Traumatic stress in children: information for parents,
carers and anyone who works with young people
About this factsheet
This is one in a series of
factsheets for parents, teachers and young people entitled
Mental Health and Growing Up. The aims of these factsheets
are to provide practical, up-to-date information about mental
health problems (emotional, behavioural and psychiatric disorders)
that can affect children and young people. This factsheet describes
the causes and symptoms of traumatic stress, and provides practical
advice on how to get help.
What is traumatic
stress?
Children, like adults,
sometimes experience or witness something extremely frightening and
dangerous, such as a road accident, a serious injury or a crime.
This can cause a traumatic stress reaction, which affects the way
the child thinks, feels and behaves. Children can be as severely
affected as adults. If you recognise it, you will be better able to
help your child to recover, and also to know when to seek
professional help.
What are the signs of
traumatic stress?
Individual children react in
different ways to traumatic events. How they react may also depend
on their age. Immediately after the traumatic event, children may
find it hard to sleep and have bad dreams and nightmares.
Sometimes, the effects may not appear for days or
weeks. Children may, however:
- become fearful, clingy and
anxious about being separated from their parents;
- start bedwetting and
thumb-sucking again;
- become preoccupied with
thoughts and memories of the event;
- be unable to
concentrate;
- be irritable and
disobedient;
- complain of physical
symptoms such as headaches and stomach-aches.
All these are normal
reactions to an extremely frightening event. With help and support
from the people close to them, children begin to get over the shock
in a few days, and usually recover after a few weeks.
Longer-lasting
effects
Sometimes a child has
feelings of depression and anxiety that go on for several weeks and
may get worse. If they go on for a long period of time, it is
likely that the child may need some help to feel better.
If the traumatic experience
was so bad that the child was in danger of being killed or
seriously injured, they may have felt terrified, horrified and
helpless. Post-traumatic stress
disorder (PTSD) might follow a dreadful experience of
this sort. It is difficult, however, to make a diagnosis in a child
under the age of 7 years-old.
Typical signs
are:
- `Flashbacks' of the event.
For a few moments, it seems as though you are re-living the
experience in your mind, like watching an action-replay, which can
be distressing and frightening - particularly for
children.
- Deliberately avoiding
thoughts or feelings about it. If you've been in a car crash, you
may avoid roads, or even TV programmes about cars, because they
remind you of the accident.
- Sleeping badly.
- Being easily startled and
jumping out of your skin at the slightest noise.
These reactions can go on
for months and can interfere considerably with a child's daily
living. They may be unable to enjoy playing or find it difficult to
concentrate on their school work. Occasionally, these problems can
continue as the child grows into adulthood.
What can help?
The best approach,
immediately after a traumatic event, is to accept that a child will
be distressed - this is normal. At this stage, parents can help
greatly by letting their child talk about the event if they want
to, or helping them to relive it in games and drawings.
Leaving children alone `to
forget things' does not help. Talking can help children to adjust.
It helps them to make sense of what has happened, to feel less
alone with their worries and to regain a sense of control. However,
forcing someone to talk about it when they don't want to does not
seem to be helpful.
If you have been involved in
the traumatic event, you may also be distressed. It is usually
better to admit to your children that you are feeling sad and
upset. At the same time, you need to make it clear that you don't
expect them to look after your feelings. If you recognise that you
have symptoms of PTSD then get help. Your child will manage their
feelings and emotions better if you are not feeling fearful or
anxious yourself.
Sometimes, children find it
easier to talk to other adults rather than their parents.
Professional help may be needed to help get them get back to normal
more quickly, and to prevent or reduce the harmful effects of
prolonged stress reactions.
Ask for help
if:
- the child's upset feelings
and behaviour seem to be getting worse;
- the signs of extreme stress
last for longer than about one month;
- worries prevent you, your
child or your family getting on with normal, everyday life;
- the child has symptoms of
PTSD that go on for longer than a month.
Where can I get
help?
If you are concerned about
your child at any time following a traumatic event, consult your
general practitioner, who will be able to offer you help and
support. If problems continue, the doctor may suggest extra help
from the local child and adolescent mental health service.
If you have been involved
directly in a community disaster, special support services will be
arranged. Do not hesitate to make contact with them if you want to
talk over your worries.
Recommended reading
References
Carr, A. (ed.) (2000)
'What Works with Children and Adolescents?' - A Critical Review
of Psychological Interventions with Children, Adolescents and their
Families. London: Brunner-Routledge.
Rutter, M. & Taylor, E.
(eds) (2002) 'Child and Adolescent Psychiatry' (4th edn).
London: Blackwell.
Scott, A., Shaw, M. &
Joughin, C. (eds) (2001) 'Finding the Evidence' - A Gateway to
the Literature in Child and Adolescent Mental Health (2nd
edn). London: Gaskell.
Sources of further
information
CRUSE Bereavement
Care: helpline 0870 167 1677; for young people
freephone 0808 808 1677.
The
Samaritans: provide a 24-hour service offering
confidential emotional support to anyone who is in crisis.
Helplines 08457 909090 (UK), 1850 609090 (ROI); e-mail:mailto:jo@samaritans.org
Victim Support:
helping people to cope with crime. Supportline 0845 303 0900.
Series
editor: Dr Mona Freeman
Editorial Board: Child and Family Public
Education Editorial Board.
Revised: December 2009; next due for review: December
2011.
© [2004] Royal College of
Psychiatrists. This leaflet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
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gained from its use. Permission to reproduce it in any other way
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Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.
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