After the tragedy: Caring for the caregivers

Schools are not truly prepared to respond to tragedy until and unless they also have plans for caring for the people who must care for those affected by the crisis.

One afternoon as school lets out for the day, a serious car accident occurs near your school. Two students from your school and a parent are critically injured in the accident. Many children walking home see the scene that includes emergency vehicles and the Jaws of Life^® to extract the victims. The parent, a longtime classroom volunteer and parent leader in the school and community, dies from her injuries, as does the 5th-grade child. The other child, a 3rd grader, is seriously injured. Many students and staff come to school the next day visibly upset and talking in detail about the incident. The loss continues as the other child succumbs to injuries and also dies two days later.

Crises such as the one described above can happen to any school at any time. Clearly, a tragedy like this one will affect the entire school community. While educators provide daily care and support for students, after a crisis these demands may go well beyond their training or expertise, particularly if they also are in distress. As a result, schools must be prepared to support all the adults in the school setting so they can continue to foster the development, learning, and achievement of students.

In the aftermath of a trauma, the care and support of children is usually considered primary, and there may be a push to return to normalcy. However, added support and encouragement to help adults cope will increase their capacity to address the educational and emotional needs of students. School staff members are best equipped to care for others when their own needs have been met.

Adults in the school community will vary in their reactions following a crisis. A variety of factors will influence a person’s reactions, including the individual’s previous experiences, personal characteristics, and proximity to the event. Additionally, certain types of tragedies may be more traumatic than others. Those with a sudden onset (such as an accident) and those that involve human-caused violence and fatalities will often provide the most challenges in terms of traumatic aftermath and recovery.

Crisis responders often put their own needs on the back burner while tending to the needs of everyone else.

Secondary trauma is the name for the stress that results from learning about another’s traumatic experience and/or helping another person who has been directly affected by such tragedy. Secondary trauma manifests the same general range of symptoms as those who have been personally victimized by the event. Any adult in the school community who assists students and takes on crisis intervention work is at risk for such stressors. Secondary trauma should be of particular concern when those adults are also experiencing traumatic stress from their own direct experience with the crisis.

History makes a difference

Most school personnel will be able to get back to the school routine quickly and without formal mental health treatment, but some individuals will require additional intervention and support. A variety of factors increase the likelihood that a crisis event will have a traumatizing effect on those who respond to it. These risk factors may include pre-existing mental illness and a previous history of psychological trauma. This is true for both initial trauma reactions and longer-term difficulties. Not surprisingly, individuals who are mentally healthy will weather traumatic events better than those who are already struggling with mental health issues.

Individuals with a history of prior trauma also have a high risk of trauma reactions. Experiencing a crisis subsequent to other traumatic stressors can severely weaken an already taxed coping system and can result in significant difficulties in day-to-day functioning as well as burnout. Burnout involves issues such as emotional exhaustion, irritability, feeling overwhelmed by daily job demands, and negative attitudes toward students and coworkers. Clearly, burnout can significantly affect the learning environment and the effectiveness of the educators and service providers working with students. South High School (a pseudonym) is a good example of how a previously traumatized system can struggle when hit with subsequent crises.

In late December, a South High School student committed suicide. The student was fairly new to the school and not well-known, so the effect was not great, and the crisis was well-managed at the building level. Then, in February, another student took his own life. This student was a popular and well-known member of the baseball and football teams. The loss affected many students, faculty, staff, and coaches. The district crisis team tried to meet the mental health needs of the school community, but because the effect was so great, the team struggled to meet the needs of all who needed interventions. A number of high-risk students subsequently became distressed and suicidal in the weeks following the crisis and were hospitalized. By summer, the entire school community was emotionally exhausted and drained. At the beginning of the new academic year, the same school lost a very popular and well-known assistant principal in a tragic accident. This additional loss triggered previous traumatic reactions in many students and staff at the school. Although the district crisis team and Employee Assistance Program provided support to students and staff in the aftermath of this event, many of the adults exhibited signs of burnout. It was spring before the school community truly began to return to its precrisis level of functioning. The passage of time and the availability of additional supports facilitated the healing process, but it took much longer than it would have had there been no previous crisis history.

In addition to previous trauma, staff in schools serving communities with chronic stressors and a lack of resources also can be at risk for burnout as caregivers. Examples include schools with large populations of children living in poverty and schools in areas where community violence is common. The staff in these systems are already stressed and meeting the day-to-day needs of students — basic needs as well as educational and mental health needs — is a challenge even when the school is not experiencing a crisis. It is important to note, however, that when provided with sufficient support, school staff who work in such high-risk schools may be more resilient and better able to cope and support others when confronted with subsequent crises.

What to watch for

The signs and symptoms of stress and secondary trauma are often observable but in some cases may be known only to the individual affected. Some are common stress reactions typically experienced after a crisis; others may warrant professional support or monitoring. These reactions can manifest as physical, emotional, or social signs.

Physical reactions, such as chronic fatigue and exhaustion, are the most frequently reported. However, other signs may also be evident, such as trouble paying attention, constantly being alert for danger, or startling easily. Headaches, stomachaches, or muscle tension may also be felt. They may have difficulty sleeping or have a loss of appetite.

Emotional symptoms can include excessive worry or anxiety about the crisis victims, disconnection or numbing, extreme anger at the situation, or feelings of compassion fatigue, demoralization, or resignation. Individuals may also find they have recurrent thoughts or distressing dreams about the crisis, a constant replaying of the events, or even some confusion and difficulty making everyday decisions. Some may experience extreme depression, hopelessness, or suicidal thoughts. Some may attempt to self-medicate their emotional symptoms with drugs or alcohol.

Social or interpersonal signs include serious difficulties in relationships at home or work. Irritability, outbursts of anger, social withdrawal, or isolation can sometimes occur. Attempts to overcontrol at work, compulsion to be a rescuer or part of every crisis situation, or excessive use of alcohol or drugs can also be warning signs of traumatic stress. These issues may increase absenteeism, result in an increase in staff arguments, or shorten adults’ patience with students.

The leader’s role

Principals and other administrators play key roles in the recovery of the school community after a tragedy. They should observe several important guidelines:

#1. Ensure that the school has an effective crisis plan.

The crisis plan should include consideration of care for the caregiver and plans for supporting school staff in the school. An effective crisis plan can facilitate a return to precrisis levels of functioning and more positive outcomes.

#2. Be aware of the emotions and needs of the community.

School personnel at risk for traumatic stress and burnout may feel their needs are neglected following a crisis. In addition, teachers may be expected to and/or feel responsible for meeting the mental health needs of students when they lack the necessary training and expertise to do so. School leaders must acknowledge and normalize the immediate reactions to a traumatic event. This means leaders must also be aware of their own reactions and limitations and take care of themselves as needed.

#3. Give school personnel access to assistance from crisis responders and/or mental health professionals.

One of the best ways that administrators can support staff is by ensuring that they have enough responders and mental health staff to carry out the crisis plan effectively and to support students and adults after the crisis. Administrators should promote a culture in which the adults in the building feel comfortable asking for help or taking a break while ensuring confidentiality and privacy. At the same time, school leadership should ensure that this is not perceived as an inability to do their job or a character weakness. Administrators also should be aware of the potential stigma associated with school personnel accessing mental health services and Employee Assistance Programs. Providing contact information and encouraging staff to meet their own mental health needs is an important first step in ensuring that staff are adequately supported.

Physical reactions, such as chronic fatigue and exhaustion, are the most frequently reported.

#4. Employ a variety of informal support strategies to support staff.

Generally, these strategies cannot occur without buy-in from school leadership. Such tactics include a back-to-school visit for staff before students return and/or some type of open house where staff and students can return to the school in a safe and supportive context. Have mental health professionals/crisis responders present at these gatherings so individuals can discuss their feelings and reactions while ensuring confidentiality. This will also allow staff to receive appropriate support to address the stress and fatigue involved when caring for and teaching affected students.

The classroom buddy system is another way to help staff after a crisis. Giving teachers the option of having a school mental health professional assigned to their classroom for the first day or two after classes resume can provide them and their students the extra support they need. The buddy can help facilitate conversations about the crisis, provide large group/classroom interventions, offer mini-breaks for the teacher, and identify students and teachers who have severe crisis reactions and escort them to where more intensive interventions are provided. Administrators also can arrange for substitute teachers for educators more closely affected — for example, if one of their students died or they witnessed a crisis in their own classroom. Consider the strategies West Middle School (a pseudonym) employed:

West Middle School experienced a nonfatal school shooting in front of the school as classes were letting out for the day. Two students were wounded, and the gunman was subdued and arrested. Hundreds of students and many teachers and staff witnessed the shooting; dozens more inside heard the gunshots. The incident shattered the sense of safety and security of the entire school community. When police allowed the school to reopen, the principal and crisis team chairperson planned an open house the day before classes resumed. At the open house, the teachers wore matching school T-shirts, and many of them stationed themselves outside to greet students and parents as they arrived. A hand-decorated banner signed by all the teachers was hung outside by the front door. The principal, security, and a crisis responder manned a check-in table inside the front door. This visible presence was a comforting and reassuring sight for visitors. Mental health professionals were stationed throughout the school, including in common areas for students and in designated counseling rooms for both students and adults. There were places students could go to draw or make get-well cards for those who were hospitalized. Food was available for everyone, and the general feel was one of nurturance and support. Signs throughout the building indicated opportunities and locations for various interventions and services. In the days after the shooting, the school assigned mental health buddies to teachers who requested them, providing whatever type of assistance was needed.

#5. Keep in mind the exhausting nature of crisis response work.

Individuals who serve on the crisis team, especially those who provide mental health interventions to trauma victims, will experience some personal effect after their own involvement in the response ends, and leaders should anticipate this. Crisis responders often put their own needs on the back burner while tending to the needs of everyone else. Participating as a crisis responder is a major risk factor for burnout. Principals can support these professionals in a variety of ways including allowing for shorter work shifts of crisis team members and letting them rotate between more and less intensive crisis response activities. Providing coverage of day-to-day duties of crisis response team members can also be helpful to ensure there won’t be a big backlog of work once the response has wrapped up.

Helping yourself and others

A diminished ability to function professionally may place students or adults at risk. Leaders can encourage all school personnel to monitor themselves and others for signs of traumatic stress and to seek help as needed. Most of all, encourage self-care. Self-care can come in many forms and can be thought of as preventing or addressing the signs and symptoms already mentioned. While many of these strategies seem intuitive, providing regular reminders of their importance in times of stress can be helpful.

Physical self-care includes getting adequate sleep and taking breaks during the workday. Exercise is also great for stress reduction. Taking walks or riding bikes can help calm the physical body. Encourage adults to eat healthy foods and limit the use of alcohol or other substances, which can interfere with sleep and aren’t good strategies for coping. Other stress management techniques such as progressive relaxation, deep breathing, calming self-talk, soothing music, and/or visualization can also be helpful.

Schools must be prepared to support adults in the school setting so they can continue to foster the development, learning, and achievement of students.

To care for emotional health, school staff should first be aware of and watch for the signs of secondary trauma. Finding a balance between work and home is important, especially when crisis demands add to already busy workloads. In the aftermath of a crisis, using good time-management skills and setting priorities can help people focus on practical activities that can be accomplished in the short-term. During these times, people often need help distinguishing between what they can change or control and what they cannot.

Social care and connection are also important aspects of self-care following a crisis. Supportive staff, friends, and family who remind you to rest and can objectively advise you can be very helpful. Some people find that practicing their spiritual or religious faith provides comfort and calm while others reduce stress by turning to action and engaging in activism or advocacy work. Others find new outlets by exploring their hobbies or passions for creativity. Most of all, look for some humor and goodness in life. Appreciate that family and friends are important, and let them know. Talk and listen to others.

Conclusion

A crisis can occur anytime to any school, and consequently schools should have plans for them. Keep in mind that recovering from tragic events takes time and does not happen in a linear fashion. Awareness, balance, and connection are critical for recovery so adults can best support students. Set and celebrate achievable goals, and celebrate the resilience of the great people in your school who go above and beyond as they support and help others in times of crisis.

CITATION: Crepeau-Hobson, F. & Kanan, L.M. (2013). After the tragedy: Caring for the caregivers. Phi Delta Kappan, 95 (4), 33-37.