Helping elementary-age children cope with disasters.

On September 11, 2001, the unthinkable occurred. Millions of people around the world witnessed on television a horrifying calamity. The towers of the World Trade Center in New York City and a section of the Pentagon were destroyed in acts of terrorism. A good percentage of onlookers were school children, who along with their families, viewed intently many days as newscasters reported the tragedy and its overwhelming toll on human life. In checking with various school personnel and children in Texas and Washington following the event, we found that many school counselors provided little or no targeted assistance to staff and students on how to psychologically process their feelings. This disturbing trend led us to question how well school counselors have been prepared to effectively respond to unanticipated disasters.

Unlike this recent tragedy, other unpredictable upheavals like earthquakes and tornadoes may not invite a protracted national spotlight. In fact, in the aftermath of a major calamity, it may take people decades to acknowledge their concerns and adapt accordingly. The negative psychological impact on children can vary from mild to severe and last for many months, even years. Children often share similar responses to a range of disasters (e.g., mild to major earthquakes, floods, mud slides, hurricanes, tornadoes, brush fires, bombings; Farberow & Gordon, 1981; Mark & Layton, 1997). Since disasters are more common and destructive than most people realize, the utility of advanced research and preparation should not be undervalued.

Recognizing the potentially deleterious impact of disasters on U.S. society and anticipating the need for mental health interventions, the Disaster Relief Act of 1974 (1974) mandated, among other services, crisis counseling for all victims. Nonetheless, how individuals cope with their adversity and what they need in terms of intervention seem to differ by age group (New York State Office of Mental Health, 2001). For instance, contrary to popular belief, most children do not "grow out" of trauma, nor are they more adaptable than adults (Galante & Foa, 1986; Gordon & Wraith, 1993). During the recovery process, children often lack the maturity to cope effectively with the complex repercussions of a disaster (Haizlip & Corder, 1996; Hofmann & Rogers, 1991; Stein, 1997). Moreover, these events can lead to uncomfortable or painful emotions in children, including mild to severe posttraumatic stress reactions. Given that distressing events in early life often influence the psychological makeup and personality development of the affected ones (Gordon & Wraith), elementary-age children require specialized attention, including intervention methods aimed explicitly at their level of personal and social development. If school counselors do not take the threat seriously and are inadequately educated, even a minor disaster may cause, for example, anxiety and nightmares in children that may be downplayed or go unaddressed.

Because they understand the mental health needs of children and youth, school counselors are perhaps a community's "first line of defense" following a major disturbance (Shen, in press). Adopting a proactive approach, they can be empowered in crisis situations to support children and their families. Unfortunately, the approaches to disaster prevention and intervention have received nominal attention in the school counseling literature. Specifically; in this article, we (a) address the effects of disasters on elementary-age children and their needs for mental health; (b) suggest possible school-based interventions; and (c) provide a case study of a traumatized first-grader, demonstrating how child-centered play therapy can be used in school settings. Before reviewing these interventions, we consider in more depth the responses of younger students and their mental health needs following disasters.

Children's Reactions to Disasters and Needs for Mental Health Assistance

Most studies that examined various interventions along with psychological and psychiatric reactions after disasters tend to focus on adults rather than on children (Gordon & Wraith, 1993; Hofmann & Rogers, 1991; Sugar, 1989). In fact, prior to the 1980s, relatively few publications examined the impact of traumatic events on children's mental health (American Psychiatric Association, 1987; Gordon & Wraith; Pynoos et al., 1993; Schaefer, 1994). Recently, in light of the September 11 catastrophic event, several Web sites have emerged which present clear information on age-related reactions of children to disasters (e.g., American Counseling Association, 2001; American Psychological Association, 2001).

As a way of exemplifying the consequences of very distressing events and because earthquakes are fairly common in the United States and abroad, we first briefly explore the impact of moderate to severe quakes on children's material and psychological well being (Shen, in press; United States Geological Survey, 2000). In February 2001, for example, Seattle area residents and school children experienced a potentially life-changing event--a major earthquake (National Public Radio, 2001). Anecdotal evidence from the local teachers and counselors suggested that many children reported significant concerns and fears about their personal and familial security.

Investigations with children and adults on the aftermath of earthquake disasters indicated various physical and psychological reactions (Maida, Gordon, & Strauss, 1993; Pynoos et al., 1993). Reported physical responses included, for instance, heart palpitations, headaches, body tremors, fatigue, suicide, hyperactivity, and aggression (e.g., Galante & Foa, 1986). Mild to severe psychological responses with their physiological manifestations were observed as well (e.g., mild feelings of insecurity, trouble focusing, loss of purpose, low self-efficacy, irritation, hypersensitivity, open defiance, irrational fears, depression, insomnia, and severe anxiety; e.g., Sharan, Chaudhary, Kavathekar, & Saxena, 1996; Shen, in press).

In addition to the above reactions, disasters may produce physical and psychological effects on children that differ in intensity and duration from adult responses (Sugar, 1989). Interestingly, children are often not aware of their distress, and it may not be recognized until their parents find it difficult to interact with them (Blaufarb & Levine, 1972). The discomfort signs may include physical complaints (e.g., loss of appetite, enuresis, nausea, headaches, stomachaches) as well as strong emotions and reactions (e.g., withdrawal, helplessness, grief, suicidal thoughts, isolation, school avoidance; New York State Office of Mental Health, 2001). In fact, many of the children's reactions mentioned above are normal ones, especially if they do not linger over a long period (Farberow & Gordon, 1981; Mark & Layton, 1997). Unlike adults, however, children's imaginative thinking is more likely to result in negative feelings, requiring more time to recuperate (Gordon, Farberow, & Maida, 1999; Hofmann & Rogers, 1991).

For some children, the emotional aftershocks and dramatic life changes can be profound. Studies suggest that disasters like large earthquakes can also lead to posttraumatic stress disorder (PTSD; Doherty, 1999; Pynoos et al., 1993). Conditions that often occur during disasters may include experiencing (a) a life-threatening event or direct exposure to the incident, (b) the lack of social support and communication, (c) the destruction of family property, or (d) parents' distress. These situations may lead children to be at risk for PTSD (Schaefer, 1994).

Subsequent to experiencing the calamitous events, primary caregivers generally become less capable of recognizing their children's needs. They seldom, therefore, supply appropriate coping assistance when their children struggle through conflicting emotions (e.g., grief, fear of abandonment, feeling of confusion) and multiple losses (e.g., loss of their schools, homes, familiar surroundings, loved ones, pets, toys; Doherty, 1999; Mark & Layton, 1997). The feeling of losing control often makes it harder for frightened parents to convince their terrified children to relax (Blaufarb & Levine, 1972). Prinstein, La Greca, Vernberg, and Silverman (1996) found that after a disaster, parents' most common communication strategies involved the reinstitution of familiar routines as well as the avoidance of emotionally provoking stimuli. The emotional processing of traumatic events was largely ignored (Prinstein et al.). Worse, the inconveniences (lack of utilities and basic services), frustrations (unemployment of adults due to bodily injury), and the emergency (securing food and drink, clothing, and shelter) resulting from disasters may increase child abuse and domestic violence (Gelman, 1989; Chen, 2000).

To summarize, research has shown that trauma unchecked can eventually result in long-term dysfunctional patterns, including developmental irregularities, school failure, personality changes, postponing life tasks, chronic peer problems, poor physical health, preoccupation with other traumas, and identity changes as well as life view changes (Gordon & Wraith, 1993). Timely and effective school-based interventions during and following crisis situations have been shown to foster children's psychological healing and their overall functioning (Blaufarb & Levine, 1972; Webb, 1999). Without adequate support and help, the disruption of children's lives can be considerable. In the following section, several school-based intervention principles and helping strategies are described.

Implications for School Counseling Practice

While elementary school counselors are key educators to coordinate and implement student interventions during crisis situations, schools offer children the reassuring environment for regaining the sense of order, security, and normalcy (Gordon et al., 1999; Nordboe, 2000). Elementary schools may also serve as response centers for large-scale community disaster relief programs (Gordon et al.). Under emergency circumstances, when the resumption of daily routine and the sense of support and stability are regained, some children may exhibit resiliency, while others vulnerability (Galante & Foa, 1986; Prinstein et al., 1996). Regardless of the children's psychological state, adults who ignore their emotions, hoping for them to return to normal, are not using a particularly helpful strategy. When the parents are less capable of modeling appropriate coping skills, counselors become a prime resource for youngsters. In addition to providing psychological support for caregivers, mental health services must be readily available to children (Sugar, 1989).

Operational Principles

Before we discuss intervention techniques, there are several guiding principles that school counselors can use as they initiate disaster assistance. The principles should be shared with the school and district personnel as well as integrated into a district-wide disaster relief plan. In this way, all educators are working from a similar perspective.

Estimate professionals' competency level. The assumption of the leadership role requires school counselors and staff to be aware of their personal reactions and feelings in times of crisis. Professionals may be among the victims of the disaster, and until counselors are able to satisfactorily cope with their complex feelings, they are generally less helpful to children (Arata & Picou, 2000). When educators are overwhelmed, it is better to call for assistance from an external counseling response team (Brooks & Siegel, 1996).

Respect children's readiness. When school counselors provide crisis interventions following disasters, it is important to keep in mind that although children need avenues to vent or mourn, they should never be forced to share (Wolfelt, 1990). Children need to proceed at their own pace and readiness level. Care providers need to remain patient and flexible, adjusting to students' timetables and concerns as the situation demands.

Foster a safe climate. Collaborating with classroom teachers, school counselors should help foster an accepting and nonjudgmental environment. A healthy recovery process seems to emerge, especially during the crisis intervention process, when children feel safe, supported, and are ready for the pain that precedes healing (Drewes, 2001; Lynn & Nisivoccia, 2001). Moreover, a warm and caring school milieu may promote the efficacy of counseling interventions.

School-Based Interventions

In the aftermath of a calamity, there are appropriate ways of supporting children and their needs, which ought to be planned in advance and discussed with the school staff. Additionally, school counseling interventions need to be timely and well focused. We present here various suggestions for helping school children that are derived largely from the psychological and counseling literature (e.g., American Red Cross, 2001; Lynn & Nisivoccia, 2001; New York Office of Mental Health, 2001; Nordboe, 2000).

Recommendations for the implementation of classroom guidance and counseling interventions. Encourage open communication. Within the context of comprehensive school counseling programs (Campbell & Dahir, 1997), large group guidance activities should first encourage children to discuss their experiences and feelings about the event. Young people need to be able to identify and express verbally their full range of feelings (Nordboe, 2000). By venting their negative emotions, children are more likely to distance themselves psychologically from their pain. In fact, if children hear each other speak of their feelings, anxious though they are, even younger ones may feel relieved (Blaufarb & Levine, 1972). Similarly, counselors should have children recognize and elicit their positive feelings. For instance, children might feel relieved to find the school day changed. Certain students will naturally be quite vulnerable and others will provide little indication of an emotional reaction. For younger students who are timid, counselors can assist them to verbalize their thoughts and emotions, for example, through puppets chosen by the children. Counselors should also model emotional openness as well. In short, teaching students to accept their own and respect others' emotions seems to not only facilitate the recovery process, but also is an integral part of emotional education (e.g., Saarni, 1999).

Use open questions to clarify children's thoughts and feelings. To further enhance classroom dialogue, counselors frequently ask general to specific how, what, and where questions. This method can help children clarify their thoughts and beliefs (Arata & Picou, 2000). A sample "where" question could be: Where were you, your family, and your friends when the event happened? The "what" questions might consist of: What did you see and hear? What were you (and other people or animals) doing? What were you thinking about then? After that, what did you do? What changed? What dreams did (or are) you have (having)? Suggested "how" questions are: How did you feel then, and now? How did you get through rough times? How did you help others? Next time something like this occurs, how might you help in a different way?

Provide relevant and truthful information about the disaster. Because school-age children are more likely to be interested in the forces behind various disasters (Brooks & Siegel 1996), providing accurate information for them can be extremely helpful and healing (Nordboe, 2000). As such, counselors, through the use of classroom guidance, should attempt to dispel inaccuracies and rumors about the disaster through the judicious use of scientific knowledge. If at all practical, school counselors should collaboratively develop classroom activities with teachers who possess expertise. Activities could include Internet searches, library research, and listening to expert guest speakers. Depending on the age of the pupils and the nature of the disaster, pose questions which can be followed up with project-based learning activities.

Decrease confusion through exploring the societal responses to the disaster. Related to the previous suggestion, learning about how others in the community respond to the upsetting event provides children an alternative channel to release their feelings of isolation and confusion. Counselors can collaborate with those teachers who have expertise in social studies. Students can clip articles, photos, and cartoons from newspapers and magazines or take photographs about the disaster and its aftermath (Arata & Picou, 2000; Mark & Layton, 1997). Articles discussing the impact of the event can be read aloud. Selected items with their captions can also be glued on colored paper to make school or classroom posters.

Allow children opportunities to mourn the loss of significant others and pets. Children, especially those who are touched by death of their loved ones and pets, need to learn that grief is not shameful, but rather, a natural human process. To help them work through their pain, school counselors can work with art, music, and language arts teachers. Moreover, because children with strong social support are more likely to cope more effectively with life stressors than those without such assistance (Compas & Epping, 1993; Prinstein et al., 1996; Vernberg, La Greca, Silverman, & Prinstein, 1996), group or classroom instruction should include cooperative learning activities (Garmston & Wellman, 1999) as well as opportunities for role playing and learning in dyads and triads (Joyce, Weil, & Calhoun, 2000). Activities, for example, to deal with loss after a disaster, include (a) writing memoirs, poems, and articles about people and pets; (b) letter or journal writing for saying good-bye; (c) creating portraits, collages, and memorial sculptures of people and pets, and (d) drawing collective murals or presenting a music drama (Arata & Picou, 2000; Mark & Layton, 1997; Nordboe, 2000; Oaklander, 1978; Shen, 2000).

Provide children opportunities to mourn the loss of toys, collections, and familiar environments. Since school-age children are developing their sense of ownership, the loss of personal belongings can be especially difficult for them (Brooks & Siegel, 1996). The activities suggested above can also be used with children who have lost their toys and other personal things. For children whose families have been evacuated from their home or become homeless, the activities can help young people grieve the loss of familiar surrounding and a safe place. It should be noted that debriefing is a key to healing after the students complete their writing, painting, or sculptures in the class. Encouraging them to tell stories and share their feelings and concerns about the people or things they are mourning often helps children become more accepting of reality and return to their normal lives (Wolfelt, 1990).

Encourage the positive side of humanity. After providing children opportunities for venting and grieving, school counselors need to assist children see the "positive" elements emerging from the tragedy (Mark & Layton, 1997; Nordboe, 2000). One activity that can be useful is the discovery of "disaster heroes" (Nordboe). Discussing these people can help children focus on how others overcame negative feelings and regained a sense of safety and security. The hero can be a person who has acted courageously by helping others in the midst of or after the disaster. Heroes need not be well known, but must be individuals whose behavior is highly esteemed by the child--a family member or a neighbor will do.

Increase awareness of the potential, negative after-effects of severe disasters. It is important to discuss with children potential dangerous situations and how to avoid them. The issues may include domestic violence, substance abuse, and child abuse. School counselors can help children gain a clearer picture of the interpersonal relationships at home. Children need to understand that they may not be the cause of their parents' sour moods, but may be the target to which the bad moods are directed. By addressing this issue, counselors may well reduce children's guilt and self-blame. The telephone numbers of crisis hot lines should be readily accessible.

Assist children to prepare a personal safety plan. It is vital that school counselors help children and their families develop and practice a safety plan. In this way, the next time a disaster strikes, they will feel less fearful and more in control (Mark & Layton, 1997; Southern California Earthquake Center, 2000). To prepare for aftershocks, for example, ask children to walk through the rooms at home and look for things that could fall when shaken and try to secure them. Classroom game playing and visiting disaster preparedness Web sites (e.g., http://www.ag.uiuc.edu/~disaster/prep.html) are excellent ways to actively involve children in the planning process. Moreover, encourage parents or guardians to help children to create a personal emergency kit. Things like a first-aid kit, bottled water, protein bars, a flashlight with extra batteries, a change of clothes, and favorite playthings will make the emergency kit a valuable companion (see, the Web site, http: //www.disasterrelief.org/Library/Prepare/supplies.html, for additional suggestions).

Identify those children who need additional intervention. Counselors need to identify those children who may require small group or individual counseling. Because psychological adjustment reflects individual differences, both the degree of emotionality and physical manifestations of stress are important clues to recognize. Counselors should be aware of the potential symptoms we discussed. To effectively screen high-risk students, counselors may adapt the short Children's Mental Health Checklist (Gordon et al., 1999). One can also use play therapy to assess children's emotional reactions to disasters (Schmidt, 2001).

Play interventions for small group and individual counseling. Applying play techniques in educational settings has been long encouraged by researchers (Drewes, Carey, & Schaefer, 2001; Landreth, Homeyer, Bratton, Kale, & Hilpl, 2000; Shen, 1998). Given that young children's verbal efficacy emerges slowly, play remains their primary language (e.g., Vygotsky, 1986). The use of play and art has been recommended for traumatized elementary-age children (e.g., Drewes, 2001; Klingman, 1993). For example, research conducted in the United States (Hofmann & Rogers, 1991; Roje, 1995), Italy (Galante & Foa, 1986), and Taiwan (Shen, in press) has shown that children's fears developed after a major earthquake can be reduced by play interventions. School counselors can subtly reduce children's resistance to change by infusing play techniques into their interventions.

In setting up the room for play and art work, we recommend counselors at least obtain these tools: (a) "real life" toys (e.g., a house with furniture, a sand tray, miniature figures, kitchen set with food, two telephones, a doctor kit, a cash register with money, stuffed animals, ambulances, police cars, airplanes); (b) energy releasing and stress reducing materials (e.g., a rope, pillows, squishy balls); and (c) creative expression materials (e.g., materials for making arts and crafts, a chalkboard or white board, musical instruments, dress up costumes). Counselors may also want to utilize in developmentally appropriate ways these items and strategies: coloring and bibliotherapeutic books, puppets, board and card games, clay, water, dolls and action figures, family figures, scribble games, storytelling, drawings, dramatic play, expressive movement, and role playing (e.g., Drewes et al., 2001).

Although a technical-eclectic approach to play therapy has been recommended by some writers (e.g., Norcross & Prochaska, 1988; Schaefer, 1994) to facilitate the recovery process of hurting children, we recommend several helping strategies that are theoretically based, including Gestalt and Rogerian child-centered approaches (Muro & Kottman, 1995; Shen, 1998). The less intrusive Rogerian method, for instance, can be modified for school-based play intervention. This approach tends to work well with elementary-age children who are having problems coping with the traumatic reminders or events. For children who seem to be less emotionally harmed and ready to process the painful event, the more directive Gestalt approach is perhaps a good option (see Oaklander, 1978). Specific child-centered play techniques are discussed in various sources (e.g., Axline, 1947; Landreth, 1991; Post, 2001). The case study presented below illustrates how an elementary school counselor worked effectively with a traumatized youngster after a disaster.

Case Study

Six-year-old Kyle experienced, along with his family, a severe earthquake. Adding to his feelings of terror, Kyle's mother, sister, and brother were injured. At school, Kyle demonstrated an ongoing constellation of troublesome behaviors that concerned his first grade teacher. She subsequently requested intervention from the elementary school counselor. Upon early consultation with Kyle's father, the counselor gained a better grasp of Kyle's at-home behavior and sensed that he presented PTSD-like symptoms.

Kyle's condition appeared to meet the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association, 2000) for PTSD. He had been exposed to a life-threatening experience and presented intense fear [Criterion A]. The behavior patterns reported by his teacher included: uncooperativeness [Criterion F], extreme sensitivity to the school bells [Criterion B (5)], interruptive behavior during classroom instruction, yelling [Criterion C (2)], social maladjustment (e.g., poor social skills, high degree of sensitivity to his classmates' words)[Criterion C (5)], decreased appetite [Criterion C (4)], and gross motor clumsiness (e.g., often tripping in class)[Criterion F]. Moreover, because Scottish folk songs were frequently replayed on the television following the earthquake, Kyle's level of irritation would increase when such songs were heard at school. At home, he threw temper tantrums with minimal provocation [Criterion D (2)], experienced nightmares [Criterion B (2)], and had difficulty falling asleep [Criterion D]. In addition, he was highly insecure and afraid of being alone [Criterion A (2)]. Kyle's father occasionally stopped by the school to make sure his son was improving [Criterion E].

Initially, when the counselor met with Kyle, he seemed to be in denial. His aggressiveness and anger also suggested that he was attempting to protect himself from further harm. While helping Kyle reduce his defensiveness, the counselor selected child-centered play therapy as an intervention in order to avoid sensitive issues that could arouse painful memories. Given the needs, the counselor decided to see him for 30 minutes twice a week. Selected information illustrating the counselor's interventions and Kyle's progress follow.

Synopsis of the Play Intervention

Session 1. (Kyle's teacher and the counselor walked him to a playroom.]

Kyle: (Stood outside the door of the playroom hesitantly.) This place is not fun.

Teacher: (Assured him that it would not take too long.) Kyle, you can play with Ms. Shen for a few minutes. She will take you back to our classroom.

Kyle: (Entered the playroom with a baby step and looked at the toys.) Okay.

Counselor: You can play with the toys in as many ways as you like. (Kyle seemed very nervous because he had never met the counselor. However, his curiosity about the place and interest in the toys convinced him to stay.)

Kyle: (Touched a toy.) What is this?

Counselor: (Did not specifically name the toy.) You are curious about that. (Kyle repeatedly used questions to reduce his anxiety and to check on the counselor's permissiveness. At one point, he picked up a plastic mallet to hit a shelf. Kyle was startled by the "bang" and looked horrified at the counselor.)

Counselor: The big noise scared you. (The counselor fostered an accepting climate to help Kyle gain some sense of trust.)

Session 2. (The music of a Scottish folk song filtered into the counseling office from the school's loudspeakers. Kyle heard the music, for the playroom was located inside the office.)

Kyle: (Obviously bothered, he asked) Do you know my mom, brother, and sister got hurt?

Counselor: (Understood his reactions to the folk song.) That must scare you.

Kyle: Yeah! It did. (He did not talk more about the event in this session. The music reminded Kyle what happened to his family. With the sense of safety in the playroom, Kyle started to verbalize the painful loss. In this session, his attention span was longer, and sometimes he voluntarily explained what he was playing.)

Session 3. (To facilitate Kyle's peer relationships and to serve the student clientele more efficiently, the counselor modified the individual intervention by including another child. Angela, a few months older than Kyle, was referred to the counselor due to her frequent crying without apparent reason. Kyle played dinosaurs with Angela in the sand tray.)

Kyle: Help! (Looked at Angela's dinosaur.) I am buried! I am your little boy! Rescue me!

Angela: (Noticed Kyle's need and moved her dinosaur toward Kyle's.) I am coming!

Counselor: Kyle needs help in the dark, and Angela is willing to save Kyle. (Kyle metaphorically played out what happened in the earthquake.)

Session 4. (Kyle leaned on a two-story dollhouse, which was shaking as it was sitting on a little chair. He removed a stairway and dropped doll people through the hole on the second floor.)

Kyle: All of them got hurt.

Counselor: Just like what happened in the earthquake. (Kyle lived in an apartment building where several people were injured. He reenacted his traumatic experience in this session.)

Session 5. (Kyle interacted with Angela in aggressive ways and hit her with a plastic mallet.)

Counselor: (Set a limit with him.) Kyle, I know you like to do that, but it's not used for hitting people. You may use that to hit a block on the carpet, if you want. (After a while, Kyle dropped some sand into Angela's shirt collar.)

Angela: (Moved away.) Don't do that.

Counselor: Kyle, I know you feel it's fun, but Angela doesn't like that. (After a while, he started the behavior again.)

Counselor: (Stated the limit in a firm voice.) I know you like to do that, but the sand is not for outside the box. If you decide to keep doing that, you are choosing to stop our play session early today.

Counselor: (Kyle did not stop his behavior.) Kyle, you choose to stop our play early today. Let's go back to the classroom. We can play together next time. (This session gave him a chance to experience the consequence of his behavior.)

Session 6. (Kyle and Angela laughed and chased each other on the way to the counseling office. Then Kyle needed to use the bathroom located outside the office. He walked out of the bathroom several times to make sure the counselor was still with him.)

Counselor: (Recognized his feeling.) You are afraid. (Reassured him.) We'll wait for you. (His insecurity was manifested in this bathroom trip.)

Sessions 7-8. (Kyle and Angela shared many toys and fixed a dinner for stuffed animals. Kyle's interpersonal skills seemed to be improving. Because the semester was ending, the counselor prepared them for termination by telling them how many sessions they had left.)

Session 9: (Kyle and Angela painted a picture on the easel without planning together about what they wanted on the picture. They enjoyed the free painting using various colors. The counselor reminded them at the end of this session that next time would be the last play session.)

Session 10: (Kyle spread the paints on to the carpet and mixed colors in a color container.)

Counselor: (Set a limit with him.) Kyle, I know you feel it's interesting, but the colors are not for the floor and not for mixing in bottles. You can put the colors on the paper, if you like. (It was not a surprise to the counselor that his behavior had somewhat regressed in this final session. Kyle's actions expressed his unwillingness to stop the play sessions.)

Outcomes

Throughout the intervention, Kyle made good progress. The teacher and family reported that he had a better mood and was more motivated. His emotional competence improved, especially after he was free to release negative feelings (Schaefer, 1994). By the fourth session, he was no longer having difficulty with his gross motor behavior. By the fifth session, Kyle's appetite and sleep became more normal. In the process of trauma re-enactment, he felt threatened at times and thus discontinued some play behavior. This play disruption is largely the function of a child's defense mechanism (Erikson, 1950), which diminished after he felt psychologically safe. The school principal commented that Kyle was happier. A few months later, his family and teacher reported that he had continued his improvement. Periodically, the counselor followed up with Kyle, his teacher, and his parents. Had the school-based intervention not been successful, the boy would have been referred to a mental health professional for further intervention.

Concluding Remarks

Major disasters may alter children's sense of security. Their hopes and concerns, however, can be articulated in talking, drawings, writings, and playing. Through creative expressions children can discharge anxieties and other feelings that are difficult for them to verbalize (Axline, 1947; Landreth, 1991). Children can benefit from working through the emotions and experiences recollected from traumatic events. School counselors, through various classroom guidance and individual counseling interventions, can restore the much-needed emotional support, provide children opportunities to release their stress, facilitate healing, strengthen their sense of being in charge, and lessen the chances for long-term emotional harm. Acknowledging the shared psychological effects on children following disasters, we hope that the school-based interventions presented in this article, along with existing large-scale emergency disaster programs, will assist elementary school counselors to work more effectively with children and their families.

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Yih-Jiun Shen, D.Ed., is an assistant professor, Division of Educational Psychology and Leadership, Texas Tech University, Lubbock. E-mail: [e-mail]

Christopher A. Sink, Ph.D., is a professor, Department of School Counseling and Psychology, Seattle Pacific University, Seattle, WA. E-mail: [e-mail]