“When I came home…Everything was gone.” The Impact of Residential Fires on Children
Children’s reactions to residential fires were explored using a qualitative methodology. Forty-four children (n = 44) between the ages of 6 and 18 (23 female and 21 male) participated. The youth were interviewed using two instruments that assessed levels of psychological distress and explored their perceptions regarding their experiences of the fire. The following five themes were identified through qualitative analysis of the interview transcriptions: vivid description, fear/trauma, physical injury, losses, and gains. Implications for future research and intervention are discussed.
KeywordsChildren Residential fire Qualitative analyses Loss Gains Injury Post traumatic symptoms
Previous research aimed at examining the impact of fire on children and adolescents has shown that post-traumatic symptoms (PTS) may follow such events [1, 2, 3, 4, 5]. In an initial study examining the impact of residential fire on 20 survivors, including eight children and adolescents (ages 4–15 years) and 12 adults (21–68 years), it was concluded that psychological reactions to residential fire could be reliably documented, and that several symptoms related to Posttraumatic Stress Disorder (PTSD) were evident in the survivors [6, 7]. Similar findings were also reported by Greenberg .
A significant shortcoming of research on children’s reactions to fires is that children’s reactions are frequently not obtained from the children themselves; rather, parents typically report on their children’s distress [9, 10]. These reports are problematic because parents often either overestimate or underestimate the level of distress experienced by their children, depending upon their own perceptions and experiences of the event [11, 12, 13]. Thus, there is a need for direct reports from the children themselves [10, 14]. This need is addressed in the present study by analyzing children’s answers to open-ended and structured interview questions. In addition, direct quotes from the children are presented, a recommended method for bringing children’s voices into the presentation of research [14, 15]. Therefore the primary purpose of this study was to capture children’s experiences during fire emergencies at their home. It was hoped that a full understanding of their perceptions and behaviors would inform parents, fire personnel, school counselors how to best respond to and assist this often neglected target group.
The study population was comprised of 44 children and adolescents who participated in interviews as part of a larger study funded by the National Institute of Mental Health . The youth ranged in age from 6 to 18 years, with a mean age of 11 years. Twenty-three were female and 21 were male. The ethnic makeup of the group was as follows: one biracial, 22 African American, one Hispanic, 18 Caucasian, and two unspecified. Three of the youth were injured during the fire whereas the remaining children either escaped their burning homes before being injured or returned to their homes from various outings (e.g., school, church, vacations) to find their homes burned. Specific injuries included burned hands, feet, and legs.
1.2 General Procedures
Families were recruited from areas in and surrounding five cities: Atlanta, Georgia; Roanoke and Richmond, Virginia; Charlotte, North Carolina; and Charleston, South Carolina. One child and parent from each family was interviewed ~3 months after they experienced the residential fire. Advanced graduate students in clinical psychology who had been trained in the administration of all measures interviewed each child separately. Interviews were carried out either in the participants’ homes or in public places such as Red Cross offices, neighborhood churches, libraries, or mental health clinics. The Fire Questionnaire—Child Form  were administered as part of the larger interview that took approximately 3 h to complete for parents and one and one half hours for children. Each family was paid $75 for their participation. Informed consent was obtained from the parents and assent from the children was solicited. Overall, the interview consisted of a series of questions designed to facilitate the report of personal experiences pertaining to the fire.
2.1 Qualitative Procedures
A qualitative analysis was performed on responses obtained from the structured interview. The Fire Questionnaire—Child Form  was the qualitative assessment used to interview the participants. The Fire Questionnaire consists of three types of questions: open-ended, short answer, and scaled answer. This measure asks about the child’s experience of the fire, their perceptions of its seriousness, its causes, feelings of responsibility, information about previous disaster experiences, and any positive outcomes related to changes in their lives as a result of the fire (see Appendix for a list of the interview questions). Conducting a qualitative analysis of the findings in this study provided several potential benefits. By employing this method, empirical data were expanded by incorporating details that might otherwise be excluded from the research report. As described by Silverman , qualitative research involves the social and cultural construction of variables. Since each participant in this study had his/her own individual perceptions of the events and interpretations of the questions asked, they were able to incorporate these viewpoints into the results while exploring commonalities among the experiences reported by the youth. In addition, through the use of this method, it was able to generate new hypotheses about relationships among the qualitative themes and findings from the quantitative measures. Explication of these connections can potentially inform treatment interventions.
During the interviews, children completed the Fire Questionnaire—Child Form . Copies of the interviews were transcribed, and then distributed to the analysis team, composed of two undergraduate researchers and one adjunct research faculty member. The adjunct faculty member had a background in counseling and crisis intervention and experience in qualitative data analysis. The two undergraduate research team members each had backgrounds in psychology/trauma. The team members were provided training regarding qualitative research in order to familiarize them with the method to be used. One 2-h training session was conducted for the undergraduate team members, followed by another 2-h training session for the entire research team. The training sessions were conducted by the co-author with extensive qualitative research experience. The training covered the mixed-method nature of the study, the added value of qualitative analysis for this study, reading for meaning, identifying themes, and the process of thematic analysis. The team then conducted a thematic analysis of the transcripts as described by Ely . The team approach was used in order to ensure credibility, which is the qualitative parallel to internal validity in quantitative research . Credibility involves “how we ensure rigor in the research process and how we communicate to others that we have done so” . The three research team members each worked independently in their review of the data as follows: the researchers began by reading over each transcription twice without taking notes so that they could become broadly familiar with the information included. Upon the third and fourth reading, the reviewers noted various themes from the interview and created a theme sheet for each participant, using an open coding system. The researchers then repeated this process to develop further themes and/or to eliminate categories, recording each theme on the appropriate theme sheet. The team then held a peer debriefing meeting to discuss the themes and their thoughts and feelings regarding the transcriptions. Peer debriefing is another means of increasing credibility in qualitative research [21, 22]. The team examined the data for duplication and themes that were not substantiated by the data. Some themes were eliminated in this process. Other themes that stood out for the researchers were also discussed. The results from each of the three review team members were then reviewed again by the adjunct faculty member and reduced further resulting in six major themes. Finally, two members of the team met with the qualitative expert to review the theme lists. One undergraduate member of the team did not attend this meeting because he had by this time graduated and left the area. The team then came to an agreement about the coding scheme and settled on the final five themes. At this point, the qualitative expert conducted an independent reading of the transcripts and affirmed the accuracy of the coding scheme.
Several techniques outlined by Lincoln and Guba  and others [20, 22] were used to conduct valid qualitative research: persistent observation, triangulation, peer debriefing and the inquiry audit. The qualitative credibility criterion dependability parallels validity in quantitative research and deals with the issue that “the way in which a study is conducted should be consistent across time, researchers, and analysis techniques” [19, 20]. In order to accomplish this, the process undertaken should be detailed and repeatable; researchers should carefully document the research design and keep a detailed list of the research activities and processes, known as an audit trail . In order to accomplish persistent observation, the extensive review described in the previous paragraph was carried out. Triangulation was achieved by having the three research team members first complete their reviews independently of one another and then coming together to discuss the findings. This provided consistency across time and researchers as described by Gasson . The peer debriefing meeting was held to discuss the findings and determine agreement about the themes. At the end of the analysis, materials, or audit trail , were presented to the qualitative expert on the team, who performed the inquiry audit. The following information was presented and reviewed, raw data, individual team members’ themes, reduced themes, and notes from the debriefing meeting. The determination of the audit trail, comprehensible, useful, were linked to this approach, meeting the requirements outlined by Lincoln and Guba  for ensuring credibility.
The children in the current study were exposed to residential fires and experienced a variety of feelings. First, they reacted to their discovery of the fire. They were afraid. They saw their belongings destroyed and their pets and family members hurt. Some of them lost their homes completely. Fortunately, they also experienced the help and support of others in the aftermath of disaster. With the assistance of others following the fire, some of the children voiced hope and optimism. The five themes identified as a result of the comprehensive interview and qualitative analysis procedures were vivid description, emotional responses (such as fear or trauma), physical injury, loss, and gains or benefits that occurred as a result of the fire. What follows is a description of each of the five themes, reinforced by actual quotations from the children themselves. Please note an annotation of each of the five themes and how many children citing each: Vivid description 22, Emotional Responses 25, Physical injury 11, Loss 14, Gains—43.
3.2 Vivid Description: “It was like thunder.”
When the fire started it came through the room like in a ball, it was like thunder…you could see it start climbing the steps…I was watching it go up the steps to the upstairs and watching it take the drapes.
I had a pretty good day that day and everything went right and when we came home we were all laughing and joking around like we usually do and my sister noticed there was smoke coming from the side of the house…Dad told us all to stand back first you know so we wouldn’t get hurt and a whole gush of black smoke just came out of the front door where the kitchen is.
Joshua, age seven, described the fire in his home as follows: “I was scared…I saw how big the fire was. It was huge. It was huge…the ground was all hot…it was big…”
3.3 Fear/Trauma/and Other Emotional Responses: “I started screaming and crying.”
When she fell out, straight on the ground I thought she had died…so me and my little brother had pushed her downstairs…I’m the one that told her if she…I’m the one that said, I could do it. I could do it. I could pick her up my own self. I could pick my own momma up…my momma had smoke coming out of her mouth.
They also spoke of overwhelming emotions, such as crying without knowing why, in addition to experiencing the adults around them crying and yelling uncontrollably. One subject mentioned suddenly thinking that he didn’t know where they would go after losing their home in the fire. Joey, age 12, described feeling “panic” during the fire, especially when his three-year-old cousin was crying for her mother (who wasn’t there). Another talked about how there was “a lot of stuff going through my mind” during the fire. One fourteen-year-old female said, “…I started crying so bad I couldn’t believe it…” Ten-year-old Keisha: “…and I started screaming and I mean I couldn’t quit. I started screaming and crying.”
I was in my room…changing clothes….I saw a lot of light and smoke at first…we saw a lot of black smoke on the walls…my grandmother kind of got into a panic…and I tried to tell her to stay calm. And we opened the door and when we opened the door you could see the fire blazing. And I said, ‘Grandma, I don’t want you to panic, but you’ve got to get out of this house.’ And she said, ‘You have to get out, too.’ I know she has a bad heart, so I was getting scared so I took her out….then called the police…After that, my grandmother was just through. She was yelling, ‘Help, Help, we have a fire! Help!’ Our next door neighbors, they came and got her….and tried to calm her down.
That’s the only thing I could do in that situation. We didn’t need two excited people and if both of us were excited neither one of us would be here today. So I knew I had to be the calm one…I’m not saying I wasn’t scared. I was scared…I think it was very dangerous.
I was nervous. I was choking a lot…there was a lot of stuff going through my mind…after that, it was ten minutes later, I passed out back of the car…I felt like I couldn’t breathe…light-headed…and I was shaking a whole lot and I couldn’t stop. After that, I got into the ambulance…I went to the hospital…panic problems. I was very, very nervous. When I looked at the house, I was nervous. I was everything. I just looked at it.
I wasn’t scared. I was just like, sad…Losing my things. And I was afraid to go into the house when we were going to get what little things we could salvage. If we like cleaned up real good and salvaged it and, um, I didn’t want to salvage nothing. I didn’t want to scrub. I let my Mom scrub it. I was scared to go in our house ‘cause I thought the roof was going to collapse in. Everything was black and the roof was sagging down.
Joshua, age seven, described his fear in this way: “I was scared…I saw how big the fire was. It was huge.”
3.4 Physical Injury: “She didn’t look like she was before.”
The team’s review of the data resulted in identifying several statements which described either the children’s own injuries or their witnessing others being injured. This led the team to label the category “Physical injury.” “We messed with fire and I got hurt…” is one child’s (Andy, age 11) description of being injured during a fire. He talks of experimenting with matches and gasoline with a friend. The result was that his clothing caught fire and his legs were burned. Two other children mentioned injuries they received during the fire, including burned hands, burned feet, burned knees, and smoke inhalation. Some of the more vivid descriptions occurred when the children described the injuries they witnessed others incur: “… she was pretty bruised up…. There were blisters all over her arms…. She didn’t look like she was before, like her usual color, she was dark and black from all the smoke and ashes…” (13-year-old Joey’s description of his mother).
As stated earlier David (age 10) described himself and his brother having to carry his mother out of the house after she fainted from the smoke. Another child described seeing a fireman being carried out of the fire after being injured by an electric shock.
3.5 Losses: “What am I coming home to?”
Subjects also reported their feelings of loss because of the fire. Five of the children lost family pets in the fire. Others described important belongings that were lost (favorite toys, collections, etc.). Some children described the loss of their homes and familiar surroundings. Research team members decided to group the statements that described these varied situations together, resulting in the “Losses” theme. One girl spoke of looking through the rubble at the site of her house and finding the burned bodies of the family’s pet birds, cats, and turtles: “…and I started to cry. I was really upset about it…It was really gross. When I was looking at everything… I didn’t really know what to do…”
And I guess the first response from everyone was where’s Zack at. That’s our dog. We’ve had him for eight years. He was like a brother to all of us and a son to Dad or whatever and we, uh, he didn’t come out of the house and he died there in the bathroom, so that was the hardest part of it all. He was supposed to be my birthday present…Yea, Zack, he was very special. We loved him…All of us were kind of down and out ‘cause of the dog, I think. That was the only part that kind of put sobs on us because we could pretty much get the things that we had back, you know? You can go to stores and buy the clocks and the radios and stuff, but you can’t buy a dog back. It’s kind of like a person and it’s not gonna happen. So I think that was the bad part. All of it was pretty bad, but…
I had a hard time staying at school because we lived in ‘Greenway’ (her city) and this is ‘Browning’ (her friend’s city)…I have no friends over here so it was kinda like I’m lost too…I mean I have no friends over here. Everything, everybody I’m familiar with…everything I know, everything I’m comfortable with is in ‘Greenway.’
I mean it was a big shock to me…so like I started crying you know, but I really couldn’t even picture what it would look like, ‘cause you know, you never thought this would happen….there’s no word that can explain to you what I’m now thinking and or really feeling, but it was like, really awkward. What am I coming home to…? I kept repeating Daddy would fix it, Daddy would fix it, you know?…I fell to the ground and then people like came over to me. ‘Cause I started crying so bad I couldn’t believe it…So it was horrible just standing and watching them (the firefighters) throw stuff out of my room. But I was still in shock. And I didn’t know, you know, what was happening…I came out of the house (leaving for school that morning) thinking everything was going to be there and when I came home literally nothing was there. Nothing on the wall, no furniture, anything. Everything was gone.
3.6 Gains/Benefits: “A little bit of light shone through.”
…But a lot of good things came from it, I realized, gosh, not a lesson, but I mean, I learned so much from this. Like not to take anything for granted, ‘cause like what I have is what I have and you know, of course, occasionally I’m gonna lose place, you know? But I mean, you know, the most dear thing to me is you know, memorable stuff….I mean, to see all these people do all this stuff, like the Walkathon, the pep rallies…what everybody did was just amazing. That was really good.
…Everybody was so nice. It was amazing…I mean, people I didn’t even know and people that hated me and they’re giving me …gift certificates…and all these people being so sweet…It was so nice and it was amazing what they were doing.
A little bit of light shone through when my mom told me the Red Cross was going to help us….And that really, that was like the highlight of that week. So the lady came and talked to us, and gave us this thing that had shampoo, soap and toothbrush in it. You know things that are essential needs. She was really nice….a really sweet lady. And that made us feel a lot better to have somebody to talk to and share what we were feeling…It was really comforting to have someone to share feelings to.
Um, right before the fire, we, our family wasn’t like, working together very well. We learned how to, we learned to stick together a lot. Um, you know, after the fire, we learned to like, bond with each other about it.
The findings from this study support the notion that children report distress following traumatic events, particularly fire. That is, this analysis reveal that children have a great deal to offer towards the understanding of reactions to trauma. As a result of directly interviewing children with the Fire Questionnaire, increased knowledge about their reactions to trauma and their needs during recovery have been ascertained. Children as young as 6 years old were able to articulate their thoughts and feelings regarding the fires they experienced. Experiencing residential fires has impacted the ways these children view their worlds. Children seemingly have a need to process these life-altering events in order to integrate the new insights they have made regarding their families, their relationships, their friends, their communities, and their lives. Some of the children interviewed felt more connected to their families and communities than before, and had the benefit of feeling supported and loved as a result. But what of the others, the ones whose experience of the fire’s outcome was entirely negative, who did not receive an outpouring of financial and emotional support? These findings illustrate the need for crisis intervention follow-up in addition to material help for these families. The help most of the participants described receiving was physical, help with basic needs; however, they also identified many emotional and psychological needs in their responses. These needs could easily be overlooked in the rush to meet basic physical needs. Crisis intervention can be invaluable to the well-being of children and their families. For example, 14-year-old Stephanie described how her entire family was helped tremendously when the woman from the Red Cross came and talked with them, she was grateful to have someone to “share feelings to.”
4.1 Vivid Descriptions/Flashbulb Memories
The vivid descriptions given by the youth are notable. Most of these descriptions were in answer to the question “Tell me about the fire you experienced.” The children’s intense memories of how the fire happened, how the flames looked, the way the smoke looked, and the appearances of their homes during and after the fire were associated with the vivid imagery in their reports of what the fire was like for them. The use of the qualitative method achieved the purpose of providing the children an opportunity to freely describe what they remember. Additionally, several of them used vivid language in their descriptions of others during the fire. It seems the instances in which the strongest emotions were involved (i.e. fear and concern for others) resulted in the most dramatic descriptive language during the interviews. The responses in this area are developmentally appropriate, with younger children’s descriptions focusing on the adults and the fire itself. The older children’s responses were more focused on the circumstances around the fire and the people outside the family who became involved in the fire or its aftermath, typical of older children and adolescents’ expanding view of the world.
This level of detail is consistent with that of “flashbulb memories,” surprisingly detailed and vivid memories of events . Brown and Kulik originally used the term to refer to people’s memories of where they were and what they were doing during important public events, including the assassinations of President John F. Kennedy and Dr. Martin Luther King, Jr. Since that time, researchers have elaborated the theory to include personal memories of events, frequently traumatic events that are not public in nature . Brown and Kulik  found that flashbulb memories are extraordinary in their vividness and clarity, though they may or may not be accurate. In addition, it is usually very difficult to check the accuracy of recall about events since they cannot be recreated. According to Conway , events that are surprising, personally consequential, important, or emotional have the maximum potential for forming flashbulb memories. The memories themselves are “unusually detailed, clear and tightly organized” and appear to be retained consistently in long-term memory.
Flashbulb memories are frequently associated with transition points ; that is, the events remembered tend to be of times when the person’s plans and goals changed. Following the traumatic fire experience for many children, there recall of many aspects of the event would meet the definition of “flashbulb memory,” in that they were vivid and quite clear. The youth in the current study described transitions that occurred for them. One example from this investigation was found with Katie who stated that she left for school before the fire thinking everything would be there and when she came home everything was gone. This is the point in Katie’s life when her perspective had to shift to include the possibility that she could lose everything she owns without warning and at any time. Her future plans, goals, and beliefs about life will likely be impacted by her memories of this event, as will those of other participants.
4.2 Fear/Trauma/and Related Emotional Responses
Data from this study support findings from some previous studies. In Greenberg’s  study, it was found that the 12 children (ages 6–17) who had been involved in separate residential fires reported fear of the fire and concern regarding their parents’ responses and functioning as a result of the fire. In the present study, several children expressed their fear of the fire and also their concerns about the adults in their families. One boy explicitly expressed that he’d been concerned about what his mother would say when she got home. Their concern was also evident in the children’s discussion of injury related to the fire; they remembered their concern about adults around them: grandma’s heart problem, mom’s looking different afterward, a firefighter being injured during the fire.
Other studies involving children and adolescents have shown that young people experience varying levels of distress, including PTSD-related symptoms, following fires (e.g., [1, 2, 4, 6, 7, 8, 25, 26]. Similar results were obtained in the current study. Participants reported distress levels ranging from not being very scared to one subject being so distraught that she was transported to a hospital.
4.3 Physical Injury
In 2008, fire departments responded to 403,000 home fires in the United States, which accounted for about 78% of all fires. These fires killed 3,320 people (not including firefighters) and injured another 16,705. On average, someone was injured in a fire every 31 min (Karter 2008). Three children in the study were injured in their residential fires. Three other children witnessed family members or firefighters being injured. Research has documented physical symptoms including itching and limited function of body parts, body image issues, anxiety, and depression resulting from burn injury . A burn injury is one of the most traumatic injuries that a child or adolescent can experience . For example, Landolt and colleagues  found that pediatric burn survivors with PTSD have impaired qualities of life, especially in psychosocial domains. Not only must the child cope with the actual traumatic burn incident, but extensive hospitalizations, painful surgeries, and his or her eventual re-immersion into the social world. These long hospitalizations often cause the child to be separated from loved ones during the critical time following a traumatic experience. This separation from friends and family not only leads to decreased social support, but can also result in separation anxiety . These issues could profoundly impact psychological recovery from the fire. Finally, children who witnessed the injury of their parents/caretakers (such as 10-year-old “David” who helped carry his unconscious mother out of the house) would be forced to cope with the secondary trauma of anxiety and fear regarding the possibility of losing a primary caretaker in addition to their feelings of fear and loss regarding the fire.
The children’s discussion of various losses associated with the fire is significant and varied. Children talked about a wide range of losses, from the more obvious losses such as pets and the home to other things that were important to them, including special toys or collections and relationships with friends that were lost as a result of moving to a new place. In several cases, their loss was compounded by guilt—for example, wishing they had been there to save a pet that was locked inside the house. Imagine the conflicting feelings surrounding the death of a loved pet in a fire: the family left the pet inside to keep it safe, yet because it was locked in the house it could not escape the fire. The images of their “best friend” choking to death on the smoke or being burned to death while trying desperately to escape could be overwhelming for a child, as well as for an adult. Children in this situation need thoughtful, compassionate assistance in order to help them come to terms with such events.
Several studies of children have examined resource loss as a predictor of distress following a trauma. Two studies investigating the effects of Hurricane Andrew on children showed a positive correlation between resource loss and children’s reports of PTSD symptomatology [30, 31, 32]. More specifically, Vernberg, La Greca, Silverman, and Prinstein  found that loss significantly contributed to the variance observed in the children’s PTSD ratings. Loss of possessions and housing, disruption of familiar roles, and disruption of routines were the primary types of loss found to be correlated with children’s PTSD. In addition, Garrison and colleagues  had similar findings when they examined 400 children’s responses after Hurricane Andrew. They categorized disaster-related losses into two groups: objective (e.g., toys, clothing, etc.) and personal-social (e.g., sleep, free time, social support, etc.). However, only personal-social resource loss proved to be a significant correlate of PTSD . Children reported that loss of companionship and loss of an understanding teacher as the two most frequently occurring forms of personal-social resource loss following the hurricane. These studies highlight the relationship between resource loss and child distress following a trauma.
Coping with loss is an important part of recovery from negative events such as a residential fire. The losses children described represent challenges in regaining a sense of “normalcy” in their lives. These results help to illuminate the many levels of loss that may be common to children under these circumstances, alerting those in the field to areas for exploration during treatment, perhaps allowing for grief work to access important points for children that may not have been previously considered.
Secondary traumas experienced by children may also interfere with their grief recovery . For example, a child would experience the distress and loss of seeing her home burned. In addition, the secondary trauma of surrounding events such as seeing her parents’ becoming upset and seeing the burned body of her pet would add to her distress. In this case the processing of grief would be complicated: the child wouldn’t be able to remember her pet without also remembering her home and vice versa, which could lead to her experiencing much greater distress than if either event had occurred independently.
Lastly, children identified both material and emotional benefits. Two youth, one male and one female, stated that they learned to not take for granted that their homes will always be there, they viewed learning about the impermanence of their dwellings as a positive, helping them to appreciate the comforts of their daily lives. Related to gains from the fire, some of the children were deeply affected by the help they received from their communities. Help in getting clothing and school supplies from local organizations including the Red Cross was noted as a positive outcome. The speed and extent of the help seemed a pleasant surprise to some of the children. The children seemed to appreciate the effort and expense taken by members of their communities in assisting them and their families. Also, it seems that the sense of isolation was lessened as a result of these community efforts. This is a significant finding in light of Bernstein’s (1990) suggestion that the isolation involved in residential fires might lead to greater levels of psychological distress and other research that asserts that social support assists individuals in coping with stressful life events [34, 35, 36, 37, 38]. This point may be especially important for the adolescents in the study, since adolescents frequently feel lonely and isolated during this stage of development . It is likely that the community support these individuals received was helpful in mitigating the psychological distress of the event as well as meeting physical needs.
Several limitations should be highlighted. First, the study has limited generalizability inasmuch as it is based on a relatively small number of participants and they may not be representative of all youth and their families involved in residential fires. Many of the families were from low-income families and it is not clear how children and families of other social strata might fare with such interviews. Another limitation was that the interviewers did not have the benefit of prolonged engagement with the children and their families where trust and rapport could have been better established and more detailed and elaborate responses potentially obtained. Better or at least more information might be obtained under circumstances where greater trust and openness are present. In addition, less structured interviews might have led to the identification of different themes. Finally, a group interview with several children at one time may also have yielded different results. However, it is cautioned against this because many children had difficulty “telling their story” even to trained professionals. Whether they would have been willing to share highly personal information with unknown peers remains to be seen. Of course, there is also the practical problem of forming a “group”—frequently residential fires are isolated and do not occur at the same time or in the same cities for families.
4.7 Recommendations for Treatment
Based on the findings, it is recommended that children exposed to the trauma of residential fires receive comprehensive follow-up evaluations. Evidenced-based and/or evidenced informed interventions are advocated. The program where the latter has been employed is the Recovery Efforts After Adult Child Trauma (REAACT) program at Virginia Tech, a program initiated by the senior author. Strategies that target children’s profound sense of loss, grief, fear, and coping with painful memories are included. In addition, the inclusion and training of referral personnel such as firefighters, ministers, and school counselors are recommended and provided in this program. It should also be noted that there are a number of “signs” that may assist teachers, fire personnel, nurses and other individuals identifying children who may be in need of mental health attention. Signs of stress following traumatic fire experiences include fear, anger, difficulty concentrating, withdrawal, avoidance of people, places and objects that remind of the fire, as well as nightmares. Behavioral disorders and acting out may also be “red flags” to parents and professionals that a child may be having difficulty coping with the negative experience. There may also be drops in a child’s grades and his/her ability to get along with others.
In summary, this study highlights the negative consequences of residential fire on children and adolescents. The qualitative reports attest to high levels of distress. In addition, these data provide distinct and rich descriptions of the children’s perceptions and the feelings they experienced in their own words. A silver lining for this traumatic event might be the “gains” reported by some of the participants. Improved relationships with family members, feeling supported by their communities and a greater value for human life over material possessions were reported. Furthermore, this study provides support for the utility of a mixed method approach for understanding children’s responses to trauma. The need for more attention to this area of study is clearly warranted.
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