Journal of Traumatic Stress

, Volume 5, Issue 1, pp 5–17 | Cite as

Work with traumatized children — Psychological effects and coping strategies

  • Atle Dyregrov
  • Jeffrey T. Mitchell


Work with traumatized children has a profound effect on emergency personnel and other health care providers. It is hypothesized that work with seriously ill or injured children potentiates motivating factors in the helper's personality, brakes down natural defenses and leads to strong identification with the victims. In this paper various psychological effects on the rescuer are outlined. Coping strategies used by health care personnel in the acute phase of an emergency are identified. Mental preparation, suppression of emotions, distancing from certain aspects of the event, and dehumanizing were frequently utilized coping strategies. Other coping mechanisms were regulating the amount of exposure, activities to restrict reflection, developing a sense of purpose, and self-reassuring comments. Postexposure response to child trauma include helplessness, fear and anxiety, existential insecurity, rage, sorrow and grief, intrusive images, self-reproach, shame and guilt, and changes in values. Emotional distancing and other self-protective strategies seem important at the scene; self-disclosure by talking about impressions and reactions is most helpful afterwards. However, carefully timed and executed interventions are necessary to break through the defensive barriers which are established by health care and other emergency personnel.

Key words

emergency personnel emotional reactions traumatized children, coping strategies 


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  1. Alexander, D. A., and Wells, A. (1990). Posttraumatic stress reactions among police officers after the Piper Alpha disaster. Paper presented at the Second European Conference on Traumatic Stress, Noordwijkerhout, Nederland, September 23–27.Google Scholar
  2. Behnke, M., Reiss, J., Neimeyer, G., and Bandstra, E. S. (1987). Grief responses of pediatric house officers to a patient's death.Death Studies 11: 169–176.PubMedGoogle Scholar
  3. Dyregrov, A. (1989). Caring for helpers in disaster situations: Psychological debriefing.Dis. Manag. 2: 25–30.Google Scholar
  4. Dyregrov, A., and Matthiesen, S. B. (1987). Similarities and differences in mothers' and fathers' grief following the death of an infant.Scand. J. Psychol. 28: 1–15.PubMedGoogle Scholar
  5. Hershiser, M. R., and Quarantelli, E. L. (1976). The handling of the dead in a disaster.Omega 7: 195–208.Google Scholar
  6. Hetherington, A., and Guppy, A. (1990). Post traumatic stress in British police, Paper presented at the Second European Conference on Traumatic Stress, Noordwijkerhout, Nederland, September 23–27.Google Scholar
  7. Janis, I. L. (1969).Stress and Frustration Harcourt Jovanovich Inc., New York.Google Scholar
  8. Janoff-Bulman, R., and Frieze, I. H. (1983). A theoretical perspective for understanding reactions to victimization.J. Social Issues 39: 1–17.Google Scholar
  9. Jones, D. R. (1985). Secondary disaster victims: The emotional effects of recovering and identifying human remains.Am. J. Psychiatry 142: 303–307.Google Scholar
  10. McCammon, S., Durham, T. W., Allison Jr., E. J., and Williamson, J. E. (1988). Emergency workers' cognitive appraisal and coping with traumatic events.J. Traum. Stress 1: 353–372.Google Scholar
  11. Mitchell, J. T. (1983). When disaster strikes .... The Critical Incident Stress Debriefing.J. Emerg. Med. Serv. 8: 36–39.Google Scholar
  12. Mitchell, J. T. (1984). The 660-run limit.J. Emerg. Med. Serv. 9: 52–54.Google Scholar
  13. Raphael, B. (1981). Squibb Academic Address. Personal disaster.Austr. New Zeal. J. Psychiatry 15: 183–198.Google Scholar
  14. Raphael, B., Singh., B., and Bradbury, L. (1980). Disaster — the helper's perspective.Med. J. Austr. 2: 445–447.Google Scholar
  15. Rayner, J. F. (1958). How do nurses behave in disaster?Nurs. Outlook 6: 572–576.PubMedGoogle Scholar
  16. Scheppele, K. L., and Bart, P. B. (1983). Through women's eyes: Defining danger in the wake of sexual assault.J. Social Issues 39: 63–81.Google Scholar
  17. Vachon, M. L. S. (1987).Occupational Stress in the Care of the Critically Ill, the Dying, and the Bereaved Hemisphere Publishing Corporation, New York.Google Scholar

Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • Atle Dyregrov
    • 1
  • Jeffrey T. Mitchell
    • 2
  1. 1.Center for Crisis PsychologyBergenNorway
  2. 2.Emergency Health Services DepartmentUniversity of Maryland Baltimore CountyBaltimore

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