Child Life Expertise within Disaster Response

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1 Child Life Expertise within Disaster Response Katie Nees, CCLS, MSHS Child Life Specialist III Cincinnati Children s Hospital Medical Center Sri Lanka 2004 Katrina 2005 Haiti 2010 Cyclone Nargis 2008 Pakistan 2005 Japan /11/2001 Hurricane Sandy

2 What about the Children? Philippines Tsunami 2013 Affect on children Immediately to Several Weeks After: o Behavior/reactions similar to the bereavement process o Reactions of fright, disbelief, denial, and grief o Sense of relief if loved ones are unharmed o Developmental regression o Sleep disturbances o Hopelessness o Emotional stress, including fear, anxiety, sadness, and isolation o Hyperactivity, aggression, and hostility Affect on children o PTSD is the most common response, occurring in up to 40% of children within three months after the event. It can still be present more than 15 years after o Disrupted consciousness, uncontrollable, intense grief, changes in sleeping or eating patterns, and extreme cognitive impairment may appear in severely affected children o Depression, anxiety, increased startle response and arousal level, irritability, sleep disturbance, safety and security concerns, restlessness, social isolation, aggression, a decline in academic performance, and a decreased interest in previously enjoyed activities or hobbies. 2

3 Best Intervention The first several weeks is a crucial time for development of resiliency Interventions should be: o Implemented by individuals who are trained and have experience working with crisis, disaster response, PTSD, and children's grief responses. o Culturally sensitive, developmentally appropriate o Focused on encouraging children to express their feelings about the event, discussing normal reactions, and teaching problem-solving skills. American Psychological Association (2014). The Impact of Terrorism and Disasters on Children. Retrieved February 27, 2014 from Jones, S. L & Schmidt, C. K. (2013). Psychosocial effects of disaster in children and adolescents. Nursing Clinics of North America, 48, Is there a need? How do we meet the need? Dr. David Schonfeld, founder of the National Center for School Crisis and Bereavement. Rachel Kaul, LCSW, CTS, Behavior Health Team Lead with the US Department of Health and Human Services Dr. Naomi Paget, Chaplain and Crisis Interventionists for the FBI with Disaster Relief Is there a need? YES! o Need people trained to work with traumatized children o There are many service gaps where needs are not met adequately or at all o The government has recently recognized the need: The National Commission on Children and Disaster 2010 Report Recommendation 1.3: DHS/FEMA should ensure that information required for the timely and effective delivery of recovery services to children and families is collected and shared with appropriate entities. DHS/FEMA should pre-identify and credential additional local and out-of-state voluntary and non-governmental organizations and networks that provide disaster assistance to children and families Recommendation 2.1: HHS should lead efforts to integrate mental and behavioral health for children into public health, medical, and other relevant disaster management activities. Congress should direct HHS to lead the development of a disaster mental and behavioral health Concept of Operations (CONOPS) to formalize disaster mental and behavioral health as a core component of disaster preparedness, response, and recovery efforts. 3

4 How do we meet the need? The field of disaster relief relies heavily on trusted entities from long-standing relationships Save the Children Southern Baptist Disaster Relief Children s Disaster Services Provides toys and some play-spaces in shelters, however it is sporadic and does not have a therapeutic foundation Brings trailers as playstations, very limited availability, and does not have an established therapeutic foundation Sets up play centers in shelters or MARCs to provide intentional childcentered and therapeutic play and resources to families on the needs of traumatized children Do you see the children? o Established in 1979 o Trained First Volunteers in 1980 o MOU with ARC and FEMA o Sets up Childcare Nationwide in Shelters and Service Centers o Joined ARC Critical Response Team in 1997 Children s Disaster Services (CDS) A Service of the Church of the Brethren #1 Agency for children American Red Cross Involved in 225+ Disasters ( ) Volunteers undergo a thorough training and screening process Provides: A safe environment in the chaos; physically and emotionally Opportunities for children to express themselves to support resiliency Child-directed play for children to begin the healing process Respite for parents Opportunity for relief agencies to work with parents Personal consultations for parents on the emotional needs of children 4

5 Oklahoma EF5 Tornado, May CDS Deployment Neesdisaster.blogspot.org MARC Volunteers 9am-7pm 5

6 CDS Center Child-Centered Play Meeting Children Where They Are 6

7 Encouraging Children to express themselves, thereby starting the healing process by carefully selecting toys to promote imaginative play Creating safe places Mastering the Experience 7

8 Processing their reality Processing their reality We Need More and Qualified People! Goals: o To increase the # of training workshops o Substantially increase the # of CDS volunteers o Find leaders and create Rapid Response teams 8

9 How Can I Get Involved? Go Online: Contact me: Katie Nees katherine.nees@cchmc.org Contact CDS Associate Director: Kathy Fry-Miller Kfry-Miller@Brethren.org QUESTIONS? Cincinnati