busload of children went through a decontamination process for minor exposure to a noxious substance, most children retuned to baseline functioning rapidly, but two girls continued to display significant stress. Further investigation revealed that one had recently seen a family member murdered and the other was being abused at home. Schonfeld also suggested that health care providers need to alter their practice patterns to include trauma history in the overall patient history.

Psychosocial Needs and Stigma

Another point Schonfeld raised is that stigma related to mental health is a still barrier, even in times of national crisis. Parents may not seek assistance because they often underestimate symptoms in their children, or they assume the children are just having normal reactions to abnormal events and professionals would not be interested. Children may withhold complaints because of concerns that they are abnormal, or they want to protect their parents who are visibly upset.


FIGURE 8-1 Adjustment over time in a crisis situation.
SOURCE: Schonfeld presentation, June 11, 2013.

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