and crisis preparedness and response plans need to consider the professional’s needs as a priority. These professionals may be impacted directly themselves and may have some of the same behavioral and mental health needs as those they serve. Professional self-care is important, but is often neglected. It is distressing to be with children who are in distress. It is critical that staff find ways to have their own personal needs met, and appreciate and address the impact of supporting children who are grieving or traumatized.

Understanding the Timeline of Recovery

Beyond the immediate response, we need to appreciate the timeline for recovery, Schonfeld said. Everyone has a baseline level of function with some highs and lows (see Figure 8-1). When a disaster event occurs people feel vulnerable, their usual coping mechanisms may fail, and they may feel helplessness and hopelessness. As communities respond and provide resources, people start to have improved functioning. This is still a vulnerable period, Schonfeld stressed. Some individuals continue their recovery and return to their baseline functioning, and some even have “posttraumatic growth” and achieve a new baseline of even higher level functioning. But others never return to their original baseline and live in a state of continued impairment. There is often an increase in suicides in this period. Unfortunately, Schonfeld said, children are thought of as “resilient” and support is often withdrawn as soon as there are signs of recovery. Instead, they need to be supported until they return to their baseline level of functioning.

The scope of need is broad, and there is a wide range of reactions and concerns beyond the acute trauma and posttraumatic stress from a disaster. For some children, bereavement is a primary issue if they have lost someone close to them. Other children face a cascade of secondary losses and stressors such as loss of their homes and relocation, loss of their peer network, difficulty integrating into new social networks or bullying at their new school, academic failure, financial stresses on the family, and parental stress, depression, substance use, or increased domestic violence. Schonfeld also pointed out that a single disaster event is really part of a cascade of other events in a child’s life and results in cumulative impact and stress, even if the prior events are completely unrelated. When responding to one event, we are responding to all of the events in the life of the child. As an example, Schonfeld said that after a



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