The general steps in the helping process include:

1. Establishing Rapport

a. Letting the children know you are interested in them and want to help them.

b. Checking with the children to make sure that they understand what you are saying and that you understand them.

c. Having genuine respect and regard for the children and their families.

d. Communicating trust and promising only what you can do.

e. Communicating acceptance of the children and their families.

f. Communicating to the children and their families that you are an informed authority.

2. Identifying, Defining And Focusing On The Problem

Like adults, children going through a crisis may seem confused and chaotic in their thinking. It is helpful to the children and families to identify a specific problem and to define it and focus on it first. If possible, the problem should be quickly resolved so that the children and families quickly experience a sense of success and control. Evaluating the seriousness of the problem should determine the families' capacity for dealing with it.

3. Understanding Feelings

Empathy is the ability to see and feel as others do. Being empathetic with children requires patience, for children frequently are unable to express their fears and the adults need to appreciate the kind and intensity of the children's feelings. For example, adults may be required to listen to a child's account of a disaster many times while the child "works through" the disaster by talking it out.

4. Listening Carefully

Frequently, the children's experiences of adults listening to them are unsatisfactory. In working with children, effort should be made to respond to them and to comment frequently. Interrupting the children should be avoided for it tends to happen often and the children may be particularly sensitive to being interrupted by adults. 5. Communicating Clearly

It is important to communicate in language the children understand. The presence of the family is useful in interviews with the children for the families will be more familiar with them and their behavior. In addition, families will be able to learn how to communicate with the children better after observing the interviewer. Simple language should be used in speaking with the children so that they are not excluded from the helping process.

The Use of Play

Few children are able to sit and talk directly about their difficulties or to explore the roots that underlie these difficulties. Most of them are not able to talk about their problems even at a superficial level. Involving the children in play is effective in helping them work through their troubled feelings. Play is one of the natural modes of communication. The fantasies that are verbalized while playing often provide much information about the psychological processes that are at the bottom of children's problems. Children's play following disasters will reflect their experiences. Paints, clay, dolls, and water play allow children outlets for their feelings. They will build dams out of blocks, for example, and have them collapse, or they will build towers and pretend the earth is shaking - activities that obviously mirror an earthquake. Children's drawings will depict on a more or less realistic level the feared hurricane winds or tornadoes. Fortunately, children's play discharges feelings that have been bottled up.

Children seem to use play therapeutically. It is best when they are allowed to make their own interpretations. Adult interpretations often dampen this expressive avenue. Any adults who care for children - teachers, counselors, parents - can encourage children to express their feelings in play. The play experience should be a pleasurable one for both adults and children. Adult helpers should get down to the children's level - literally play on the floor with them when necessary. Secondly, the workers must have the capacity to project themselves into the children's situation and to see the world through the children's eyes. The workers must also have the ability to remember their own childhood experiences sufficiently to be able to appreciate the children's situation.

Parents sometimes feel guilty about the fact that their children are having problems and may feel threatened that outsiders are needed to help. Play therapy involves the parents who can be taught to understand how the children express their feelings and fears through play. Under optimal circumstances, parents play with their children. Following a disaster or other family crisis, parental energies are perforce drawn away from the children. Attracting the families back to their ordinary roles with the children is therapeutic to all concerned.

Individual Counseling

Individual counseling may simply be a time for children to "have someone to talk to". As stated earlier, most children find "just talking about feelings" difficult. However, there are times when friendly, supportive adults are just what children need when their own parents are not able to listen to them because they are busy with their own problems. Following a disaster in which there may be a shortage of trained mental health workers, friendly, caring people who have received some crisis training can be helpful to the children. Because disasters arouse natural fears and anxieties in children, workers' reassurances and emotional support are important. Individual therapy by trained, experienced therapists can be used in severe cases to help the families and children understand the underlying roots of the problem.

Group Sessions

a. Children's Groups

The group experience for children of latency age and older is a natural one because of their daily experiences in classroom settings. Children find it easier to relate to each other than to adults. They gain a lot from a group in which they can talk openly and honestly about their feelings after a disaster. Finding peers who are interested encourages even withdrawn children to talk about their feelings. A leader can provide emotional support and needed information to the group. Children frequently distort the information they receive and are afraid of "feeling foolish" about asking questions. A peer group encourages them to ask their questions, foolish or not.

Group intervention with children is especially useful for therapeutic expression, as they are able to express their fears before their peers once they are reassured that having fears and anxieties is acceptable and that other children (even the bravest ones) also have these feelings. Children retell their experiences with great enthusiasm in group discussions with other children of similar age levels.

Groups function well when the leaders are democratic and care about children. If adults run the group in an authoritarian manner, the group will not "work", and the children will not feel free to talk about their feelings. When groups of children talk about disaster, or draw pictures about them, they are helped to dispel their fears about such happenings.

The following is one example of a group technique:

Form a group with a maximum of 12 children. Introduce the purpose as a chance for everyone to learn about the experiences of others in the disaster.

(1) Ask all the children what happened to them and their families in the disaster.

(2) As the stories appear, ask the children to tell about their own fears (perhaps even act them out in dramatic play).

(3) In the course of the discussion, provide factual information on the disaster (what happened, why).

(4) Ask members of the group to take turns being helpers. The children are paired and then take turns, first asking for help with a problem and then acting as helpers with the others' problems.

(5) Assign two children as co-leaders to help control restlessness and distractibility among the children.

(6) Provide the children with paper, plastic materials, clay, or paints, and ask them to depict the disaster. The less verbal children will find this helpful.

b. Parents' Groups

Working with parents in a group is an excellent means of helping them understand their children's behavior and providing them with specific advice on how they can deal with problems. In the group, parents have the opportunity to share their concerns with other parents who may be having similar concerns. Advice from other parents is frequently more acceptable than advice from "experts".

A parent group is useful when it is also educational. Parents often want to be informed on techniques for handling specific problems, such as fears and anxieties, sleep problems, school difficulties, and behavior problems.

Often the parents in groups express their own fears. Helping the parents understand their own fears makes them more effective with their children. The groups and group leaders are most supportive to the parents when they reinforce strengths present in the families and help them see how they have been able to deal efficiently with problems in the past. If additional help is needed from other resources in the community, the group leaders should have the information available.

Telephone Crisis Service

A telephone crisis line offering help with problems of children in disasters is effective in reaching the community. Families find it is an acceptable way to ask for help, and it is an efficient way to reach large numbers of families. The crisis line can be publicized on radio and TV as available "to help parents deal with their children's fears and anxieties". The media are usually pleased to announce the availability of the crisis line as a public service. The telephone line should be staffed by professionals and by trained volunteers under supervision. Volunteers can be recruited from local colleges and universities and from the community at large and, prior to receiving calls, should be trained in crisis techniques. Experience has shown that only a small proportion of the families calling need to be seen in person. Most of the callers are able to be helped by telephone advice. When they do need to be seen in the clinic, they often can be helped in group sessions. Specific, directive advice is crucial for the success of the telephone crisis line.

The typical calls will be about bedtime fears, clinging, and other behaviors that seem to reflect separation anxiety. For example: