MENTAL HEALTH MOMENT
MENTAL HEALTH MOMENT
August 4, 2000
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The first ever delegate from the United States to the
United Nations also chaired the UN Human Rights
Committee, drafted and got passed the UN Human Rights
declaration. Her name was Eleanor Roosevelt.
"No one can make you feel inferior without your consent."
- Eleanor Roosevelt
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Research in Eating Disorders
http://www.nimh.nih.gov/events/edsummary.cfm
This page offers an overview of research reviewed at a
recent workshop on anorexia nervosa and bulimia nervosa,
held at NIMH. The site reviews inroads into understanding
neural and genetic underpinnings of eating disorders as
well as research-based strategies for preventing and
intervening with these disorders.
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September 23-27, 2000:
The fifth international conference on family violence:
"Working together to end abuse", San Diego
Participants will discuss new strategies in advocacy,
assessment, intervention, education, prevention and
research in all aspects of family violence. Contact:
Joe Marciano, Family Violence and Sexual Assault Institute,
6160 Cornerstone Court East, San Diego, CA 92121
(858)623-2777 ext. 427; fax: (858)646-0761; email:
fvsai@mail.cspp.edu
Web site: http://www.fvsai.org
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China Cultural Tour Information:
https://www.angelfire.com/biz3/odocspan/trip.html
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PROVIDING HELP FOR CHILDREN AND
FAMILIES FOLLOWING DISASTERS
Part III
1. The Use of Play
Few children are able to sit and talk directly about their
difficulties or to explore the roots that underlie these
difficulties. Most of them are not able to talk about
their problems even at a superficial level. Involving
the children in play is effective in helping them work
through their troubled feelings. Play is one of the
natural modes of communication. The fantasies that are
verbalized while playing often provide much information
about the psychological processes that are at the
bottom of children's problems. Children's play following
disasters will reflect their experiences. Paints, clay,
dolls, and water play allow children outlets for their
feelings. They will build dams out of blocks, for
example, and have them collapse, or they will build
towers and pretend the earth is shaking - activities
that obviously mirror an earthquake. Children's drawings
will depict on a more or less realistic level the feared
hurricane winds or tornados. Fortunately, children's
play discharges feelings that have been bottled up.
Children seem to use play therapeutically. It is best
when they are allowed to make their own interpretations.
Adult interpretations often dampen this expressive
avenue. Any adults who care for children - teachers,
counselors, parents - can encourage children to express
their feelings in play. The play experience should be a
pleasurable one for both adults and children. Adult
helpers should get down to the children's level -
literally play on the floor with them when necessary.
Secondly, the workers must have the capacity to project
themselves into the children's situation and to see the
world through the children's eyes. The workers must also
have the ability to remember their own childhood
experiences sufficiently to be able to appreciate the
children's situation.
Parents sometimes feel guilty about the fact that their
children are having problems and may feel threatened that
outsiders are needed to help. Play therapy involves the
parents who can be taught to understand how the children
express their feelings and fears through play. Under
optimal circumstances, parents play with their children.
Following a disaster or other family crisis, parental
energies are perforce drawn away from the children.
Attracting the families back to their ordinary roles
with the children is therapeutic to all concerned.
2. Individual Counseling
Individual counseling may simply be a time for children
to "have someone to talk to". As stated earlier, most
children find "just talking about feelings" difficult.
However, there are times when friendly, supportive
adults are just what children need when their own parents
are not able to listen to them because they are busy with
their own problems. Following a disaster in which there
may be a shortage of trained mental health workers,
friendly, caring people who have received some crisis
training can be helpful to the children. Because disasters
arouse natural fears and anxieties in children, workers'
reassurances and emotional support are important.
Individual therapy by trained, experienced therapists
can be used in severe cases to help the families and
children understand the underlying roots of the problem.
3. Group Sessions
a. Children' Groups
The group experience for children of latency age and
older is a natural one because of their daily
experiences in classroom settings. Children find it
easier to relate to each other than to adults. They
gain a lot from a group in which they can talk openly
and honestly about their feelings after a disaster.
Finding peers who are interested encourages even
withdrawn children to talk about their feelings. A
leader can provide emotional support and needed
information to the group. Children frequently distort
the information they receive and are afraid of "feeling
foolish" about asking questions. A peer group encourages
them to ask their questions, foolish or not.
Group intervention with children is especially useful
for therapeutic expression, as they are able to express
their fears before their peers once they are reassured
that having fears and anxieties is acceptable and that
other children (even the bravest ones) also have these
feelings. Children retell their experiences with great
enthusiasm in group discussions with other children of
similar age levels.
Groups function well when the leaders are democratic and
care about children. If adults run the group in an
authoritarian manner, the group will not "work", and
the children will not feel free to talk about their
feelings. When groups of children talk about disaster,
or drwa pictures about them, they are helped to dispel
their fears about such happenings.
The following is one example of a group technique:
Form a group with a maximum of 12 children. Introduce
the purpose as a chance for everyone to learn about the
experiences of others in the disaster.
(1) Ask all the children what happened to them and
their families in the disaster.
(2) As the stories appear, ask the children to tell
about their own fears (perhaps even act them out
in dramatic play).
(3) In the course of the discussion, provide factual
information on the disaster (what happened, why).
(4) Ask members of the group to take turns being
helpers. The children are paired and then take turns,
first asking for help with a problem and then
acting as helpers with the others' problems.
(5) Assign two children as co-leaders to help control
restlessness and distractibility among the children.
(6) Provide the children with paper, plastic materials,
clay, or paints, and ask them to depict the disaster.
The less verbal children will find this helpful.
b. Parents' Groups
Working with parents in a group is an excellent means of
helping them understand their children's behavior and
providing them with specific advice on how they can
deal with problems. In the group, parents have the
opportunity to share their concerns with other parents
who may be having similar concerns. Advice from other
parents is frequently more acceptable than advice from
"experts".
A parent group is useful when it is also educational.
Parents often want to be informed on techniques for
handling specific problems, such as fears and anxieties,
sleep problems, school difficulties, and behavior
problems.
Often the parents in groups express their own fears.
Helping the parents understand their own fears makes
them more effective with their children. The groups and
group leaders are most supportive to the parents when
they reinforce strengths present in the families and
help them see how they have been able to deal efficiently
with problems in the past. If additional help is needed
from other resources in the community, the group leaders
should have the information available.
4. Telephone Crisis Service
A telephone crisis line offering help with problems of
children in disasters is effective in reaching the
community. Families find it is an acceptable way to ask
for help, and it is an efficient way to reach large
numbers of families. The crisis line can be publicized
on radio and TV as available "to help parents deal with
their children's fears and anxieties". The media are
usually pleased to announce the availability of the
crisis line as a public service. The telephone line
should be staffed by professionals and by trained
volunteers under supervision. Volunteers can be recruited
from local colleges and universities and from the
community at large and, prior to receiving calls,
should be trained in crisis techniques. Experience has
shown that only a small proportion of the families
calling need to be seen in person. Most of the callers
are able to be helped by telephone advice. When they
do need to be seen in the clinic, they often can be
helped in group sessions. Specific, directive advice
is crucial for the success of the telephone crisis line.
The typical calls will be about bedtime fears, clinging,
and other behaviors that seem to reflect separation
anxiety. For example:
* A mother calls to ask advice about her toddler who
will not stay in his crib. The advice might be for
the parent to stay in the child's room until he
falls asleep or to move the crib into the parents'
bedroom for a few days.
* Another typical call is from a parent of a 6-year
old who states that the child has become fearful of
leaving the parent's side. An increase in the amount
of time spent with the child, much verbal reassurance,
and more holding might be advised.
* A mother of an 8-year-old girl reports that her
daughter seems "obsessed" with talking about the
disaster and is fearful of another one occurring.
The worker listens supportively to the mother, asks
her to elaborate on the family situation, on what
has already been done to comfort the child, and asks
which methods she has already tried to deal with
the situation. The worker helps the mother understand
the behavior by telling her this is the child's
method of mastering anxiety. The worker offers
reassurance by indicating that this is normal
behavior and that the child needs to ventilate her
feelings. Ways of handling the problem may include
rap groups for the child to share anxieties with
peers, and play or school projects which would use
the disaster as their subject. If the parent's fears
need to be alleviated, some individual counseling or
group discussions may be recommended.
In all cases a follow-up is necessary. The mother is
asked to call back to report on the success of the
suggestions. The worker may also call her to see what
has happened since they last talked. If feasible, an
outreach visit can be made if the mother is not able
to come to the agency to receive counseling.
Arrangements may need to be made through the local
disaster coordinator to establish an "800" number so
that callers from outlying areas can easily contact
the service.
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For further information from books and self-help books,
go to the following and use the search engine to find
books, etc. Start by using the following descriptors:
Disaster Counseling, Children and disasters, Crisis
intervention, telephone counseling, Play therapy, Group
intervention, group counseling, parent groups, children's
groups, etc.
https://www.angelfire.com/biz/odochartaigh/searchbooks.html
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Contact your local Mental Health Center or
check the yellow pages for counselors, psychologists,
therapists, and other Mental health Professionals in
your area for further information.
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