Counseling children following the Sandy Hook Elementary School shooting

When the lives of six educators and 20 children between the ages of 6 and 7 were cut short in a mass shooting at a Newtown, Conn., school Dec. 14, the entire country found itself reeling.

The tragedy at Sandy Hook Elementary School is the second deadliest school shooting in U.S. history, following only the 2007 Virginia Tech massacre. It is, however, the most deadly shooting to take place at an elementary school.

Deb Del Vecchio-Scully, the executive director of the Connecticut Counseling Association and trauma expert, says the ages of the victims and the fact that the shooting took place at a school make the tragedy resonate with people in every corner of the country.

“School is supposed to be a safe place,” says Del Vecchio-Scully, a member of the American Counseling Association. “Not just [Sandy Hook Elementary] is going to be affected but also other schools in the area. There are going to be long-reaching effects on parents and children that we are going to see in the days, weeks, months and years to come.”

And as the community of Newtown grieves, Del Vecchio-Scully says the initial question is how the tragedy should be discussed with children.

“You want parents to be the source of information,” she says. “Not other kids, not the news.  Be honest and direct, take your cues from your child and respond accordingly.”

Del Vecchio-Scully recommends keeping children away from news reports, as studies have shown they can increase the risk of posttraumatic stress disorder.

She says counselors, parents and teachers will need to be mindful of the way they help children cope with the tragedy because kids are still mentally and emotionally maturing.

“The younger child’s brain  is not developed to understand the permanence of death, and that’s going to add a difficult layer to it,” Del Vecchio-Scully says. “[Children] are the ones who are going to ask ‘What happened? Why can’t I go back to school?’”

In addition, Del Vecchio-Scully says, it’s often hard for children to find the right words to describe how they feeling about what they’ve experienced.

Del Vecchio-Scully recommends giving children a creative outlet as a way to express their feelings. “Kids act out their worries and concerns through play and their artwork,” she says.

Because the event is still recent, Del Vecchio-Scully says most reactions a child may exhibit for the next week or two can still be considered normal. This may include regressive behaviors such as wanting to sleep in bed with parents, bed-wetting or acting out.

“Normalizing and fostering a sense of safety and routine is important right now, and that’s going to start at home,” she says.

It is also important for parents to foster open communication and to be open and honest about their feelings as well.

“Kids are very sensitive,” Del Vecchio-Scully says, “ and they’re going to get their cues from their parents.”

Similar to parents, teachers should also focus on maintaining a daily routine and should aim to answer questions from students to the best of their ability.

Del Vecchio-Scully says the impact of the trauma and the mental health needs of communities are layered like concentric circles.

“The inner circle includes the children, school staff and first responders who witnessed the event and/or the crime scene, as well as the officials who informed the families of the death of their loved ones,” she says. “Next are the parents of the surviving children and those whose children were killed. On the more outer rim of the circle is the rest of the greater Newtown community and the entire Connecticut community.”

The fourth layer includes the general public watching the tragedy unfold in the news media and through social media who are vicariously impacted, Del Vecchio-Scully says.

Crisis intervention is already occurring in Newtown, and for most counselors, Del Vecchio-Scully says, “our services will be needed once the crisis period passes and a void in caring for the community is evident.”

Although Del Vecchio-Scully says that now may not be the time for therapy, counselors, too, can take on the role of listener for those impacted by the shooting if the situation calls for it.

But in the months to follow, Del Vecchio-Scully says, “the crisis intervention teams will withdraw, creating a void of support, which will result in a shift of responsibility of the ongoing mental health needs of the community to local agencies and volunteer counselors.”

Counselors should be on the lookout for individuals who are at risk of re-traumatization.

“Newtown was one of the towns that was hit by Hurricane Sandy,” Del Vecchio-Scully explains. “They went without power for a week. As traumatic events get layered, the ability to cope gets less.”

This is also the time for counselors to focus on individuals in the outer concentric circles — those who may not have been directly impacted by the events in Newtown but are having trouble coping.

The shooting at Sandy Hook Elementary will have an especially far-reaching impact because a school setting is something that all children share and experience, Del Vecchio-Scully says.

Del Vecchio-Scully says the events mirror the attacks on 9/11. “The world watched in real-time, and individuals will be impacted in some way that we can’t really know right now,” she warns counselors.

Del Vecchio-Scully stresses the importance of the role of counselors in helping children and communities cope and move forward in the months following a tragedy such as this.

“Kids are extraordinarily resilient,” she says, “and we have to give them the chance to be.”

[by Heather Rudow, Counseling Today]

Responding to the Connecticut School Shooting: Six “T’s” for Helping Kids through Trauma

Six “T’s” for Helping Kids through Trauma:

1. Togetherness. This is a night where your kids need to have you close. They need to know they’re safe. Pull in together as a family. Pray together. Be together. The antidote to trauma is safe, loving relationships. Coddle your children a little bit more. Stay in close proximity to them, particularly if they’re anxious or afraid.
2. Touch and Tenderness. Touch is an expression of affection that reinforces proximity and closeness. It produces a calming affect. Fear makes our minds race and wander, but tender touch dispels it. Hold a hand. Stroke your children’s hair. Let them sit in your lap. Wrap your arms around them. Kiss them. Be present emotionally. If they’re acting out a little bit with anger, rebellion or defiance, it very well could be a fear response. Be sensitive to their behavior.
3. Talk. The questions will come: “Will a shooter come to my school?” “Why did he hurt those kids?” Be present, sensitive, and don’t offer pat answers. Engage them in age-appropriate discussion. Contrary to what many of us believe, talk doesn't perpetuate anxiety—it helps to reduce it. Avoid graphic details, but don’t skirt around the issue. Become a safe place for them to bring their questions.
4. Truth. Fears of the unknown can paralyze us. Anchor their hearts in truths like, “Not everyone in the world is bad. You’re safe now. God loves us and is close to us.” Remember, our kids absorb us. Your mood, thoughts, and actions directly influence theirs. These truths flow through you—Mom and/or Dad. Share the promises of God’s Word with your kids. Pray for, and with, them.
5. Triggers. Someone screaming. A door slamming. A siren. What children experience or see on the news can deeply affect them. Don’t let your kids get overdosed with the news stories and all the gory details. This can lead to nightmares, excessive bouts of crying, deepening fear, and not wanting to attend school. Be attuned to your children. Don’t react to their emotions, respond lovingly.
6. Time. Don’t rush or ignore this process. Over the next several days, we will all be flooded with information about the shooting. Keep your life as normal as possible. Sameness and routine reinforce the message of safety for your kids. Your family stability over time will help dispel their fears.

Our children are not immune to the darkness and brokenness of our world. We may think that if we ignore this incident, our kids won’t know about it or feel the impact. Nothing could be further from the truth! Our kids need parents and teachers—those who have influence in their lives—to be emotionally present and invested, especially in moments like these.

[Tim Clinton, Ed.D., LPC, LMFT]

How to Cope With School Shooting Tragedy

In the aftermath of a deadly shooting at a Newtown elementary school, in which 20 young children and eight adults were killed, individuals in the community and across the nation are coping with tragedy and trauma. That trauma can occur without physical injury and can last long after the medical problems heal, according to the American Psychological Association.  Here are some healthy ways to cope:

• Watch for signs of severe stress:  Signs include re-experiencing the trauma during play or dreams, avoidance of reminders of the trauma and general numbness to all emotional topics, increased “arousal” symptoms such as trouble staying or falling asleep, irritableness and difficulty to concentrate. Fears and phobias often are developed. Children may also keep repeating a part of the trauma.
• Be supportive: Children will benefit greatly from support and caring expressed by the adults in their lives.
• Be available: Let children know you are available to talk with them. Let children ask questions. It is OK if you don’t know the answers to the questions.
• Be caring: Help children express their feelings with care and understanding.
• Be reassuring: Acknowledge the frightening part of the event. Explain what happened in words the child understands. Reassure children they are safe and loved. and let them know it is OK to feel upset.
• Be thoughtful: Be aware of how you talk about the event and cope with the tragedy. Children often learn how to cope by watching the reactions of parents, peers and the media. Keep in mind children may not express their concerns verbally.
• Be creative: For children too young to truly express their feelings, consider expressive techniques such as play, art and music.
• Remind them that trustworthy people are in charge:  Explain that the government emergency workers, police, firefighters, doctors and other authority figures are helping people who are hurt and are working to ensure that no further tragedies occur.
• Tell the truth: Don’t pretend an event has not occurred or is not serious - and stick to the facts. They will be more worried if they think the parent is shielding them from the truth. Talk to them. Answer their questions.
• Get back into routine: To help create a sense of security, try to maintain family schedules for daily activities such as eating, playing and sleeping.
• Give children the amount of information they can understand: This involves turning off news reports of the event and controlling or limiting their exposure to threatening images on TV.
• Encourage multiple methods of grieving: Call a therapist or counselor, join a support group, attend a church function or go to a community center where others are holding rituals dealing with grief. Often, during the grieving process, discussing feelings with others helps in understanding the event and knowing you are not alone.

[By Kelly Metz, Digital First Media.  Sources: American Psychological Association (APA), Brett Holden, Ph.D., KidsHealth.org, PBS, National Association of School Psychologists, National Center for PTSD.]

Mandated reporting of violence risk?

Likely, you are participating in the current national soul-searching after the latest tragic school shooting/mass murder.  In our angst we ask, “Why God?” and “What can we do to try to stop this kind of senseless killing?”  It is the second question that is on my mind right now.

Political debates will abound about gun control measures or the right to bear arms.  In my humble opinion it is time to move beyond that debate to address the treatment of those who are most at risk to engage in mass killings.  I have no idea about the mental status of this most recent killer but that shouldn't stop us from trying to figure out how to better care for such individuals.

Who is at risk?  A complex matter

Violence risk assessments have morphed over the years from clinical judgement (turns out it wasn't very accurate!) to an actuarial approach looking at factors like: active psychotic symptoms, family problems, history of aggression/domestic violence and or criminal behavior, social withdrawal/skills deficits, and substance abuse.  But of course, there are many who have positive indicators on several of these factors who are in no danger of becoming a mass murderer.  And others who meet none who become killers.

One possible (partial) solution

Right now mental health professionals and educators are required to report possible child abuse.  In addition, we counselors have duties to warn and protect when our clients indicate they are an imminent danger to self or other.  Sadly, many adults in high risk categories are not likely to be in treatment (due to costs, treatment availability and refusal) and may not be in contact with educators.  So, what might we do to help those who do come in contact with at-risk individuals?  In some states, all civilians are required to report potential child abuse.  What if we develop a reporting mechanism for civilians to report those who are making statements about violent acts.  To make this work, there are some additional things we would need to do (some of which are not simple).

We would have to engage in a large public awareness campaign and to train law enforcement and even mental health professionals as to these risk factors and develop humane but required treatments
We would need to stop cutting public funds for mental health (and increase quality of community mental health care providers).

We would need to consider limiting some of the currents rights to decline treatment when a number of the risk factors are present (this is, of course, no small matter.  In this country we have the right to be insane…as long as we don't hurt others).

What do you think?

[from “Musings of a Christian Psychologist” by Phil]

Helping Your Children Cope With Connecticut School Shooting

1. Hug your kids tight and reassure them they are safe
2. Listen to your kids and discuss with them their concerns
3. Limit younger kids’ exposure to TV and other media reports
4. Monitor older kids’ social media activity in relation to the incidents, because that is often where they will share worries or concerns
5. For more tips on helping your kids cope with a tragic situation, call us for an appointment

Hoilday Overeating

Whether it's the "holiday blues" or festivities with family and friends, we are all prone to turn to food to meet our emotional needs.  Obesity is one of our nation's greatest health challenges, and a significant concern for those in the helping field.  The statistics are shocking:

• More than one-third of U.S. adults (35.7%) are obese.
• Approximately 31% of children and adolescents aged 2-19 years are obese.
• Since 1980, obesity prevalence among children and adolescents has almost tripled.

There a number of well-documented health risks associated with extra weight, including asthma, sleep apnea, high blood pressure, elevated cholesterol, and diabetes—not only among adults, but also children.  However, obesity is not just a physical concern, it’s also an important mental health concern—and a spiritual concern, as well.

Author Kristen Weir of the APA reports, "The repercussions of excess weight extend to the brain…linked to changes in brain structure as well as changes impairments in learning and attention span."  The emotional and cognitive aspects of overeating are important considerations in treatment planning with this population. Oftentimes, stress, emotional difficulties, and faulty self-perceptions fuel overeating and must be addressed in counseling.

There is a connection between physical and mental health.  How can we develop a healthy lifestyle—emotionally, physically, and spiritually?  Here’s several suggestions:

Include the whole family.  "The most successful ways to…shed pounds are interventions that combine diet, physical activity and behavioral recommendations," the article notes.  When an entire family recognizes the importance of physical, spiritual and emotional health, they can begin developing a family culture that promotes these values, developing new traditions and routines.

Build a healthy home environment.  "The trick is to help parents engineer healthy home environments—removing TVs from bedrooms, limiting computer time, making physical activity a routine for the entire family, and teaching parents how to find and prepare nutritious food on a budget,"  Weir shares.

Develop a healthy, active lifestyle.  Preventing and treating obesity isn't as simple as avoiding "junk food." While most interventions focus on the negative—telling people what not to eat—it's important to emphasize the positive as well, such as nutritious holiday foods and ways to incorporate exercise into Christmas activities.

Find emotional support.  Meaningful relationships are an important factor in weight loss or maintenance.  How easy it is to turn to food, rather than God or other people, when we are hurt, confused, overwhelmed or lonely.  As with any other area of change, accountability is critical—not only for exercise, but also to control overeating and find healthier ways to cope with stress.

Incorporate a team approach.  Exercise may be helpful, but without addressing the emotional and cognitive issues often underlying compulsive eating, it will likely be difficult to keep weight off.  By the same token, the best therapy in the world without appropriate lifestyle changes will not be thoroughly effective either.  Building healthy communities requires collaboration between counselors, medical doctors, dietitians/nutritionists, physical trainers, health coaches, and more.

God's Word has quite a few things to say about lack of self-control when it comes to eating.  In fact, Proverbs speaks strongly about the destructive nature of overeating: "And put a knife to your throat if you are given to appetite" (Prov. 23:2).  By contrast, we are encouraged, "Whether you eat or drink, or whatever you do, do all to the glory of God" (1 Cor. 10:31).

This Christmas and New Year’s, we encourage you to evaluate your holiday lifestyle.  More than any other time of the year, the holidays are a season for overeating and overstressing, while exercise and sleep often fall by the wayside.  But long after the "holiday cheer" has come and gone, the negative impact of these lifestyle choices can affect our mental, emotional, and even spiritual health.

[by Laura Captari]

Binge eating disorder to be recognized in the new DSM-V

As the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is set to be released in May, counselors are preparing for the changes that will come along with it, including the inclusion of binge eating disorder as a mental illness. Binge eating disorder had previously been listed as “under review” because symptoms... continue reading

Anger Management

A growing number of teens are suffering from anger attacks!

That's the finding of a new study from Harvard University.  Researchers studied 10,000 teenagers and asked them things like, "How often do you get angry?" and "What do you do when you're upset?"

The result?  About 10% of teenagers regularly have "anger attacks," where they go from "0 to 60 mph" in seconds, and get so fired up that they destroy property, or become violent, getting into fights, or punching holes in walls.  What they're suffering from is called "intermittent explosive disorder," or IED, and it can last a lifetime.

For example, 1 in 10 adult men, and 1 in 20 adult women, get so angry they're literally sick.

How do you know you have it?  If you blow up at least twice a week, and get so angry you're likely to damage property, threaten others, or hurt somebody.

Experts say that people who suffer from IED also have fewer friends, are more likely to be divorced, and are less likely to have a decent job.  Also, studies show that being chronically angry increases your risk of heart disease and stroke.

So what can you do if that diagnosis sounds all too familiar?

Lead researcher Dr. Ronald Kessler says people with IED need to receive anger management, whether they're teens or adults.

They need to find a way to deal with their angry feelings and channel their energy.  One trick is to do something incompatible with anger.  In other words, distract yourself with a movie, a game, or your favorite magazine until you calm down.  But the experts say, most people with IED do need counseling to help manage their behavior.

Want To Avoid Dementia and Alzheimer's?

An active lifestyle helps preserve the brain's grey matter and lowers the risk of dementia and Alzheimer's disease (AD), says a new study.

More than 35 million people worldwide are living with dementia, and the numbers are expected to double by 2030, according to the World Health Organization. AD is the most common cause of dementia and is incurable.

"The grey matter volume is a key marker of brain health.  Larger grey matter volume means a healthier brain. Shrinking volume is seen in Alzheimer's disease," said Cyrus Raji, radiology resident at the University of California in Los Angeles (UCLA), who conducted the study.

Raji and colleagues recently examined how an active lifestyle can influence brain structure.

They studied 876 adults of an average age of 78 years, drawn from the multi-site Cardiovascular Health Study.  The patients' conditions ranged from normal cognition to Alzheimer's dementia, according to an UCLA statement.

"We had 20 years of clinical data on this group, including body mass index and lifestyle habits," Raji said. "We drew our patients from four sites across the country, and we were able to assess energy output in the form of kilo-calories per week."

The lifestyle factors examined included recreational sports, gardening and yard work, bicycling, dancing and riding exercise cycle.

"The areas of the brain that benefited from an active lifestyle are the ones that consume the most energy and are very sensitive to damage," Raji added.

"What struck me most about the study results is that it is not one but a combination of lifestyle choices and activities that benefit the brain," Raji said.

"Virtually all of the physical activities examined in this study are some variation of aerobic physical activity, which we know from other work can improve cerebral blood flow and strengthen neuronal (brain cell) connections," he said.

Researchers used magnetic resonance imaging (MRI) and a technique called voxel-based morphometry, "an advanced method that allows a computer to analyze an MR image and build a mathematical model that helps us understand the relationship between active lifestyle and gray matter volume," said Raji.

These findings were presented at the annual meeting of the Radiological Society of North America (RSNA).

Divorce Prevention

Couples counseling isn't just for unhappily married couples anymore, or longtime partners struggling to salvage their relationship.  These days, even people who've only been dating a few months are going to couples' therapy!  But why would a new couple want to go to therapy?

For starters, there's a whole generation of young adults who lived through their parents' divorces and they don't want to make the same mistakes.  Another factor is, these days, we hire pros for all sorts of things - we have personal trainers, fashion stylists, and life coaches.  So, some people see couple's counseling as an alternative to getting advice from friends, and they hire a pro to do it.  And it can also be especially helpful for young couples who've grown up texting and tweeting.  They have a harder time communicating face-to-face in every aspect of life - especially when it comes to their relationships.  That’s why we are seeing more young adults, and new couples, coming in for help.  So, how do you know if you need a counselor, or if you can work things out on your own?

• Well, if the sizzle has temporarily fizzled, you don’t need therapy.  You just need to make your relationship a priority.  Today, couples can get so busy with work that they don’t make time for each other, so carving out time may fix the problem.  But if you haven’t been intimate in ages, we can help, because it could mean you've got bigger issues.
• So, what if you’re bickering nonstop?  You need a therapist.  If small problems blow up into big fights, there are probably deeper issues to fix.
• Finally, you might want to try therapy if you never fight.  If you turn away from your partner more than you turn toward them – it’s a sign that there’s distance between you.

Computer or iPad Counseling Sessions

There's a TV show called "Web Therapy" on Showtime, starring Lisa Kudrow from "Friends."  She plays a psychologist who practices online.  Well, now it’s a reality.

The latest trend in therapy is videoconference sessions, which means, no matter where you are, you can have a private session with your psychologist, or counselor via Skype or FaceTime on your computer, iPad or smart phone.

Clients appreciate online therapy sessions, because they can schedule an appointment anywhere, at any time. And a lot of them feel they need less therapy because their counselor is always just a click away.

And a lot of therapists like live video sessions because they can work from home, instead of renting an office. They also no longer have to worry about canceled appointments because of blizzards, broken legs, or business trips.  And they can still treat patients if they, or the patient, moves away.

There are some drawbacks, but it works well enough to grow a trend.  Kinks are still being worked out, but studies show that patient satisfaction is just about equal whether they interact with their therapist face-to-face, or online.  So, online therapy sessions are here now at the Synergy Counseling Center.

If you'd like to set up an appointment for a Skype or FaceTime counseling session, call 256-273-7216 anytime day or night.  We can also do most assessments online.

Seeing things? Hearing things?

What does it mean if you hear things that no one else hears?  See things that no one else sees?  Does it mean you are having a spiritual experience?  Or, do you have some form of psychotic disorder?

I submit for your reading pleasure a NY Times essay by Oliver Sacks.  Dr. Sacks suggests there may be some other possible reasons why you might hear or see or feel something that isn't heard, seen, or felt by others.  In fact, he points to research that a large portion of those who do have these experiences never tell others or doctors about them for fear of being labeled falsely with schizophrenia.