumatized children Pre-K through
college. Lanham, MD: University Press of
America.
Online
Child Trauma Academy: http://www.childtrauma.org
National Child Traumatic Stress Network:
http://www. nctsnet.org
National Institute for Trauma and Loss in Children
(TLC): http://www.tlcinst.org
Parent Trauma Resource Center: http://www.tlcinst.
org/PTRC.html
Kathy Sieve ring, MA, NCSP, is a "retired" school psychologist now
working part-time at Lincoln Academy School in the Jefferson County
School District, CO; she also continues to maintain a private practice. She
is an active member and presenter for the Colorado Society of School
Psychology, State Crisis Team. She responded to the Columbine and Bailey
school shootings and is a founding member of CoCERN, the Colorado
Crisis Education and Response Network.
SUMMARY
While there are some general behavioral patterns
noted in children following traumatic events, many
react in unique ways. Despite individual differences,
traumatized children need to feel safe and secure,
experience empathy, and feel a sense of
empowerment.
73
Suicidal Students: Intervening at School
BY STEPHEN E. BROCK, PHD, NCSP, California State University, Sacramento
MARY ANN RIFFEY, MA, Roseville Joint Union High School District, CA
Suicidal ideation and behaviors have a tremendous effect on learning. Within a typical high school classroom of
30 students, it is likely that 3 students will have made suicide attempts within the past year. In most cases, these
students will be psychologically unavailable for academic instruction. Districts have been held liable when they
failed to provide suicide prevention programs and adequate supervision of suicidal students. For these reasons
and more, it is critical that providers of school mental health services and other personnel are informed about
suicide prevention and intervention, and that school suicide prevention and intervention plans are in place.
SUICIDE PREVENTION
School suicide prevention actions may include the use of suicide prevention and awareness curricula, staff
training programs, and risk screening.
Suicide Prevention and Awareness Curricula
Curriculum programs typically target the entire student body. They strive to raise the school's overall
responsiveness to students who are at risk for suicidal ideation and/or behaviors. They acknowledge that peers
are an important part of an adolescent's life, and that young people usually will share suicidal ideation with
peers. Goals of curriculum programs include increasing awareness of the problem, providing knowledge about
the behaviors associated with suicide, and describing available resources.
Because of developmental issues and the fact that suicide is rare among younger children, elementary schools'
suicide prevention efforts should focus more exclusively on prevention programs that enhance problem solving,
decision making, and coping skills.
Effectiveness of prevention and awareness programs. Historically, these programs have not always been viewed as
effective. Concerns have included the observations that very few adolescents attending these programs attempt
or commit suicide, that the programs may have a tendency to normalize suicidal behavior, and that they may
have a negative effect on students with a history of suicidal behavior.
Programs developed more recently have responded to these concerns and have been supported by empirical
research. Specifically, the Signs of Suicide (50S) program incorporates a curriculum component with a brief
screening for depression and other suicide risk factors. The goal is to make automatic the action steps required
when confronting suicide (Le., Acknowledge, Care, and Tell, or ACT). Using a randomized control-group
model, researchers demonstrated that the 50S program significantly lowered self-reported suicide attempts over a
3month period (Aseltine & DeMartino, 2004). In addition, relative to the control group, evaluation data
suggested that 50S program participants had greater knowledge and more adaptive attitudes about depression.
Resiliency and warning signs. Programs that promote resiliency are often reported to be helpful in the prevention
of suicidal ideation and behaviors. It is rare for an individual to commit suicide suddenly and unexpectedly.
Rather, suicide is typically the result of a lack of resiliency factors and an accumulation of risk factors
(especially mental illness). Further, many people who are suicidal may display warning signs that predict their
behavior.
Table 1 summarizes these resiliency factors, risk factors, and warning signs. It is important to note that the
absence of resiliency factors and the presence of risk factors do not perfectly predict suicidal ideation and
behaviors. However, these variables do signal the need to increase vigilance for suicide warning signs.
School Staff Training
Education of school staff members is frequently identified as an essential component of any prevention program.
Teachers are the school professionals who spend the most time with at-risk students. It is crucial for them to be
able to identify and to bring to the attention of school psychologists those students they suspect or believe may
be suicidal. A good practice for school districts is to provide staff with periodic training sessions, using suicide
intervention scenarios and roleplaying to apply the knowledge and to practice skills. UCLA's Technical Assistance
Sampler on School Interventions to Prevent Youth Suicide provides a wealth of information on suicide prevention,
intervention, and postvention (i.e., follow-up) and identifies specific gatekeeper training programs available
throughout the country (see Recommended Resources).
74
Table 1. Resiliency, Risk Factors, and Warning Signs
Resiliency Factors
Family support and cohesion
General life satisfaction
Good family communication
Parent involvement and engagement
Peer support and close social networks
School connectedness
Adaptive coping/problem-solving skills
Cultural/religious beliefs that discourage suicide
Good conflict resolution skills
Ties to neighborhood and community
High self-esteem
Easy access to mental health resources
Restricted access to lethal means
Feeling that one has a purpose in life
Effective medical and mental health care
Mental disorders (particularly depression)
Comorbid disorders
Hopelessness/helplessness
Self-injurious behavior (e.g., cutting)
Easy access to lethal suicide methods
Physical illness
Significant others have died by suicide
Relational, social, work, or financial loss
Local epidemics of suicide
Risk Factor
Previous suicide attempt(s)
Alcohol/substance abuse
Family history of suicide
Impulsive or aggressive behavior
Sexual and/or physical abuse
Impulsive or aggressive tendencies
Isolation
Barriers to mental health treatment
Cultural/religious beliefs that allow suicide
Unwillingness to seek mental health assistance
Warning Signs
Making direct suicide threats
Putting personal affairs in order
Giving away prized possessions
Talking about suicide and death
Talking about having no reason to live
Withdrawing from family and friends
Losing interest in once pleasurable activities
Abrupt changes in appearance
Altering patterns of sleeping or eating
Inability to concentrate or think rationally
Suddenly and unexpectedly acting happy
Showing drastic changes in behavior/mood
Increased use/abuse of alcohol and/or drugs
Running away from home
Note. From "Suicidal Ideation and Behaviors," by S. E. Brock, J. Sandoval, and S. Hart, 2006, in G. G. Bear
and K. M. Minke (Eds.), Children's needs III: Development, prevention, and interventian, p. 227. Bethesda, MD:
National Association of School Psychologists. Copyright 2006 by the National Association of School
Psychologists. Adapted with permission.
75
student are concluded. The resources listed below
provide additional information regarding the suicide
risk assessment that would be conducted by the
school psychologist.
Suicide Risk Screening
It is possible to screen an individual efficiently and
briefly for suicide risk. These screenings rarely yield
false negatives, but they will often yield false
positives. Thus, a second-stage evaluation of all
positive results is required. Limitations of schoolwide screening include the fact that suicidal ideation
waxes and wanes over time and circumstances. Thus,
multiple screenings may be necessary to capture all
potentially at-risk students. An additional limitation
is the relative lack of acceptance among school
administrators, school psychologist, and other
schoolpersonnel of school-wide suicide risk
screenings. Given these difficulties, school-wide
screening may be most useful when there is concern
regarding suicide contagion, the possibility that other
students may attempt suicide following the suicide of
a peer.
SUMMARY
Suicide is a reality in U.S. public schools.
Prevalence data suggest that in a typical high school,
1 suicide occurs within each 5-year period and
approximately 170 nonfatal suicidal behaviors occur
each year. Many of these incidents will not come to
the school's attention. Suicidal behavior is a problem
that diligent school mental health practitioners, in
partnership with other school personnel and
community-based professionals, must address to
develop effective prevention and intervention plans.
REFERENCE
Aseltine, R. H., & DeMartino, R. (2004). An outcome
evaluation of the 50S Suicide Prevention Program.
American Journal of Public Health, 94(3), 446-451.
SUICIDE INTERVENTION
Even the best prevention efforts will not eliminate all
instances of suicidal ideation and behavior. Thus,
schools must develop procedures for responding to
the presence of a suicide threat and the occurrence of
suicidal behavior. Goals of suicide intervention
include ensuring student safety, assessing and
responding to suicide risk, determining needed
services, and ensuring appropriate care.
Both general staff procedures and specific risk
assessment and referral procedures need to be
developed. These procedures should be followed
whenever a staff member suspects a student is at risk
for suicidal behavior. They identify how such a
student will be brought to the attention of a school
mental health professional who has been trained to
conduct suicide risk assessment and who is
competent to make referral decisions.
RECOMMENDED RESOURCES
Print
Berman, A. L., Jobes, D. A., & Silverman, M. M. (Eds.).
(2006). Adolescent suicide: Assessment and intervention.
Washington, DC: American Psychological
Association.
Brock, S. E., Nickerson, A. B., Reeves, M. A., Jimerson,
S. R., Feinberg, T., & Lieberman, R. (2009).
School crisis prevention and intervention: The PREPaRE
model. Bethesda, MD: National Association of
School Psychologists.
Brock, S. E., Sandoval, J., & Hart, S. (2006). Suicidal
ideation and behaviors. In G. G. Bear & K. M. Minke
Children's needs III: Development, prevention, and
intervention (pp. 225-238). Bethesda, MD: National
Association of School Psychologists.
Capuzzi, D. (2002). Legal and ethical challenges in
counseling suicidal students.
Professional School Counseling, 6, 36-46.
Center for Mental Health in Schools at UCLA. (2003).
A technical assistance sampler on school interventions to
prevent youth suicide. Los Angeles, CA: Author.
General staff procedures include:
Staying with the student thought to be suicidal
constantly and without exception
Not allowing the student to leave school
Not promising to keep suicidal ideation
confidential
Determining if the student has the means to
commit suicide at hand (and, if it is safe to do so,
requesting that such means be relinquished)
Taking the student to a prearranged,
nonthreatening, and private room
Notifying the school psychologist and school
principal that a student is suspected to be suicidal
Online
American Association of Suicidology:
http://www.suicidology.org
Signs of Suicide (50S) Program: http://www. mental hea
Ithscreeni ng.org/ sos_h ighschool
Suicide Awareness/Voices of Education (SAVE):
http:// www.save.org
After informing the student of the actions that have
been taken to ensure his or her safety, and upon the
arrival of the school psychologist and/or principal,
the staff member's responsibilities for the suicidal
76
Suicide Risk Assessment
BY SHELLEY R. HART, MA, NCSP, University of California, Santa Barbara
STEPHEN E. BROCK, PHD, NCSP, California State University, Sacrament o
According to the Centers for Disease Control and Prevention (CDC), suicide has been and continues to be a
leading cause of death for young people. It is currently the third leading cause of death among individuals ages
10-24, claiming more lives than cancer, heart disease, AIDS, birth defects, stroke, chronic lung disease,
pneumonia, and influenza combined (CDC, 2005, 2008). Therefore, it is critical that school personnel be
prepared to conduct suicide risk assessments.
Recent Youth Risk Behavior Surveillance System data (CDC, 2008) indicate that, in 2007, 14.5% of students in
Grades 9-12 had seriously considered attempting suicide, 11.3% had made a suicide plan, 6.9% reported making
a suicide attempt, and 2% had made an attempt serious enough to require medical attention. Suicidal behaviors
vary depending on gender, ethnicity, and age (e.g., females are significantly more likely to report ideation,
planning, and attempts than males). Although completed suicide has and continues to be relatively rare among
children, it is important to note that suicide is a leading cause of death in the 10- to 14-year age group.
It is recommended that all schools have in place a comprehensive crisis management plan that includes suicide
intervention activities, which should include determining suicide risk. The goals of such assessment are to (a)
address the student's immediate safety, (b) identify specific factors that may affect the risk for suicide or other
suicidal behaviors, and (c) determine the need and most appropriate setting for further intervention. The work of
Ramsey, Tanney, Lang, & Kinzel (2004) provides a structure for the following framework.
RECOGNIZING RISK FOR SUICIDAL THINKING
Before educators can offer to help, they must be able to recognize that help is needed. They should know the risk
and protective factors, as well as the warning signs, related to suicidal thinking and behaviors.
Risk Factors
Several factors increase or decrease the risk of suicidal thinking and signal the need to increase vigilance for
suicide warning signs and behaviors:
Prior suicidal behavior. Prior behavior predicts future behavior, and the more frequent and serious the prior
behavior (e.g., attempts requiring medical attention), the greater the risk. In addition, suicidal intent is an
important consideration. When a student has mixed feelings about wanting to die, the risk is somewhat lower.
Questions to ask include:
"Have you ever attempted suicide?"
"What happened after the attempt? Did you go to the hospital? Did you see a counselor?"
"How many times have you attempted suicide?"
"How long ago was your last attempt? When was your first attempt?"
History of mental illness. Suicide is associated with mental illness. Mood disorders, schizophrenia, alcohol and
substance abuse, psychological trauma, and borderline personality disorders are particular concerns. Questions
to ask include:
"Have you ever had mental health care?"
"Are you currently taking, or have you ever taken, any prescribed medications?"
"Are you currently not taking medications that have been prescribed to you?"
77
Precipitants/stressors. It is not unusual for suicidal
ideation and behaviors to be associated with a
stressful event, particularly one resulting in
humiliation, shame, or despair for the student (e.g.,
disciplinary action, breaking up with a boyfriend or
girlfriend). Ongoing medical illnesses, abuse or
neglect, intoxication, and suicidal behaviors of peers
may also lead to suicidal thoughts. Questions to ask
include:
WARNING SIGNS
Individuals typically give some indication of suicidal
ideation. The most common warning signs include the
following:
Overt Signs
These are indications that leave no doubt the student
is considering suicide, including:
"Has anything really bad or sad happened to you
or your family in the past year?"
"Have you or anyone close to you (family,
friend) had a serious illness, problem with
alcohol or drugs, or attempted suicide in the past
year?"
Indirect Clues
These are indications that should lead educators to
suspect suicidal thinking, including:
Family history. A history of mental illness
(particularly illness requiring hospitalization) and
suicidal behaviors increases risk. Thus, important
questions to ask include:
"Has anyone in your family been diagnosed with
a mental illness? (Think about not only your
living relatives, but what you know about past
generations.)"
"Has anyone in your family been hospitalized
due to a mental illness?"
"Has anyone in your family ever attempted
suicide?"
Protective Factors
The presence of internal protective factors (e.g., the
ability to cope successfully with stress, strong
religious beliefs, tolerance of frustration or
psychological pain, and hope or plans for the future)
and external protective factors (e.g., connectedness or
responsibility to significant others) and resources
may decrease the risk for suicidal ideation and
behaviors. These factors should also be considered
when assessing risk. Some information about
protective factors may be available from friends and
family members. Questions to ask the student
include:
Direct statements, verbal or written (e.g., "I want
to kill myself")
Behaviors (e.g., running in front of a car)
"Do you or your family belong to a church,
synagogue, or other religious organization?"
"Is there someone in your family, church, school,
or among your friends to whom you can always
depend on to support you, no matter what?"
78
Changes in appearance, behaviors, thoughts, or
feelings (e.g., withdrawing from friends, sudden
happiness after period of depression)
Indirect statements (e.g., "I don't want to be here
anymore")
Actions (e.g., giving away prized possessions)
DIRECT INQUIRY ABOUT SUICIDAL THINKING
If suicide risk factors and/or warning signs are
present, particularly in the absence of protective
factors, direct inquiry into suicidal ideation, current
suicide plan, level of pain, and resources available for
the student is necessary. A critical thread present
throughout the suicide inquiry is establishing and
maintaining rapport with the student through a
demonstration of empathy, respect, and warmth.
Obviously, the situation will dictate the specifics of
these rapport-building and maintaining activities (e.g.,
a student you have had frequent contact with versus a
student you are meeting for the first time). Once
rapport is established, the goal is to understand if, in
fact, the student has suicidal thoughts and, if so, to
determine the degree of risk for engaging in suicidal
behavior.
Questions regarding the nature, frequency, intensity,
depth, timing, and duration of suicidal thoughts are
important to assessing risk. When inquiring about
suicidal ideation, it is essential to be direct and remain
calm and nonjudgmental. Suicide is a difficult topic
to discuss, and unless the student truly believes the
educator is willing to discuss it, he or she may be
reluctant to be honest about feelings and plans.
Questions that will identify suicidal thinking include:
"Sometimes when people have had your experiences
and are feeling the way you do, they have thoughts of
suicide. Is this something that you're thinking about?"
EVALUATING THE SEVERITY OF
SUICIDAL THINKING
If the student acknowledges having suicidal thoughts,
the next step is to inquire about the presence of a
suicide plan, pain, and helping resources. Note that to
proceed with a suicide risk assessment and intervention, it is necessary to confirm the presence of
suicidal thinking. Obviously, educators should
continue to help the student with risk factors and
warning signs even when he or she denies suicidal
thinking. However, this assistance would not
necessarily be considered a suicide intervention.
Extreme Risk
If a student has suicidal thoughts and has the means
of her threatened suicide at hand (Le., the risk of
suicide is imminent), follow these procedures:
1.
2.
3.
4.
Current Suicide Plan
The more detailed the planning (Le., the student has
clearly thought out the specifics of the act), the more
immediate the planned behavior, and the more lethal
and accessible the means, the greater the risk.
Questions that will identify a suicide plan include:
"How might you do it?"
"How soon are you planning on suicide?"
"How prepared are you to commit suicide?"
5.
6.
7.
Pain
Direct questions about the pain the student is feeling
will help the educator to understand the degree of
despair and desperation. The more unbearable the
pain, the greater the risk of suicide. It is also
important to ask about symptoms of hopelessness,
anxiety, and agitation. Questions to ask include:
"Does your physical or emotional pain feel
unbearable?"
"On a scale of 1 to 10, how bad is the pain right
now?"
Personal Resources
Determining the resources in the student's life will
help the educator to understand the degree to which
the individual views herself or himself as being
alone. The more isolation the student reports, the
greater the suicide risk. Therefore, this inquiry
includes not only understanding a student's protective
factors, but also his or her perception of the resources
available. Questions that will identify these resources
include: "Is there anyone you can talk to about your
suicidal feelings?"
RESPONDING TO SUICIDAL THOUGHTS
AND BEHAVIORS
Suicide risk assessment should never be conducted
alone. Consultation with fellow staff members and
community mental health professionals, as indicated,
is imperative. The goal of risk assessment is to guide
further intervention. The degree of evaluated risk will
help determine appropriate action plans.
79
Call the police. Educators should not put
themselves in harm's way and should not exert
physical force to
remove means. Authorities should be called to
handle such a situation.
Calm the student by talking and reassuring until
the police arrive.
Request that the student relinquish the means of
the threatened suicide and try to prevent the
student from harming herself. Make certain that
such requests do not place anyone else in danger.
Call the parents and inform them of the actions
taken.
Document the results of the suicide inquiry, level
of risk assessed, steps taken in the intervention,
and plan for follow-up.
Follow up with mental health practitioners
involved and caregivers to determine future plans
for ongoing care.
Moderate to High and Low Risk
A student is thought to demonstrate moderate to high
risk if he has suicidal thoughts, has a suicide plan,
reports being in unbearable pain, and/or views
himself as being all alone (but the suicide threat is not
immediate). A student with low risk has suicidal
thoughts but does not have a suicide plan, report
unbearable pain, and/or view himself as all alone. The
procedures for both levels of risk are similar and
include the following:
1. Consider if the student's distress is the result of
parent or caregiver abuse, neglect, or
exploitation. If so, contact child protective
services instead of a parent or caregiver.
2. Meet with the student's parents (or child
protective services).
3. Make appropriate referrals. For individuals with
a moderate to high level of risk, these might
include referral to a community crisis
intervention agency. For individuals with a low
estimated risk, they might include referral to a
community mental health professional.
4. Determine what to do if the parents are unable or
unwilling to assist with the suicidal crisis (e.g.,
call the police, child protective services) and
provide needed services to the student.
5. Document the results of the suicide inquiry, level
of risk assessed, steps taken in the intervention,
and plan for follow-up.
6. Follow up with mental health practitioners
involved and caregivers to determine future plans
for ongoing treatment, if necessary.
SUMMARY
Educators are uniquely positioned to intervene with
suicidal youth. Comprehensive assessment and
intervention include evaluation of risk factors,
protective factors, and warning signs, in addition to a
thorough suicide inquiry (Le., ideation, plan, pain,
resources). The purpose of the risk assessment is to
guide intervention. Action plans can be developed
based on the level of the evaluated risk.
Online
American Psychiatric Association, Suicidal behavior:
http://www.psych.org/psychJ)ract/treatglpg/Suicida
IBehavioc 05-15-06.pdf.
'
National Association of School Psychologists, Suicide
resources:http://www.nasponline.org/resources/cris
is_ safety/suicideresources.aspx
National Center for Chronic Disease Prevention and
Health Promotion, Youth Risk BehavioralSurveillance:
http://www.cdc.gov/HealthyYouth/yrbs/
National Suicide Prevention Lifeline 1 (800) 273TALK: http://www.suicidepreventionlifeline.org/
Suicide Prevention Resource Center:
http://www.sprc. org
UCLA Center for Mental Health in Schools:
http://smhp. psych.ucla.edu
REFERENCES
Centers for Disease Control and Prevention. (2005).
WISQARS leading causes of death reports, 19992002). Washington, DC: Author.
Centers for Disease Control and Prevention, (2008,
June 6). Youth Risk Behavior Surveillance-United
States, 2007.
Morbidity and Mortality Weekly Report, S7 (SS4).
Retrieved July 6, 2009, from http://www.cdc.gov/
HealthyYouth/yrbs/pdf/yrbss07 _mmwr.pdf
Ramsey, R. F., Tanney, B. L., Lang, W. A., &
Kinzel, T.
(2004). Suicide intervention handbook (10th ed.).
Calgary, AB: LivingWorks.
Shelley R. Hart, MA, NCSP, is a doctoral candidate in the Department of
Counseling, Clinical, and School Psychology at the University of California,
Santa Barbara. Stephen E. Brock, PhD, NCSP, is a Professor in the
Department of Special Education, Rehabilitation, School Psychology, and
Deaf Studies at California State University, Sacramento and a member of
the NASP National Emergency Assistance Tea m.
RECOMMENDED RESOURCES
Print
Brock, S. E., Sandoval, 1., & Hart, S. (2006). Suicidal
ideation and behaviors. In G. G. Bear & K. M. Minke
(Eds,),
Children's needs III: Development, prevention, and
intervention (pp. 225-238). Bethesda, MD:
National Association of School Psychologists.
Centers for Disease Control and Prevention. (2007).
Suicide trends among youths and young adults aged
10-24 years: United States, 1990-2004.
Morbidity and Mortality Weekly Report, S6, 905-908.
80
Suicide Prevention: Information
and Strategies for Educators
BY SHELLEY R. HART, MA, NCSP, & SHANE R. JIMERSON, PHD, NCSP, University of California, Santa Barbara
Suicide is the third leading cause of death in the United States among youth 10-24 years of age, and the only
cause of death to increase for 10- to 14-year-olds in recent years (Center for Disease Control and Prevention
[CDC], 2007). Nationwide, in 2004, approximately 33,000 youth were hospitalized as a result of suicide
attempts. Accordingly, more than a quarter of high school teachers report that they have been involved in
response to a student's suicidal behavior. Unfortunately, many educators do not feel prepared to deal with such
situations. This handout will provide basic information regarding suicide as well as direction for the positive role
that educators can play in the prevention of suicidality.
CHARACTERISTICS
Suicidal behaviors include intentional injuries that are self-inflicted with the goal to end one's life. These
behaviors may be either fatal (completion) or nonfatal (attempt). Suicidal ideation includes thoughts and feelings
about wanting to end one's life. Obviously, suicidal ideation is more common than attempts or completions.
Age
Suicide completion rates increase as people get older; for example, suicide is fairly rare in individuals under 5
years, while elderly adults have the highest rates. However, rates of suicide attempts are highest among
adolescents and young adults and rare among the elderly. Regarding ideation, approximately 15% of high school
students report seriously considering suicide, and 11% report having made a suicide plan within the 12 months
prior to being surveyed (CDC, 2008).
Gender
Males are almost five times more likely to die by suicide; however, females are two to three times as likely to
attempt suicide or to report suicidal ideation (CDC, 2002). Males tend to act more impulsively (e.g., in response
to a stressful situation), while females are much more likely to tell someone about thoughts or plans regarding a
suicide attempt. Choice of method differs as well, with males more likely to use firearms, while females use
poisoning more frequently (CDC, 2007).
Ethnicity
Caucasian males have the highest absolute numbers of suicide deaths (i.e., accounting for approximately 70% of
all suicide deaths). However, the rate of youth suicide is highest among Native American/ Alaska Natives and
the second leading cause of death for Native American males under the age of 25. Among young women ages
10-24, Hispanic youth have the highest rate of suicide deaths as well as the highest rate of suicide attempts
among all youth of both genders (National Adolescent Health Information Center, 2006).
Method
Firearms have consistently ranked first among methods of suicide, accounting for nearly three of five suicide
deaths (American Association of Suicidology, 2003). However, since 1990, significant increases in the rates of
death by suffocation/hanging have occurred, particularly for females (CDC, 2007).
SUICIDE RISK
There are a number of factors that place students at risk, as well as factors that provide protection from suicidal
ideation and behaviors.
81
Contextual factors. The most important contextual
protective factor is restricted access to firearms. Additionally, family factors (good communication and
supportive relationships), peer variables (supportive
peers and dense social networks), and school factors
(feelings of connectedness and parent involvement)
offer opportunities to protect individuals from
suicidal thoughts and behaviors.
Suicide Risk Factors
Suicide is typically the result of a relative lack of
resilience or protective factors and an accumulation
of risk. The presence of these risk factors may signal
the need to increase vigilance for the warning signs
of suicide.
History of mental illness. In approximately 90% of
suicide deaths, a mental or addictive disorder is
present. Mood disorders (particularly depression) are
the most common diagnoses, followed by substance
abuse, conduct disorders, and anxiety disorders
(Seeley, Rohde, Lewinsohn, & Clarke, 2002).
SUICIDE WARNING SIGNS
Individuals who engage in suicidal behaviors
typically give some indication of their thoughts,
feelings, and plans. Unfortunately, most high school
students indicate that they would not feel comfortable
directly talking with school staff about personal
problems, highlighting the importance of staff
awareness of the observable behaviors that may
signal the presence of suicidal thinking. When
combined with risk factors, the presence of warning
signs requires school professionals to directly inquire
about suicidal behaviors (e.g., "Are you thinking
about suicide?") and may suggest the need for further
intervention (see Brock & Riffey, 2010; Hart &
Brock, 2010). Educators should notify school mental
health workers (e.g., school psychologists) if they
become aware of any of the following warning signs:
Prior suicide attempt. A previous suicide attempt is
one of the most important predictors of future
suicidal behaviors. It is estimated that between one
quarter and one half of individuals who attempt once
will attempt again (Bradvik, 2003).
Environment. A childhood history of sexual or
physical abuse, a parental history of mental illness or
substance abuse, low levels of parental support and
involvement, social isolation and lack of connection
to school, and availability of firearms have all been
associated with suicidal thoughts and behaviors. The
availability of firearms is associated with a risk of
suicide 2-10 times higher than in homes without
firearms, depending on the individual's age and
method of gun storage (Miller & Hemenway, 2008).
Overt Signs
Signs might be sufficiently overt to leave no doubt
about suicidal intentions:
Direct statements, either verbal (e.g., "I want to
kill myself") or written (e.g., suicide note)
Dangerous behaviors (e.g., attempting to walk
out in front of a car)
Sexual orientation and gender identity status.
Stressors related to violence, harassment, prejudice,
discrimination, and stigmatization place lesbian, gay,
bisexual, transgender, and questioning (LGBTQ)
youth at risk for mental health problems including
depression. Rates of suicidal ideation, attempts, and
completion by LGBTQ youth are estimated to be two
to three times higher than for heterosexual youth
(Weiler-Timmins, 2010).
Indirect Clues
Individuals may also give indication of thoughts,
feelings, or plans indirectly, including:
Statements (e.g., "I don't want to be here
anymore")
Actions (e.g., giving away prized possessions,
writing a will, or making final arrangements)
Preoccupations (e.g., excessive talking, writing,
and/ or reading about death)
Situations. Often there are precipitating events that
occur prior to a suicide. These situations typically
produce an overwhelming sense of loss. Examples
include: exposure to suicidal behaviors of a family
member or friend, relationship breakup or rejection,
or disciplinary action at school.
Changes in Behavior, Appearance, Thoughts, or
Feelings
The following changes may indicate the need to
inquire about suicidal thoughts or behaviors:
Excessive sadness or moodiness
Sudden calmness or happiness (particularly after
a period of depression)
Withdrawing from friends or social events
Sudden changes in personality (e.g., speaking
with unusual speed) or activities (e.g., losing
interest in things once enjoyed)
Suicide Protective Factors
A number of factors increase individual resilience
and thus protect against suicidal thoughts and actions.
Internal factors. Several factors offer protection
against suicidality, including the ability to cope with
stress, good problem-solving skills, high frustration
tolerance, and high self-esteem.
82
WHAT CAN SCHOOLS DO?
School professionals are uniquely positioned to
prevent suicidal behaviors, as well as to identify and
intervene when such behaviors are demonstrated.
Efforts geared toward addressing suicidal behaviors
can be categorized as prevention (before suicidal
behaviors occur), intervention (as suicidal behaviors
occur), and postvention (after suicidal behaviors have
occurred). Ultimately, all activities in relation to
suicidal behaviors are prevention efforts, in that the
outcome is to prevent suicidal behaviors from
escalating or recurring in the individual, and/or to
prevent suicidal behaviors from occurring in others.
Schools should embrace a comprehensive approach
outlining plans to promote student mental health and
addressing each area of suicide prevention. The
following summarizes key ways schools can be
involved in prevention efforts.
Crisis Management Teams
School crisis teams provide leadership prior to,
during, and after crises. In the planning stage, school
personnel are assigned to particular roles, and, in the
event of a crisis, other duties are suspended as needed.
One of the most important responsibilities of such
teams is the development of policies and procedures
related to crises.
Policies and Procedures
A critical aspect of suicide prevention efforts is
outlining policies and procedures. If an educator
suspects a student is suicidal, it is important for the
educator to know how to interact, whom to turn to,
and the necessary steps to take. The following steps
are recommended:
health worker (e.g., school psychologist).
Pro'mising to keep suicidal thoughts or behaviors
a secret is never recommended.
Notify parents. Parents should be immediately
contacted and the school should retain a record
of this notification and outcomes. Ideally, this
notification would involve recommendations
about immediate steps (e.g., intake with mental
health resource), necessary supervision,
removing lethal means, and follow-up regarding
mental health needs and referrals.
Prevention and Awareness Curricula
Prevention and awareness curricula target the entire
school population and strive to increase awareness of
the issue, share knowledge regarding suicidal
behaviors, and identify available resources. Programs
that employ a mental illness model (Le., suicide as a
consequence of mental illness) are recommended
over programs that employ a stress model of suicide
(Le., suicide as a reaction to stress).
Gatekeeper Training
Another commo'n form of prevention efforts involves
the training of individuals who have close contact
with youth (e,g., teachers). These "gatekeeper"
trainings provide knowledge regarding risk factors
and warning signs, necessary skills for intervention,
and resources and referrals to provide appropriate
support to students in need.
Risk Screening
Several screening measures have been shown to be
quick and efficient, and it is recommended that if
used, screening take place several different times
throughout the year.
Stay calm. Being presented with a suicidal student
can be an anxiety-provoking and emotional
experience. It is important for the caregiver to
remain calm in order to communicate that he or
she is capable of handling the situation and of
talking about suicide.
Do not leave the student alone. When adults suspect
a student is potentially suicidal, that student
should not be left unsupervised or allowed to
leave campus.
Remove the means. If the student has the means
(e.g., pills, gun) readily available, the educator
should attempt to have the student relinquish it,
as long as it does not put the educator or others in
danger.
Get help. Any type of intervention with a
suicidal student is best undertaken with additional
staff. As soon as possible (and without leaving
the student alone), the educator should notify the
principal or assistant principal and school mental
83
Combined Programs
Several recent programs use a combination of
strategies. Two promising programs identified by the
national Best Practices Registry (Suicide Prevention
Center) for students ages 14-18 years include the
Counselors-Care (C-CARE), the Coping and Support
Training (CAST), and the SOS Signs of Suicide High
School Program (see Recommended Resources at the
end of this handout).
Promotion of Positive School Climate
Curricula and policies addressing peripheral issues or
protective factors (e.g., problem-solving, bullying)
may also have an indirect impact on suicidality.
Promoting "zero tolerance" for bullying, encouraging
an open atmosphere between students and staff, and
having a visible staff presence on campus are all
ways to enhance positive school climate.
SUMMARY
Suicide is a major health concern in the United States.
Schools offer a natural setting to provide
comprehensive suicide prevention efforts. These
efforts may include prevention and awareness
curricula (which employ a mental illness model),
gatekeeper training, risk screening, intervention, and
postvention activities. The most effective efforts
utilize a combination of these strategies.
REFERENCES
American Association of Suicidology. (2003). Youth
suicide fact sheet. Retrieved June 2, 2004, from
http://www.suicidology.org
Anderson, R. N., & Smith, B. L. (2003). Deaths:
Leading causes for 200l National Vital Statistics
Report, 52(9), 1-47.
Bradvik, L. (2003). Suicide after suicide attempt in
severe depression: A long-term follow-up. Suicide
and Ufe- Threatening Behavior, 33, 381-388.
Brock, S. E. , & Riffey, M. A. (2010). Suicidal
students: Intervening at school. In A. Canter, L. Z.
Paige, & S. Shaw (Eds.), Helping children at home
and school III: Handouts for families and educators
(S9H16). Bethesda, MD: National Association of
School Psychologists.
Centers for Disease Control and Prevention. (2008).
Youth risk behavior surveillance-United States, 2007.
Morbidity and Mortality Weekly Report, 57 (No. SS4).
Centers for Disease Control and Prevention. (2007).
Suicide trends among youths and young adults
aged 10-24 years-United States, 1990-2004.
Morbidity and Mortality Weekly Report, 56(35), 905908.
Centers for Disease Control and Prevention. (2002,
June). Surveillance summaries. Morbidity and
Mortality Weekly Report, 51 (No. SS-4).
Hart, S., & Brock, S. E. (2010). Suicide risk
assessment. In A. Canter, L. Z. Paige, & S. Shaw
(Eds.), Helping children at home and school III:
Handouts for families and educators (S9H19).
Bethesda, MD: National Association of School
Psychologists.
Miller, M., & Hemenway, D. (2008). Guns and suicide
in the United States. New England Journal of
Medicine, 359, 989-991.
National Adolescent Health Information Center.
(2006). Fact sheet on suicide: Adolescents & young
adults. San Francisco: University of California,
San Francisco.
84
Seeley, J. R., Rohde, P., Lewinsohn, P. M., & Clarke,
G. N. (2002). Depression in youth: Epidemiology,
identification, and intervention. In M. R. Shinn, G.
M. Walker, & G. Stoner (Eds.), Interventions for
academic and behavior problems II: Preventive and
remedial approaches (pp. 885-911). Bethesda, MD:
National Association of School Psychologists.
Weiler-Timmins, E. (2010). Safe schools for lesbian,
gay, bisexual, transgender, and questioning
(LGBTQ) youth. In A. Canter, L. Z. Paige, & S.
Shaw (Eds.), Helping children at home and school III:
Handouts for families and educators (S7H13).
Bethesda, MD: National Association of School
Psychologists.
RECOMMENDED RESOURCES
Brock, S. E., Sandoval, 1., & Hart, S. (2006).
Suicidal ideation and behaviors. In G. G. Bear &
K. M. Minke (Eds.), Children's needs III:
Development, prevention, and intervention (pp. 225238). Bethesda, MD: National Association of
School Psychologists.
Coping and Support Training (CAST): http://www.
reconnectingyouth.com/CAST /
Counselors Care: http://www.promisingpractices.net/
program.asp?programid =156
Lazear, K., Roggenbaum, S., & Blase, K. (2003).
Youth suicide prevention school-based guide. Tampa,
FL: Department of Child & Family Studies.
Available: http://theguide.fmhLusf.edu/
SOS Signs of Suicide High School Program: http://
www.mentalhealthscreening.org/highschool/index
. aspx
Suicide Prevention Resource Center. Customized
information, teachers:
http://www.sprc.org/featured_resources/
customized/teachers.asp
Suicide Prevention Resource Center. Best Practices
Registry for suicide prevention: http://www.sprc.org/
featured_resources/bpr jindex.asp
World Health Organization. (2000). Preventing suicide:
A resource for teachers and other school staff.
Available:
http://www.who.inVmentaLhealth/media/
en/62.pdf
Shelley R. Hart, MA, NCSP, is a doctoral candidate and Shane R.
Jimerson, PhD, NCSP, is a Professor, both in the Department of
Counseling, Clinical, and School Psychology at the University of
California, Santa Barbara.
Suicide: Postvention Strategies for
School Personnel
BY ELLIE MARTINEZ, MA, & STEPHEN E. BROCK, PHD, NCSP, California State University, Sacramento
The American Association of Suicidology (AAS) defines suicide postvention as "the provision of crisis
intervention, support and assistance for those affected by a completed suicide" (1998, p. 1). It has been estimated
that six people are directly affected by each completed suicide. From this statistic, it has been suggested that
there are 4.6 million survivors of suicide in the United States (AAS, 2009). A survivor of suicide is considered a
family member, friend, classmate, teacher, or coworker who has been directly affected by suicide (Parrish &
Tunkle, 2005).
Because suicide is such an abrupt and tragic act, the emotions experienced by survivors vary in intensity and
duration. Survivors may experience shock, guilt, despair, denial, anger, disbelief, pain, shame, hopelessness,
rejection, confusion, and self-blame. While the bereavement of suicide survivors closely resembles the grieving
of other types of loss, survivors of suicide experience their emotional distress for 612 months longer and at a
measurably greater intensity than the nonsuicide group (Sakinofsky, 2007). This may lead to the exacerbation of
depression, suicidal ideation, posttraumatic stress, and preexisting substance abuse disorders. In addition, suicide
survivors initiate less social support during bereavement, possibly due to the stigma, guilt, and denial frequently
associated with suicide (Parrish & Tunkle, 2005).
Postvention typically involves procedures aimed at identifying individuals who may be significantly affected by
a suicide, as well as decreasing negative reactions by facilitating adaptive coping. The goals of suicide
postvention are to (a) assist the survivors of suicide with the grief process and (b) identify and refer those
survivors who may be at risk for depression, anxiety, and suicidal behaviors. Other goals include reducing
suicide contagion and providing appropriate and accurate information regarding the suicide (Brock, Sandoval, &
Hart, 2006; Parrish & Tunkle, 2005).
REDUCING SUICIDE CONTAGION
Suicide contagion accounts for 1-5% of adolescent suicides (Debski, Spadafore, Jacob, Poole, & Hixson, 2007).
Contagion is the phenomenon that involves an increase of suicidal behaviors shortly after a completed suicide.
Strategies to decrease the likelihood of contagion include avoiding sensationalism, which minimizes the
attention drawn towards the suicide. It is also important to avoid school·wide activities and permanent physical
memorials. If the suicide act is glorified in any way, survivors may identify with the victim, leading to imitation.
Thus, the death should not be romanticized or portrayed as noble. Details pertaining to the suicide act should be
disclosed at the request of the students only to dispel rumors, but specific details regarding the means, time,
location, and contents of a suicide note should not be provided.
ASSESSING THE NEED FOR AND PROVIDING SUPPORT
Assessment of students who may be affected by a completed suicide should take place immediately. Physical
and emotional closeness to the suicide as well as prior exposure to other instances of suicidal behavior are
important to consider. Sakinofsky (2007) found that students who were physically close to a suicide had an 18%
increased likelihood of developing posttraumatic stress disorder (PTSD) symptoms, whereas individuals who
were emotionally close (e.g., siblings and parents of the suicide victim) experienced increased rates of
depression and suicidal thoughts.
POSTVENTION STRATEGIES
Once the suicide impact has been assessed, postvention should be implemented. It is important to note that
postvention is not always needed. For example, if a suicide occurred during the summer months when school
was not in session, the likelihood that the death will affect the school will be minimized. In these
instances, postvention should not be provided, as it may bring unnecessary attention to the act and lead to
glorification (Brock, 2002). On the other hand, if postvention is not provided when it is needed, it may be
perceived that the suicide is being avoided, which can lead to shame and further complicate bereavement.
85
Address Social Stigma
Suicide is associated with stigma. If not dispelled, it
will negatively affect the bereavement process.
Survivors are often avoided or shunned by friends
and relatives either because of a lack of ability to
comfort or a fear of contagion. This in turn can lead
to isolation, self-blame, and reluctance to seek
emotional support from professionals (Parrish &
Tunkle, 2005; Brock, 2002). Thus, it is critical to
help provide social support as part of postvention.
Assess the suicide's impact on the school and
estimate the level of postvention response.
Assessment is conducted by evaluating physical and
emotional closeness to the suicide victim, and
temporal proximity to prior instances of suicidal
behavior. Students who may have been physically or
emotionally close to the suicide include classmates,
friends, girl/boyfriend(s), siblings, current and
previous teachers, and any individual(s) who found
the suicide victim. In addition, students who have a
history of suicidal behavior or mental illness may be
considered at risk for difficulty coping with the death.
Provide Information
Information should be provided to students in a way
that allows for understanding and clarification
without glorifying the act. It is recommended that
mental health professionals follow the victim's class
schedule to ensure that the disclosure of the death is
personal and that professional help is available to
address immediate needs. In addition, it is best that
the information regarding the death be presented to
students simultaneously and as soon as possible to
alleviate rumors. Information should not be disclosed
over a school's public address system or via an
assembly, as this may lead to glorifying or vilifying
the suicide act.
Notify other school personnel. Within the first hour
following verification of a death, other school
personnel who may be affected by the death and/or
playa role in the crisis team should be notified. All
other staff members at the student's school site should
be notified as soon as possible to allow them
adequate time to confront their own emotional
reactions. Teachers will need time to cope with the
death in order to be emotionally available for their
students.
The district office should also be notified, as families
within the community or the media may contact
them. Other potentially affected school sites (e.g.,
those with siblings or friends of the suicide victim)
should be notified as well.
Support Siblings
Particular attention should be given to siblings of the
suicide victim. Parents, in addition to their need to
discuss the suicide, may inadvertently place their
high expectations for the deceased child on the
surviving sibling, causing a sense of inadequacy
(Parrish & Tunkle, 2005). Because survivors may not
initiate mental health services, it is important that
they receive information about resources available to
them at school.
Contact the family of the suicide victim. The school
should offer their condolences to the family, as well
as postvention assistance and/or referrals. In addition,
the family can help identify any friends or relatives
who may need postvention.
Determine what and how to share information about
the death. As soon as possible and appropriate after a
reported death, information should be reported to
staff, students, and parents. Because it can take time
for the coroner's office to classify a death as a suicide,
the cause of death may be unknown at the time of the
initial communication with survivors. In this instance,
the crisis team will report that a death has occurred
and provide sympathy. Once the death has been
classified as a suicide, the crisis team should directly
acknowledge this fact, as well as address warning
signs, offer information about referrals, and address
contagion. It is important for the crisis team to
provide this information without sensationalizing or
vilifying the victim or providing excessive detail
about the act.
Suicide Postvention Protocol
If it is determined that postvention is needed, the
postvention team should follow specific procedures.
The following are from a suicide postvention
protocol developed by Brock (2002).
Verify that a death has occurred. It would be
detrimental to disclose a death to the student body
prior to verifying that a death has, in fact, occurred.
Without facts, the postvention team may not have the
information needed to dispel rumors. In addition, the
classification of a death as a suicide should be
avoided until such is confirmed by a coroner's office.
Mobilize the crisis intervention team. Successful
postvention is conducted as a team effort. Team
member roles should be assigned in advance and
responsibilities discussed.
86
Intervention services. Students identified as high risk
should be screened by a trained mental health professional to determine the level of support needed.
Referrals to outside agencies should be made if
emotional reactions indicate a need for mental health
treatment. School-based interventions include
classroom visits, drop-in counseling, individual and
group counseling, classroom activities and/or
presentations, parent meetings, and staff meetings.
Brock, S. E. (2002). School suicide postvention. In S. E.
Brock, P. J. Lazarus, & S. R. Jimerson (Eds.), Best
practices in school crisis prevention and intervention
(pp. 361-374). Bethesda, MD: National Association
of School Psychologists.
Brock, S. E., Sandoval, J., & Hart, S. R. (2006). Suicidal
ideation and behaviors. In G. G. Bear & K. M.
Minke (Eds.), Children's needs III: Development,
prevention, and intervention (pp. 225-237). Bethesda,
MD: National Association of School Psychologists.
Debski, J., Spadafore, C. D., Jacob, S., Poole, D. A, &
Hixson, M. D. (2007). Suicide intervention:
Training, roles, and knowledge of school
psychologists. Psychology in the Schools, 44, 157-170.
Parrish, M., & Tunkle, J. (2005). Clinical challenges
following an adolescent death by suicide:
Bereavement issues faced by family, friends,
schools, and clinicians. Clinical Social Work Journal,
33, 81-102.
Sakinofsky, I. (2007). The aftermath of suicide:
Managing survivors' bereavement. The Canadian
Journal of Psychiatry, 52, 129-136.
Memorials and funerals. Affected students with
parental permission can be encouraged to attend the
funeral service. Permitting permanent physical
memorials, flying a flag at half-mast, providing
transportation to the funeral service, and/or canceling
instruction for the funeral service should all be
avoided, as they may sensationalize the student's
death.
Dealing with the media. To avoid sensationalizing the
death, media personnel should be encouraged to not
make the death a front-page story, not use the term
"suicide" in the caption, and not use the victim's
picture in the story. Rather, media personnel should
be encouraged to portray the suicide as a poor choice
and an irreversible act, and to offer information
regarding suicide warning signs, risk factors, and
mental health referrals.
RECOMMENDED RESOURCES
American Association of Suicidology (AAS): http://
www.suicidology.org
American Association of Suicidology, Survivors of
suicide fact sheet:
http://www.suicidology.org/c/documenL
librarY/geUile?folderld =232&name= DLFE-23.
pdf
National Institute of Mental Health. (2008). Suicide in
the U.S.: Statistics and prevention:
http://www.nimh.nih. gov Ihea Ith/ publ ications/
suicide-i n-the-us-statisticsand-prevention.shtml
Suicide Awareness/Voices of Education (SAVE): http://
www.save.org
Debriefing. School staff members who are involved in
postvention need a structured environment to discuss
and process their emotional reactions. In addition,
debriefing provides the team an opportunity to
evaluate their performance and make changes to the
plan for future postventions.
CONCLUDING COMMENTS
Educators should strive to prevent suicide through
risk assessment and intervention. However, it is
equally important to provide postvention to suicide
survivors to help minimize severe psychopathology
and contagion. School personnel must be prepared to
deal with a suicide to ensure an emotionally
supportive environment for these survivors.
Ellie Martinez, MA, was a school psychology graduate student at California
State University, Sacramento at the time this handout was written. Stephen
E. Brock, PhD, NCSP, is a Professor in the Department of Special
Education, Rehabilitation, School Psychology, and Deaf Studies at
California State University, Sacramento and a member of the NASP National
Emergency Assistance Team. This handout is updated and adapted from
Weekly, N., &. Brock, S. E. (2004). Suicide: Postvention strategies for school
personnel. In A. S. Canter, L. Z. Paige, M. E. Roth, I. Romero, &. S. A.
Carroll (Eds.), Helping children at home and school II: Handouts for
families and educators (pp. S9: 45-47
REFERENCES
American Association of Suicidology. (1998). Suicide
postvention guidelines: Suggestions for dealing with
the aftermath of a suicide in the schools.
Washington, DC: Author.
American Association of Suicidology. (2009, April
19). U.S.A. suicide 2006: Official final data.
Washington, DC: Author. Retrieved June 30,
2009, from http:// www.suic id 01 ogy.o rg/ we bl
guest! stats-a nd -toolsl statistics
87
Save a Friend: Tips for Teens to
Prevent Suicide
BY RICHARD LIEBERMAN, MA, NCSP, Los Angeles Unified School District, CA
Growing up is not easy. Children and teens face many tough decisions and difficult life experiences that can
seem overwhelming at times. For some kids, a difficult, scary, or threatening situation can cause so much distress
that they start to think about killing themselves.
Suicide is the third leading cause of death for kids in middle school and high school, and it can be prevented if
adults and kids know the warning signs and what to do. Friends are especially in a position to help, because
research shows the #1 person a teenager wants to talk to in times of crisis is another teenager.
Although kids thinking about suicide are not likely to seek help, they may do say or do something, or write or
draw something that comes to the attention of a friend, classmate, parent, or school staff. Never ignore these signs.
You can help!
Situations that might cause some kids to think about suicide include breaking up with a boyfriend or girlfriend,
the death of a loved one, failing in school, an argument with a parent, getting in trouble with the law, and being
bullied or humiliated by friends. After a tragedy such as a natural disaster, school shooting, or terrorist attack,
some students might show warning signs of suicidal behavior. Children and youth who have experienced a
personal loss, abuse, or an earlier tragic or frightening event, or who suffer from depression or other emotional
problems, have a higher risk of suicide. Sometimes kids try to cope with these problems poorly by abusing
alcohol and drugs or engaging in self-injury. These attempts to feel better rarely work out that way.
SUICIDE WARNING SIGNS
If you want to help prevent a suicide, the first step is to learn the warning signs. Then learn the steps to take to
save a friend.
Warning signs include:
Suicide notes. These are a very real sign of danger and should be taken seriously.
Plan/method/access. A suicidal child or adolescent may show an increased interest in guns and other weapons,
may seem to have increased access to such things as guns and pills, and/or may talk about or hint at a suicide
plan. The greater the planning, the greater the potential for suicide.
Threats. Threats may be direct statements ("I want to die," "I am going to kill myself") or indirect comments
("The world would be better without me," "Nobody will miss me anyway"). Among teenagers, indirect clues
could be offered through joking or comments in school assignments, particularly creative writing or artwork.
Younger children and those who may have some delays in their development may not be able to express
their feelings in words, but may provide indirect clues in the form of acting out or violent behavior, often
with threatening or suicidal comments.
Previous attempts. If a child or teenager has attempted suicide in the past, there is a greater likelihood that he
or she will try again. Keep a close eye on any friends who have tried suicide before.
Depression (helplessness/hopelessness). When symptoms of depression include strong thoughts of helplessness
and hopelessness, a child or adolescent is possibly at greater risk for suicide. Watch out for behaviors or
comments that indicate your friend is feeling overwhelmed by sadness or negative views of his or her future.
Masked depression. Sometimes kids cope in very poor ways that look different from how we expect a
depressed person to act. Risk-taking behaviors can include acts of aggression, gunplay, and alcohol or other
drug abuse. While your friend does not act depressed, his or her behavior might suggest a lack of concern for
his or her own safety. Drinking and dangerous driving is the #1 killer of youth in America and it is
preventable.
88
Final arrangements. This behavior may take many
forms. Teens might give away prized possessions
such as jewelry, clothing, journals, or pictures.
Efforts to hurt oneself. Self-injury behaviors are
warning signs for young children as well as
teenagers. Common self-destructive behaviors
include running into traffic, jumping from heights,
and scratching, cutting, or marking the body.
Inability to concentrate or think clearly. Such
problems may be reflected in classroom behavior,
homework habits, academic performance,
household chores, even conversation. If your friend
starts skipping classes, getting poor grades, acting
up in class, forgetting or poorly performing chores
around the house, and/or talking in a way that
suggests he or she is having trouble concentrating,
these might be signs of stress and risk for suicide.
Changes in physical habits and appearance. These
include being unable to sleep or sleeping all the
time, sudden weight gain or loss, and/or loss of
interest in appearance or personal hygiene.
Sudden changes in personality, friends, and behaviors.
Parents, teachers, and friends are often the best
observers of sudden changes in suicidal students.
Changes can include withdrawing from friends and
family, skipping school or classes, dropping out of
activities that were once important, and/or avoiding
friends.
Death and suicidal themes. These might appear in
classroom drawings, work samples, journals, or
homework.
WHAT CAN YOU DO TO HELP A FRIEND?
There are several things you can do to help a friend
who is thinking about suicide:
Know the warning signs. Read the list. Keep it in a
safe place.
Do not be afraid to talk to your friends. listen to their
feelings. Make sure they know how important they
are to you, but don't believe you can keep them
from hurting themselves on your own. Preventing
suicide will require adult help.
89
Make no deals. Never keep secret' a friend's suicidal
plans or thoughts. You cannot promise that you
will not tell-you have to tell to save your friend.
Tell an adult. Talk to your parent, your friend's
parent, your school's psychologist or counselor-a
trusted adult. Don't wait. Don't be afraid that the
adults will not believe you or take you seriouslykeep talking until they listen. Even if you are not
sure your friend is suicidal, talk to someone. This
is definitely the time to be safe and not sorry.
Ask if your school has a crisis team. Many schools
(elementary, middle, and high schools) have organized crisis teams that include teachers,
counselors, social workers, psychologists, and
principals. These teams help train all staff to
recognize warning signs of suicide as well as how
to help in a crisis situation. These teams can also
help students understand warning signs of
violence and suicide. If your school does not have
a crisis team, ask your student council or faculty
advisor to look into starting one. If your school
does have a crisis team with student members,
look into joining it.
RECOMMENDED RESOURCES
Boys Town Suicide and Crisis line: (800) 448-3000
or (800) 448-1833 (TDD)
National Suicide Hotline: (800) 273- TALK [(800)
2738255]
Self-Injury Hotline: 800-DONTCUT [(800) 3668288]
Suicide Prevention Resource Center:
http://www.sprc. org
Richard Lieberman, MA, NCSP, is a school psychologist
and crisis specialist with the Los Angeles Unified School
District and a member of the National Emergency
Assistance Team of the National Association of School
Psychologists.
Crisis Caregivers:
Taking Care of Ourselves
BY CATHY KENNEDY PAINE, SSSP, Springfield Public Schools, OR
Parents, teachers, and other caregivers playa critical role in helping children cope with crises. Typically, crisis
caregivers respond at the scene of a tragic event and are specially trained to assist victims or survivors to cope
with the impact of the event. Teachers and other educators may also become crisis caregivers when the event
affects children in their care. The natural instinct is to put one's own needs aside and tend to children first. It is
extremely important, however, for caregivers to monitor their own reactions and take care of their own needs. No
one who responds to a crisis event is untouched by it. All caregivers are at risk for burnout, also known as
compassion fatigue, which interferes with one's ability to provide crisis intervention assistance. This occurs when
caregivers experience a trauma event through listening to the story of the event and experience emotional
reactions through empathetic contact with the survivors. This can occur in the aftermath of an immediate crisis,
like a natural disaster or terrorist attack, as well as during extended periods of stress and anxiety, like the war in
Iraq.
Following are some suggestions to help caregivers maintain their own well-being as they support the needs of
children in their care.
ROLE OF THE CAREGIVER
Crisis caregivers usually include emergency response professionals, mental health providers, medical
professionals, victim assistance counselors, and faith leaders. They are trained to handle exposure to images of
destruction and loss and to assist victims or survivors to cope with the impact of the event. They seek to help
individuals, schools, and communities reestablish a sense of balance in a world that seems radically out of kilter
with what they previously knew.
Preparation
When caregivers go to the scene of an event to help those affected, they should have formal training in crisis
response and only go into the situation if they are invited to do so by major authorities in the affected area. Going
into such a setting without an invitation may be perceived as an intrusion or an invasion of privacy. Teachers and
administrators are key stabilizing elements in the lives of children, but most have had no formal training in
mental health or crisis response and intervention. Educators who lack the requisite skills need to be careful not to
go beyond their training because they run the risk of making a very difficult situation worse.
Education and Support
Caregivers help to educate survivors with accurate information and connect them to available resources in their
community, city, or state. They also help survivors deal with feelings of guilt, helplessness, anger, fear, and grief.
While most individuals will not require intensive services, caregivers sometimes are needed to provide ongoing
support to individuals who are feeling anxious, stressed, and/or fearful about the event and its impact on their
future. Effective crisis caregivers try to offer support and assistance in ways that maintain the freedom of choice
of the individual(s) in need, and they coordinate their efforts with other crisis response activities. Caregivers may
also help frontline responders who may have experienced the horror of death and destruction and the immediate
aftermath of an event.
THE RISK AND SIGNS OF BURNOUT
Caring for the victims of crisis events is both physically and emotionally draining. The sense of normalcy is
disrupted, the services we all rely on may not function, and the level of human need may be enormous. Need for
care may continue for an extended period of time, as in the September 2001 terrorist attacks of the aftermath of
school violence. Meeting this need can be particularly difficult, since many crisis responders have other jobs
from which they are taking a leave of abosence or are trying to conduct at the same time. This is especially true
for teachers, school mental health professionals, and administrators who are trying to meet the needs of students,
90
Affective
staff members, and families while maintaining a
normal learning environment. Caregivers must
understand their own vulnerability to stress and
recognize signs of burnout.
Suicidal thoughts and/or severe depression
Irritability leading to anger or rage
Intense cynicism and/or pessimism
Excessive worry about crisis victims and their
families
Being upset or jealous when others are doing crisis
interventions
A compulsion to be involved in every crisis
intervention
Significant agitation and restlessness after
conducting a crisis intervention
Risk for Burnout
Caregivers must be aware of their own needs while at
the same time attending to the many needs of others.
At the early stages of crisis response, caregivers may
have abundant energy and motivation. Their
cognitive functioning, training, and resilience make
them important assets to the children under their care.
However, as a crisis intervention continues,
caregivers may find themselves experiencing
physical or psychological burnout. Images of
violence, despair, and hardship and/or continuous
concern over possible danger can contribute to
feeling professionally isolated and depressed, particularly if caregivers do not have the opportunity to
process their reactions.
Successes may be ambiguous or few and far
between. In some cases, lack of sleep and limited
opportunities for healthy nourishment break down the
capacity to cope effectively. Caregivers can begin to
feel more like victims than helpers. Additionally,
caregivers who have their own history of prior
psychological trauma or mental illness (including
substance abuse) will be more vulnerable to burnout,
as will those who lack social and family resources.
Behavioral
Alcohol and substance abuse
Withdrawal from contact with coworkers, friends,
and/or family
Impulsive behaviors
Maintaining an unnecessary degree of contact!
follow-up with crisis victims and their families
An inability to complete/return to normal job
responsibilities
Attempting to work independently of the crisis
intervention team
The Warning Signs of Burnout
It is important to realize that burnout develops
gradually, but its warning signs are recognizable
beforehand. These include:
Cognitive
An inability to stop thinking about the crisis, crisis
victims, and/or the crisis intervention
Loss of objectivity
An inability to make decisions and/or express
oneself either verbally or in writing
Disorientation or confusion, or difficulty
concentrating
Personal identification with crisis victims and their
families
Physical
Overwhelming/chronic fatigue and/or sleep disturbances
Gastrointestinal problems, headaches, nausea, and
other aches and pains
Eating problems including eating too much or loss
of appetite
91
PREVENTING BURNOUT AND MINIMIZING STRESS
Whether it is in the aftermath of a serious crisis or during
an extended period of high stress, the repeated stories of
crisis-affected individuals, as well as the unrelenting
demand for support, may result in burnout for even the
most seasoned crisis caregivers. The risk may be higher
for teachers and other caregivers who are not trained
crisis responders.
Stress management is key to effective crisis
response. Crisis caregivers can manage and alleviate
stress by taking care of themselves while helping
others, thus preventing or minimizing burnout. All
crisis caregivers should consider the following
personal and professional suggestions to aid in
preventing burnout.
Know Yourself and Your Role
Know your limitations and what you feel
reasonably comfortable or uncomfortable handling.
Know your own triggers for stress.
Recognize that your reactions are normal and occur
frequently among many well-trained crisis professionals.
Understand when your own experience with
trauma may interfere with your effectiveness as a
caregiver.
Recognize and heed the early warning signs of
burnout-listen to your body.
Be clear about your role in the crisis intervention
and always work as part of a team.
Know the crisis plan in your place of work.
RECOMMENDED RESOURCES
Print
Brock, S. E., Sandoval, J., & Lewis, S. (2001).
Preparing for crises in the schools: A manual 'for
building school crisis response teams. New York:
Wiley.
Figley, C. R. (2002). Treating compassion fatigue. New
York: Brunner-Routledge.
Heath, M. A., & Sheen, D. (2005). School-based crisis
intervention: Preparing all personnel to assist. New
York: Guilford Press.
Mitchell, J. T., & Everly, G. S. (2001). Critical Incident
Stress Debriefing: An operations manual for ClSD,
defusing and other group crisis intervention services
(3rd ed.). Ellicott City, MD: Chevron.
Poland, S., & McCormick, J. (2000). Coping with crisis:
A quick reference. Longmont, CO: Sopris West.
Available from Cambium Learning at http://store.
cambiumlearning.com
U.s. Department of Health and Human Services.
(2005). A guide to managing stress in crisis response
professions. DHHS Pub. No. SMA 4113. Rockville,
MD: Center for Mental Health Services, Substance
Abuse and Mental Health Services Administration.
Free copies available at 1-800-789-2647.
Available: http:// download.ncadLsam
hsa.gov/ken/pdf/SMA4113/Stressmgt.pdf
Take Care of Yourself
To the extent possible, maintain normal daily
routines.
Connect with trusted friends or family members
who can help support you.
Eat healthy foods and drink plenty of water.
Take frequent rest breaks-at least every couple of
hours.
As much as possible, try to get some restful sleep.
Get physical exercise.
Give yourself permission to do things that you
find pleasurable (e.g., going shopping or out to
dinner with friends).
Avoid using alcohol and drugs to cope with the
effects of being a caregiver.
Ask for help from family and friends to reduce
pressures or demands during the crisis response.
Renew your spiritual connections.
Avoid excessive news coverage of the event.
Do the things that reduce stress for you (read,
listen to music, take deep breaths, meditate, walk,
laugh).
Take time at the end of each day to process or
debrief the events of the day with other caregivers
or colleagues.
Use a buddy system so coworkers can monitor
each other's stress reactions.
Be kind and gentle on yourself and others, as you
have all shared exposure to a life-changing event.
Everyone needs time to process the impact of these
events on their lives.
Take advantage of employee assistance programs
if you need to do so.
Online
Centers for Disease Control and Prevention: http://
www.cdc.gov
National Association of School Psychologists: http://
www.nasponline.org
National Institute of Mental Health: http://www.nimh.
nih.gov
National Organization for Victim Assistance: http://
www.trynova.org
Substance Abuse and Mental Health Services
Administration, National Mental Health
Information Center:
http://mentalhealth.samhsa.gov
SUMMARY
Parents, teachers, administrators, and emergency professionals all play an important role in helping
children cope with crises. As caregivers to those who
need support after tragic events, we must take good
care of ourselves so we are able to take good care of
those in our charge.
Adapted from materials posted on the National Association of School
Psychologists website. Cathy Kennedy Paine, SSSP, is a Program
Administrator and Crisis Team Leader in the Springfield Public Schools in
Oregon and a member of the NASP National Emergency Assistance Team .
92
Trauma Reactions in Children:
Information for Parents and Caregivers
BY LINDA M. KANAN, PHD, & AMY E. PLOG, PHD, Cherry Creek School District, Greenwood Village, CO
The National Child Traumatic Stress Network defines trauma as "an intense event that threatens or causes harm
to [a child's] emotional and physical well-being" (NCTSN, 2003). Trauma can result from children's exposure to
a variety of events that typically evoke feelings of fear or helplessness. It follows exposure to natural disasters,
such as floods or hurricanes; witnessing or being the victim of violence, serious injury, or abuse; or from threats
or acts of terrorism and war. Trauma can also result from events such as accidents, medical procedures, or the
loss of a loved one.
Children may experience both physical and emotional distress as a result of a traumatic event.
However, most children are resilient following trauma and do not develop long-lasting problems. While some
reactions such as emotional upset or overreaction, headaches or stomachaches, and jumpiness or agitation are
considered normal immediately following a traumatic event, caregivers must be alert for longer-lasting reactions
that interfere with daily functioning, school performance, and/or relationships over time.
FACTORS AFFECTING TRAUMA REACTIONS IN CHILDREN
Children's reactions to trauma differ, even for children who are exposed to the same event. Differences depend
on:
Event factors. These differences result from the type of traumatic event, the source of the physical threat or
injury, and the presence of fatalities. Acts of violence may be perceived as more traumatic than natural
disasters. Events that result in injury or deaths are more traumatic than events without such outcomes.
Experience factors. Children's reactions to traumatic events depend on how close they were to the event, the
nature of their relationship with others who were victimized, and their own perceived degree threat and
initial reactions.
Personal factors. Reactions may differ as a result of a child's age, previous trauma exposure, overall
emotional health, previous coping skills, self-esteem, cultural norms, developmental level, and the
availability of family and social support.
CHILDREN'S REACTIONS TO TRAUMA
Children's trauma reactions fall into in four general categories that can be found across all developmental stages:
Emotional: shock, anger, fear, irritability, sadness, grief, guilt, loss of pleasure, depression
Cognitive: difficulty with concentration, decision-making, memory; confusion; worry; intrusive thoughts,
memories, nightmares; decreased self-esteem
Physical: fatigue, sleep disturbance, physical complaints, increased activity level, decreased appetite
Behavioral: social withdrawal, relationship conflicts or aggression, school refusal or school difficulties,
avoidance of reminders, crying easily, regression to a previous developmental level, increased risktaking
93
Children react differently to trauma depending
on their developmental stage.
Increased activity level, restlessness, irritability
Behavior problems at home or school
Preschoolers' Reactions
Because preschool children have more difficulty
describing their feelings in words, their trauma
reactions may be expressed through nonverbal
behavior. They also may be displayed as general fears
not clearly connected to the traumatic event itself.
Reactions may include:
Adolescents' Reactions
Adolescents may become more self-conscious about
their emotional responses, fears, and feelings of
vulnerability after a trauma. They proc'ess events
more cognitively and verbally than younger children.
However, behavioral reactions to trauma do occur
and may include:
Clinging, difficulty being alone (including
sleeping
alone) or separating from caregivers
Tantrums, misbehavior
Crying easily
Appearing scared, generalized fear
Loss of previously acquired developmental
milestones (e.g., speech and toileting)
Recreation of the traumatic event through play
(may be repetitive play related to the event)
Disturbed sleep, fear of going to sleep, or
nightmares (may be specific or generalized fears)
Worry about recurrence or consequences of the
event, fear for their own safety or the safety of
others
Self-consciousness about fears or worries, shame
or guilt
Repeated discussion about the event or avoidance
of discussion
Exaggerated reactions to loud or startling stimuli
Difficulty expressing feelings or worries due to
concerns about being different from peers
Withdrawal from others, school refusal,
attendance
difficulties, avoidance of reminders
Revenge or retribution fantasies
Decreased attention/concentration in school
Increased activity level
Irritability, anger, aggression, oppositional
responses, difficulty with authority
Sleep disturbance, nightmares (may also
reexperience
event in daydreams)
Physical complaints (e.g., headaches,
stomachaches)
Repetitive thoughts, comments about death and
dying
Sense of a foreshortened future or changed
identity (e.g., life isn't worth it anyway)
Risk-taking or self-destructive behavior (e.g.,
alcohol, drug use, sexual risk-taking, self-injury,
suicidal ideation/behavior)
Reactions of Elementary School Children Elementaryage children may communicate their trauma reactions
verbally or directly, but behavioral expression
continues to be common in this age group. Trauma
reactions tend to focus on more event-specific fears
or concerns and may include:
Worry about recurrence of the event, or about
their own safety or the safety of others
Fear of being alone
More clingy or anxious; overreaction to startling
noises
Talking a lot about the event or not at all
Overwhelming emotions or apparent lack of
feelings about event
Preoccupation with their own behavior during the
event (e.g., guilt or shame over something
done/not done)
Difficulty learning and concentrating in school
Difficulty with authority
Physical symptoms or complaints (e.g.,
headaches/ stomachaches)
Withdrawal from others, avoidance of activities,
school refusal
Loss of previously acquired developmental
milestones (e.g., speech, toileting, school skills)
Recreation of the traumatic event through talk,
writing, drawing, or play
Disturbed sleep, fear of going to sleep, or
nightmares
HOW ADULTS CAN HELP
Caregivers are key sources of support to children
after a traumatic event. By following some general
guidelines, caring adults can help children who have
been traumatized, regardless of their age. It is
important to understand that children and adults may
react to trauma in different ways. Caregivers should
familiarize themselves with the normal range of
developmental reactions to trauma. Also, adults
should remember that they also need to come to terms
with the event and care for themselves, so they can
care for children. Some general strategies include:
94
Help reestablish the child's sense of safety and
security
Reassure children they will be cared for and that
events are not their fault
Minimize exposure to media or traumatic
reminders
Give opportunities to talk about the event in a
safe, supportive environment
Correct misperceptions the child may have about
the event; give clear explanations when the child
asks; repeat information as needed
Don't give details or information that would
unnecessarily frighten children
Encourage expression of feelings and help
normalize upset feelings
Tolerate regressive behavior in the immediate
aftermath (e.g., sleeping with the light on or with
an adult)
Return to home and school routines as soon as
possible to connect children with their natural
support systems
Provide opportunities for children to build skills
for coping, anger management, problem solving,
and dealing with intense emotions
Know when and how to get help for serious or
ongoing difficulties
Reassure children that the event is over, they are
safe, and adults are working to keep them safe
Provide a safe place and encouragement and
opportunities for children to talk about their
concerns, fears, worries
Reassure children that their feelings are normal
Clarify the difference between reminders of the
event (e.g., sounds, smells, memories) and the
event itself
Understand that children will' have difficulties
with concentration and learning
Give children choices, when possible
Encourage problem solving as needed and recreational activities as an outlet
Responding to Adolescents After Trauma
Adults must be alert to warning signs such as
possible increased risk-taking, substance abuse, or
suicidal feelings that may be experienced by
adolescents:
Provide a safe place, encouragement, and
opportunities for teens to talk about the event and
their concerns, fears, worries
Reassure teens that their feelings/attitudes are
normal; provide information on normal trauma
reactions
Discourage watching repetitive media coverage;
discuss their potential for triggering fear or other
reactions
Encourage positive coping strategies and reaching
out to others for needed support
Discuss and discourage risk-taking behavior (e.g.,
alcohol, drugs, sexual risk-taking, suicidal
behavior) as a dangerous way of coping
Support teens through strains on their
relationships and academics
Help teens understand and tolerate others'
reactions to trauma
Help teens understand their negative behavior as
an effort to voice anger about trauma
Discuss and discourage any expressed actions of
retribution/revenge
Encourage constructive activities as an outlet for
concerns
Responding to Preschool Children After Trauma
Parents and educators of preschool children provide
the primary role of support and comfort to the child:
Reassure children that the event is over and they
are safe
Provide opportunities to rest, play, draw
Help children put feelings or fears into words, as
possible
Stay as calm as you can
Provide consistent caregiving (e.g., make sure
children are picked up at the right time, continue
the routine of preschool)
Tolerate a return to earlier behaviors for a brief
time following the trauma (e.g., thumb sucking,
bedwetting, needing to be in your lap)
Provide calming activities before bedtime, allow
child to sleep with a night light on or with parent
for limited time
Take your cues from the children about the
amount of information needed
WHEN MORE HELP IS NEEDED
For children of any age, an important role for
caregivers is to be observant and recognize when the
child's trauma reactions may warrant a referral to an
appropriate mental health professional. Signs that
adults should look for generally include more severe
or persistent expression of the responses described
Responding to School-Age Children After Trauma
School-age children take their cues from parents' and
educators' reactions to traumatic events. Caregivers
can help provide calming and clarifying information:
95
above or symptoms that continue for four weeks or
more. Adults should watch for the following warning
signs, both by directly observing children's behavior
and by asking children how they are doing and what
they are feeling:
Mental detachment or disconnection from
surround ings
Panic attacks
Severe memory, concentration, or sleep problems
Persistent and severe reexperiencing of the trauma
(e.g., flashbacks, nightmares, thoughts/images)
Extreme social withdrawal or isolation to avoid
crisis
reminders
Persistent depression symptoms
Delusions, hallucinations, or bizarre thoughts
Substance abuse/self medication
Suicidal or homicidal thoughts or behavior
Extreme inappropriate anger or abuse of others
Your school mental health professional and family
physician can help you identify appropriate sources
of treatment in your community. A growing body of
research suggests that youth with severe trauma
reactions respond well to mental health treatment.
Parents and other caregivers can be hopeful about
long-term recovery for children after traumatic
events.
Brock, S. E. (2006). PREP£RE: Crisis intervention and
recovery: The roles of the school-based mental health
professional. Bethesda, MD: National Association
of School Psychologists.
Brock, S. E., & Jimerson, S. R. (2004). School crisis
interventions: Strategies for addressing the consequences of crisis events. In E. R. Gerler, Jr. (Ed.),
Handbook of school violence (pp. 285-332).
Binghamton, NY: Haworth Press.
Online
Brymer, M., Jacobs, A., Layne, c., Pynoos, R., Ruzek,
J., Steinberg, A., et al. (2006). Psychological first
aid: Field operations guide (2nd ed.). Washington,
DC: National Child Traumatic Stress Network and
National Center for PTSD. Available:
http://www.ptsd.va.gov/professionaV
manuals/psych-first-aid.asp
FEMA for Kids, Resources for parents and teachers:
http:// www.fema.gov/kids/teacher.htm #school
safe National Association of School
Psychologists, School safety and crisis response
resources: http://www. nasponl ine.org! resources/
cri sis_safety
National Child Traumatic Stress Network:
http://www. nctsn.org
In Spanish:
http://www.nctsn.org!nccts/nav.do?pid= ctr
_aud_spanish
National Child Traumatic Stress Network. (2008).
Child trauma toolkit for educators. Available:
http://www. nctsnet.org!nccts/nav.do ?pid = ctr
_ctte
REFERENCE
National Child Traumatic Stress Network. (2003).
What is child traumatic stress? Washington, DC:
Substance Abuse and Mental Health Services
Administration. Retrieved July 26, 2009, from:
http://www.nctsnet. org! nets n_a ssets/ pdfs/ wh
aU s_ ch i I d_ t ra u m at i C stress.pdf
Linda M. Kanan, PhD, is a school psychologist and Intervention
Coordinator in the Cherry Creek School District in Greenwood Village,
CO. Amy E. Plog, PhD, is a Research and Data Coordinator with the
Cherry Creek School District.
RECOMMENDED RESOURCES
Print
Brock, S. E. (2002). Identifying individuals at risk for
psychological trauma. In S. E. Brock, P. J.
Lazarus, & S. R. Jimerson (Eds.), Best practices in
school crisis prevention and intervention (pp. 367383). Bethesda, MD: National Association of
School Psychologists.
96
Trauma Victims and Psychological Triage:
Considerations for School Mental Health
Professionals
BY STEPHEN E. BROCK, PHD, NCSP, California State University, Sacramento
MELISSA A. REEVES, PHD, NCSP, Winthrop University, Rock Hill, SC
Psychological triage is a technique for determining crisis intervention treatment priorities and needs following a
crisis event. The use of these strategies is especially important whenever the number of psychological trauma
victims exceeds the number of available crisis interveners. While virtually anyone exposed to a traumatic event
will be affected to some degree, not everyone will become a psychological trauma victim.
DETERMINING RISK FOR PSYCHOLOGICAL TRAUMA
Psychological trauma is not simply a consequence of crisis event exposure. It is also a consequence of how
individuals experience the event (Le., personal crisis experiences) and how that experience interacts with a
number of individual characteristics (Le., personal vulnerabilities). Individual crisis threat perceptions are also
key to determining the risk for psychological trauma. Additionally, warning signs, or crisis reactions, should be
considered when evaluating an individual's risk for psychological trauma.
Personal Crisis Experiences
Individual crisis experiences relevant to psychological triage include both physical and emotional proximity to
the traumatic event. Physical proximity is the single most important triage factor to consider. The closer the
individual is to the traumatic event, and the longer the exposure, the greater the likelihood of psychological
trauma. Emotional proximity is the second most important factor. Having (or having had) a relationship with
crisis victims is also associated with psychological trauma. The stronger the relationship(s) the individual has
with crisis victims, the greater the likelihood that psychological trauma will result. In particular, crisis events
that involve the sudden and unexpected death of a family member have a high probability of generating
significant stress in a person.
Personal Vulnerabilities
Individual characteristics or personal vulnerabilities associated with psychological trauma include both external
and internal factors.
External factors. External factors that increase an individual's vulnerability to traumatic stress reactions include
familial and social relationships. More specifically, individuals are more likely to become psychological trauma
victims when exposed to a traumatic event if they:
Do not have easy physical access to a nuclear family member
Come from dysfunctional family situations
Are exposed to family violence
Have a family history of mental illness
Live with caregivers who have acute stress disorder (ASD) or posttraumatic stress disorder (PTSD)
Individuals who face a traumatic event without supportive and nurturing friends or relatives suffer more than
those who have at lease one source of such support. The following factors increase vulnerability to
psychological trauma:
The absence of close peer friendships
Limited or no access to positive adult models outside of the family
Limited or no connections to prosocial organizations or institutions (such as school)
97
Primary Evaluation
Primary evaluation begins as soon as possible and
before individual students or staff are offered any
interventions. Initial decisions are made regarding
what form of school crisis intervention (if any) is
needed and are based on the trauma risk factors (Le.,
physical and emotional proximity to the traumatic
event, personal vulnerabilities, immediate crisis
reactions). Primary evaluation relies heavily on facts
and identifies individuals most likely to have been
traumatized and those needing initial supportive
interventions.
Internal factors. Internal factors that increase an
individual's vulnerability to traumatic stress reactions
include:
Tendency to make use of avoidance coping
behaviors
Prior mental illness
Poor emotional control
Low developmental level
Poor self-efficacy
Personal trauma history
Secondary Evaluation
Secondary evaluation takes place as initial immediate
school crisis intervention responses are provided.
This level examines the crisis facts in addition to
warning signs (Le., crisis reactions). Individual
and/or group screening measures may be used.
Threat Perceptions
It is important for crisis interveners to recognize that
if a child subjectively views an event as personally
threatening, regardless of the presence or lack of
objective danger, then that child is more at risk for
psychological trauma. Children's perceptions of a
threat are strongly correlated and influenced by the
reactions of caregivers. Crises that are initially not
perceived as threatening may become so after a child
observes the panic reactions of parents, caregivers, or
teachers. In addition, it is important to remember that
children may not view a traumatic event as
threatening because they are too young to recognize
and understand the potential danger. Conversely,
relative cognitive sophistication may make a young
child more vulnerable to understanding the
magnitude of a traumatic event.
Tertiary Evaluation
Tertiary evaluation takes place during the later stages
of school crisis intervention and documents more
severe trauma reactions indicative of
psychopathology. The primary goal of this level of
evaluation is to identify students and staff who
require professional mental health interventions.
CONCLUDING COMMENTS
A number of factors contribute to psychological
trauma. The evaluation of psychological trauma
begins before conducting crisis interventions;
however, the process of identifying those individuals
who need support services is an ongoing activity'that
continues as interventions are delivered.
Although physical proximity to the crisis plays a
primary role (and all exposed individuals will be
affected to some degree), other variables such as
familiarity with victims, personal vulnerabilities,
perceptions of crisis-related danger, and reactions to
the crisis event are also important. Knowledge of
these factors may be especially helpful when
distinguishing those who are likely to cope with a
traumatic event in an adaptive manner from those
who are likely to have ongoing difficulties, such as
developing posttraumatic stress disorder.
Warning Signs: Crisis Readions
Those individuals who display more severe reactions
(e.g., those who dissociate or panic) during a crisis
event are also at increased risk for traumatic stress.
Following a crisis event, there are concrete warning
signs indicating an individual has been
psychologically traumatized. Although some initial
crisis reactions are to be expected, more severe crisis
reactions and highly maladaptive coping behaviors
will signal the need for immediate mental health
referrals. Examples of these extreme reactions
include dissociative amnesia, panic attacks, behaving
as if the event was reoccurring, agoraphobic
avoidance of crisis reminders, severe depression, and
psychosis. Examples of highly maladaptive coping
behaviors include suicidal and homicidal ideation.
RECOMMENDED RESOURCES
Print
Brock, S. E. (2002). Identifying psychological trauma
victims. In S. E. Brock, P. J. Lazarus, & S. R.
Jimerson (Eds.), Best practices in school crisis
prevention and intervention (pp. 367-383). Bethesda,
MD: National Association of School
Psychologists.
CONDUCTING PSYCHOLOGICAL TRIAGE
Psychological triage is a dynamic process, not an
event, beginning with the evaluation of psychological
trauma. Before conducting triage, it is important to
have an alreadydeveloped list of mental health
resources for individuals to access. Psychological
triage has three specific levels.
98
National Child Traumatic Stress Network, Assessing
exposure to psychological trauma and post-traumatic
stress in the juvenile justice population. Available:
http://www.nctsnet.org/ncctS/asset.do ?id = 515
Brock, S. E., Nickerson, A. B., Reeves, M. A.,
Jimerson, S. R., Lieberman, R. A., & Feinberg. T.
A. (2009). School crisis prevention and intervention:
The PREP£!.RE model. Bethesda, MD: National
Association of School Psychologists.
Brock, S. E., Sandoval, J., & Lewis, S. (2001).
Preparing for crises in the schools: A manual for
building school crisis response teams (2nd ed.). New
York: Wiley.
Stephen E. Brock, PhD, NCSP, is a Professor in the
Department of Special Education, Rehabilitation, School
Psychology, and Deaf Studies at California State University,
Sacramento and a member of the NASP National Emergency
Assistance Team. Melissa Reeves, PhD, is on the faculty of
the School Psychology Program at Winthrop University in
Rock Hill, Sc. Both are coauthors and trainers of the NASP
PREP£RE curriculum designed to train crisis responders.
Online
National Centerfor Posttraumatic Stress
Disorder/National Child Traumatic Stress
Network, Psychological first aid: Field operations
guide for disaster mental health responders. Available:
http://www.ncptsd.va.gov/ncmain/ ncdocs/
manuals/ nc_manuaLpsyfi rstaid.html
National Child Traumatic Stress Network:
http://www. nctsnet.org
99
Memorial Activities and Traumatic Events:
Guidelines for Educators
BY DONALD W. KODLUBOY, PHD, LP, NCSP, St. Paul, MN
Responding to the death of a student, staff member, or family member of students or staff is one of the most
difficult tasks educators face. The school is often asked to participate in the production of temporary or
permanent memorials to the deceased. Memorials can unite the school, emphasize the value of each life, and
promote growth. Conversely, memorials can divide a school community.
TYPES OF MEMORIALS
Memorials can take several forms. Transient or impromptu memorials may be static, such as posters, letters of
condolence, or flowers placed at a particular location. Alternately, transient memorials may be active and include
gatherings of students to give mutual support and share memories of the deceased, or formal assemblies to
discuss the death.
Permanent memorials persist beyond the immediate time of the incident or loss. Examples include establishing a
scholarship fund, installing a plaque, planting a tree on school grounds, or sealing a locker formerly occupied by
a student lost to violence. Permanent memorials are often controversial. Their design, placement, and message
can be either healing or divisive.
When reviewing the suitability of any memorial, it is imperative to clarify:
The function of the memorial
Whether the memorial is consistent with the mission of the school and the age of the students
Whether the memorial is inclusive of all students rather than potentially divisive
That the decision making about the memorial is not hasty or driven solely by emotion
Whether the memorial is consistent with best practices in mental health and school safety
Whether the memorial promotes safety in the school and community (and does not increase risk)
PRIOR PLANNING
Once a crisis occurs and the issue of memorials arises in a school, it is generally too late for calm consideration
of critical issues. In the aftermath of a loss, it is common for stressed personnel to make questionable decisions
regarding memorials. The best approach to memorials is prior preparation of clear written procedures and
protocols for the process and placement of memorials in and around a school. The school district legal counsel
should review any plans. School personnel are encouraged to include policies and procedures for memorials in
crisis plans and to have them at hand or in their go kit.
Decision Making
While most schools have a crisis response team, stressed administrative or staff members may bypass the team or
challenge team decisions in response to other pressures. Additionally, many crisis response protocols do not
address the issue of memorials. It is important to not publicly challenge potentially problematic suggestions
regarding memorials. Private discussion with decision makers to recommend a deliberate course of action may
be more effective. Offer informed alternatives, giving reasons why each alternative is a better choice and
highlighting the ethical, legal, or procedural reasons. A simple protocol to facilitate planning and consideration
of any memorial before such activities get underway or before permanent memorials are proposed can make the
process go more smoothly.
100
Basic Assumptions for Memorials
School personnel should consider the following in
developing plans and policies:
Safety is a priority.
Any action or activity that decreases safety or
increases risk should be avoided.
Because people grieve and seek to memorialize
loss in their own manner, it is inappropriate to
recommend a single secular or nonsecular
activity, especially when a proposal may be
antithetical to deeply held beliefs of any member
of the school.
Students and staff may elect to decline to
participate in any memorial activity without
ostracism.
School staff should supervise all memorial
activities involving students.
All persons invited as support must be vetted by
the school district and understand and endorse
the role and mission of the school.
SPECIFIC MEMORIAL GUIDELINES
The circumstance of death and loss dictate different
approaches to memorials.
Violent Death
When death is due to violence, especially a gangrelated homicide, caution is necessary to prevent
memorial activities from resulting in further violence,
school disruption, and increased fear for the safety of
staff, students, and parents.
Acknowledging death and grief. The death of a student
is always tragic and greatly felt by friends, family,
and staff, and must be acknowledged and mourned.
This is true even when the student was in some way
complicit in his or her own death. Extending
sympathy and support for all who feel the loss is
necessary, appropriate, and professional. Nonetheless,
it is imperative to restrict public memorials when
death is an outcome of homicidal violence. No
memorials to a violent death should be allowed in or
around school.
Untimely Death
While encouraging or allowing groups of students to
attend a large memorial is often unwise, in some
instances it may be both appropriate and necessary.
Following an untimely death of a student, as in a
tragic accident, such a gathering may be comforting
and supportive, facilitate a sense of community, and
provide participants some measure of comfort.
Because such a memorial gathering may lead to
expressions of unusual sadness or depression by
some students, the school should be aware of
students who may be struggling with unusually
intense emotional issues that may require further
individual support. Mental health professionals, such
as the school psychologist and other staff who are
familiar with the students, should be present at large
memorials to monitor for signs of distress.
The following activities are suggested to remember
the life of the deceased:
Small-group gatherings based in individual classrooms are ideal. Support staff may move between
classrooms providing guidance as needed. Large, allschool gatherings are best held after school as an
elective or self-selected activity. Memorials placed
throughout the school are not recommended, as they
are difficult to monitor.
Impromptu or spontaneous memorials, put in place
without direct administrative approval, generally must
be left in place, at least briefly. A discussion with
students, staff, and/or parents may be needed to
determine a reasonable duration for the memorial. In
addition, the memorial should be carefully examined
to make certain there are no divisive or worrisome
aspects, such as gang colors or symbols. If the
memorial is likely to cause problems, it should be
immediately and respectfully removed. The reason for
removal should be explained to students and staff.
Ensuring safety. It is equally necessary to provide for
the security of the school through strict oversight and
control of any memorials. This requires increased
supervision and decreased student movement.
Sending students to a central area to receive
information, mourn, or prepare memorials is strongly
discouraged, as are spontaneous, impromptu, or
transient memorials during such times. Such displays
can precipitate violence from rival gang-involved
youth in the school, increase the level of fear among
other students who associate visible gang displays as
evidence of their influence in the school, and increase
the status of the gang in the school.
In the first hours and days following a violent death, it
is not uncommon for staff to face challenges from
students. Students may want to place memorial
posters, banners, graffiti, and other displays around
the school following the death. They may want to
wear memorial T-shirts or gather to mourn and
Prepare letters and posters for the family of the
deceased.
Collect contributions for the family funeral
expenses.
Discuss appropriate contributions to an existing,
recognized charity, foundation, or scholarship
fund.
Share personal stories and how, through one's
own life, personal goals will be achieved that
reflect the best attributes of the deceased.
101
memorialize the classmate lost to violence. Students
from other schools may arrive on campus and attempt
to gain entry to the school to mourn, protect relatives,
or, in some instances, seek revenge. Any display of
funeral shirts, armbands, graffiti, posters, banners, or
gang paraphernalia should be immediately removed.
Students who display such symbols should be spoken
with in private, acknowledging their loss but
redirecting them to prosocial expressions. Gatherings
of students, some of whom may have a history of
gang-related behavior or gang association, are strongly
discouraged.
newspaper or yearbook.
Frank and open discussions of suicide and depression
are appropriate and are best' held in the classroom,
with assistance from support staff as needed. Cards
and letters to the family of the deceased, attending a
funeral, pledging personal resolve to honor the positive
aspirations of the deceased, and implementing actions
to support others at risk (e.g., implementing suicide
prevention or screening programs) are always
appropriate memorials and are comforting to the
family and friends of the deceased.
living memorials are appropriate, such as providing
financial support to the family for funeral expenses or
making contributions to well-established suicide
prevention, depression treatment, or adolescentfocused medical foundations or facilities for youth.
Contributions to a scholarship or memorial fund are
not recommended in this instance.
Alternatives. Alternatives for students include
remaining in a core classroom with support staff as
needed. Staff should guide student discussion,
promoting a prosocial response and not allowing
expressions of violence, rumors, or allegations that
may later prove to be untrue. Especially distraught
students may be escorted to a quiet office to meet with
a professional support person. Parents, if necessary,
may be called to retrieve inconsolable students.
PERMANENT MEMORIALS
School staff, students, and community members may
desire a permanent memorial such as a plaque or
scholarship fund. It is wise to table such suggestions
until a respectful time has passed, ideally several
months following the death.
Scholarship funds rarely survive more than a few
years. New populations of students, new staff, and
new families may forget memorial walls and plaques.
Donations to an existing, long-standing program or
scholarship fund will help provide long-term sustainability of the memorial.
Special circumstance: The violent death of innocents.
Sometimes the victim of violence is a bystander, such
as when a child is killed in gang crossfire. Such a
tragic loss presents special challenges. While
memorials may be planned consistent with the above
recommendations for loss of a student from an
untimely death, special challenges may occur if gang
members, associates, or family members of the
individual who inadvertently killed the innocent child
are present in the victim's school. Rumors abound,
inaccuracies arise, retribution may be planned, and
chaos may ensue. Students who mayor may not be
involved or somehow related to the alleged assailant
may become targets of violence. For these reasons,
memorials are best prepared, consistent with above
recommendations, in a quiet, controlled setting of the
classroom.
COMMUNITY RESPONSE
Many seek comfort in asking a person of faith to
speak with staff or students at a memorial service.
Caution must be taken if a person of faith begins
ministering to staff or students from a particular
perspective, inadvertently offending and alienating
those who hold different but equally valid religious
beliefs. Divisive or exclusive religious expressions
are not appropriate. Decision makers must avoid
endorsing a particular secular memorial action or
activity.
Suicide
When a death is from a suicide, great care must be
taken to prevent contagion. When students or staff
gather to discuss a memorial to the deceased student,
great sensitivity is necessary to prevent cluster suicidal
behavior of other students. It is necessary to be
mindful that staff and students may be distraught,
secondguessing themselves, and feeling uneasy that
they may have missed some sign or clue that the
deceased student was suicidal.
Memorials may increase the risk of romanticizing the
suicide of the student. Therefore, public memorials to
a student who died from suicide are not appropriate
in the school setting. This includes posters, graffiti,
banners, funeral shirts, or pages in a school
THE FINAL WORD
It is good to remind students and staff that a true,
lasting memorial to the deceased is to live a good life
mindful of that person. To move beyond the circumstances that led to the death of their friend is a
memorial that is renewed daily and lasts a lifetime.
Memorializing a death from cancer may lead students
to study hard to become medical professionals;
violent death may lead students to promote social
justice, enter law related fields, or become prosocial
activists. Such proposals are generally met with
understanding by youth and adults
102
RECOMMENDED RESOURCES
Print
Brock, S. E, & Jimerson, S. R. (2004). School cnsls
interventions: Strategies for addressing the consequences of crisis events. In E. R. Gerler, Jr. (Ed.),
Handbook of school violence (pp. 285-332).
Binghamton, NY: Haworth Press.
Brock, S. E., Sandoval, J., & Lewis, S. (2001).
Preparing for crises in the schools: A manual for
building school crisis response teams (2nd ed.). New
York: Wiley.
Poland, S., & Poland, D. (2004, April). Dealing with
death at school. Principal Leadership, 4(8), 8-12.
Available: http://www. nasponl ine.org/
resources/pri nci pals/ Deal ing%20with%20
Death%20at%20School%20 April%2004.pdf
Steele, W. (2004). School memorials: Should we?
How should we? Trauma and Loss: Research and
Interventions, 4(2), 17-22. Available: http://www.
tlci nstitute.org/ Memoria IS.html
Online
National Association of School Psychologists.
(2002). Memorial activities at school: A list of
do's and don'ts. Available:
http://ww'w.nasponline.org/ resou rces/
crisis_safety/memoria Id o_donot. pdf
National Association of School Psychologists.
(2002). Memorials/activities/rituals following
traumatic events:Suggestions for schools. Available:
http://www.ed.gov/admins/lead/safety/training/res
ponding/memorials. pdf
National Center for Children Exposed to Violence:
http://www.nccev.org
National Institute for Trauma and Loss in Children:
http://www.tlcinstitute.org
Donald W. Kodluboy, PhD, LP, NCSP, retired from the Minneapolis
Public Schools after 30 years as a school psychologist and behavior
consultant. He lectures and consults on youth gangs and violence in
schools.
103
Suicide Prevention
104
105
106
Appendix B
BOMB THREAT PROCEDURES
BOMB THREAT TELEPHONE CHECK LIST
KEEP CALLER ON LINE AND TALKING AS LONG AS POSSIBLE
1.
DATE
2.
TEL.NO.OF REC.STATION
3.
TIME OF CALL
4.
DURATION OF CALL
5.
EXACT WORDS OF CALLER
6.
WAS CALLER FAMILIAR WITH THE BUILDING? EXPLAIN.
7.
QUESTIONS TO ASK WHILE THE CALLER IS ON THE PHONE:
8.
A.
WHAT TIME WILL THE BOMB EXPLORE?
B.
WHERE IS THE BOMB LOCATED?
C.
WHAT DOES THE BOMB LOOK LIKE?
D.
WHAT KIND OF BOMB IS IT?
E.
WHY WAS THE BOMB PLACED?
F.
WHAT IS IT MADE OUT OF?
G.
WHAT IS THE CALLER‘S NAME?
9.
SEX OF CALLER
B.
ACCENT
APPROXIMATE AGE
D.
VOICE CHARACTERISTICS (LISP, STUTTER)
E.
EDUCATION
F.
CALLER NERVOUSE?
G.
CALLER INTOXICATED?
BACKGROUND NOISES
A.
MUSIC
B.
STREET TRAFFIC
C.
TRAINS / BUSES
D.
VOICES
E.
MACHINERY / TYPEWRITERS
F.
OTHER
10. PERSON RECEIVING CALL:
POSITION
11. REMARKS / IMPRESSION OF THE CALL?
12. NOTIFICATIONS
VOICE IDENTITY
A.
C.
107
NAME
TELEPHONE
NAME
TELEPHONE
NAME
TELEPHONE
NAME
TELEPHONE
ขั้นตอนการรับโทรศัพท์ ข่ ูวางระเบิด
ขั้นตอนการรับโทรศัพท์ ขู่วางระเบิด
C. อายุประมาณ
พูดคุยโทรศัพท์ กบั ผู้ข่ วู างระเบิดให้ นานที่สุดเท่ าที่จะเป็ นไปได้
D. ลักษณะการพูด (พูดไม่ ชัด, พูดติดอ่ าง)
1. วันที่
E. การศึกษา
2. หมายเลขโทรศัพท์ ของเครื่องที่รับสาย
F. ผู้พูดมีอาการตื่นเต้ นหรือวิตกกังวลหรือไม่ ?
3. เวลาที่โทรศัพท์ เรียกเข้ า
G. เสียงผู้พูดบอกอาการมีนเมาหรือไม่ ?
4. ระยะเวลาของการสนทนา
9. เสียงแทรกอืน่ ๆ ที่ได้ยนิ ในโทรศัพท์
5. คาพูดทุกคาของผู้ขู่วางระเบิด
A. เสียงเพลง
6. ผู้ขู่วางระเบิดมีความคุ้นเคยกับอาคารหรือไม่ อธิบาย
B. เสียงการจราจรบนถนน
C. รถไฟ / รถประจาทาง
D. เสียงคนพูดคุยกัน
7. คาถามสาหรับใช้ ถามในขณะที่ผ้ขู ่ ูวางระเบิดยังอยู่ในสาย:
A. ระเบิดจะระเบิดเมื่อไหร่ ?
E. เสียงเครื่องจักร / พิมพ์ดดี
B. ระเบิดอยู่ที่ใด ?
F. อืน่ ๆ
C. ลักษณะของระเบิดเป็ นอย่างไร ?
10. ผู้รับโทรศัพท์ :
ตาแหน่ ง
D. ระเบิดเป็ นระเบิดชนิดใด ?
E. เพราะเหตุใดจึงมีการวางระเบิด ?
11. ข้ อสังเกต/ ข้ อควรจดจา?
F. ระเบิดทามาจากอะไร ?
G. ชื่อของผู้โทรศัพท์ เข้ ามา ?
12. การแจ้ งข้ อมูล
8. ลักษณะของเสียงพูด
A. เพศ
B. สาเนียง
108
ชื่อ
หมายเลขโทรศัพท์
ชื่อ
หมายเลขโทรศัพท์
ชื่อ
หมายเลขโทรศัพท์
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