Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Introduction & Reducing 9/11 PTSD

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Answer Booklet | Table of Contents
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Welcome to the Home Study Course sponsored by the Healthcare Training Institute, homestudycredit.com.  This course is entitled Children Coping with Terrorism and Disasters: Diagnosis & Treatment.

Our primary intent for this home study course is to provide quality education to foster your professional growth.  The Institute has provided quality education since 1979.
 
We appreciate that you have chosen us as a vehicle for you to earn your Continuing Education Credit.

The purpose of the course is to assist you in increasing your knowledge regarding how to treat patients, clients, etc. dealing with terrorism and natural disasters.  As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting.  However, these notes are for your purposes only and are not to be sent to the Institute.  Also each track is very content dense.  So feel free to replay the track to review the content either for your own purposes, or if you feel appropriate play the track in an individual or group session for client education.  Also permission is granted to reproduce this CD.  We encourage you to duplicate and give copies of this CD to colleagues, clients, etc. as you deem appropriate. We feel the information on our CD's is valuable.  Thus, we have an interest in distributing CD's in as many ways as possible, to benefit the greatest number of people, who have a need and are receptive to this practical information.

The questions in your Answer Booklet are sequential and deal with the section of content that preceded it.  For this reason, to facilitate the answering of each question, you might read the question from the Answer Booklet prior to listening to that CD track.  By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer.  So just a hint, after you write down the answer to a question in your Answer Booklet, read on to the next question in order to give you a “heads up” to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line in your answer booklet. Each answer is only used once. Keep in mind there is nothing tricky or hard about these questions.  They are merely intended to verify the playing of this CD.

For the purpose of brevity, most generally, I will use the term “therapists” or “mental health professional.”  However, don’t let these terms deter you from applying the concepts to your situations.  When you hear the word “therapists,” if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don’t let my use of the term “therapists” cognitively set you off track from hearing the content because your job title is school counselor, for example.  I will also use the term “client” for the purposes of brevity.  However, if you deal with patients, residents, students, consumers, etc., transpose “client” for the term that is the most meaningful to you in your work setting. 

On this CD set we will discuss such topics as: the long-term effects of terrorism on children, questions about safety and security, questions about terrorism, the conversational comfort zone, helping parents manage their own fears, children’s stages of reactions to trauma, contributing factors in disaster reactions, assessing children exposed to disaster or terrorism, introducing children to emergency preparedness, effects of different natural disasters, treating children recovering from natural disasters, and the impact of wildfires on children.

So  let’s get started

On the rest of this track, we will discuss the impact of September 11, 2001 on children, and a technique for reducing post traumatic stress as a result of media exposure.

On September 11, 2001, an estimated 3,000 children lost a parent in the terrorist attacks on New York and Washington D.C.  The average age of these children was nine years old.  In the years following the attacks, a great deal of attention has been focused on how these children, and other children exposed to the events, have been affected by the trauma.

The New York City Board of Education reported after 9/11 that school children in the city experienced rates of Post Traumatic Stress Disorder five times higher than normal.  Even children up to 3,000 miles away from the events felt the trauma keenly.   Experts studying the effects on young people say that adolescents growing up today are struggling with the sense of invulnerability and optimism that usually characterizes adolescent life.

One of the primary ways in which children who were not directly affected by the terrorist attacks became exposed to traumatic stress is through the television and the news.  David, age 4, was brought in to see me by his father, Albert, about a month after the terrorist attacks of September 11, 2001.  Albert stated, “I was completely convinced I had kept David from knowing about the attacks.  I knew he was having trouble sleeping at night, but I thought that was because he was having trouble adjusting to daycare.  The last week, when a plane flew above the daycare, David started screaming and ran under a tree.  So I asked David if he had heard about anything happening in a place called New York.  Sure enough, he had.  And when I asked him if that was why he’d been getting up at night, David told me he was scared a plane would fly into our house!”

I reminded Albert that it is often a continual surprise just how much children pick up from even brief television viewing.  I stated, “Even if you completely eliminate television from your home , children will hear things from older kids, or see the covers of newspapers and magazines at the store or the doctor’s office.  Instead of focusing on trying to protect David completely, you might want to consider working on strategies to help recognize and cope with the information David does absorb.”  Specific guidelines for helping children process information they learn from outside sources will be discussed in detail on Track 5 of this course.

Another client, Leroy, brought his eight year old daughter Nellie in to see me after Nellie began having repeating, terrifying nightmares.  Leroy stated, “I work in television, so I know how important news coverage can be.  So I figured it would be important for Nellie to see the news regarding September 11th… I mean, it was a historic event!  The TV was on all day, and Nellie was right there with me all day.  Now I realize that I made a terrible mistake.  How do I know how much TV is too much for Nellie before I make a mistake like that again?”  I stated to Leroy, “The best advice may be not to have the television news on at all when Nellie is around.  Tape the news and watch it after Nellie goes to sleep.  Even if the television is just ‘in the background’, Nellie may still be responding to it on some level.  Besides, a study in the Wall Street Journal indicates that background news about war and terrorism isn’t good for adults either.  The study revealed that adults who keep the news on in the background may be at greater risk for depression, stress, and a weakened immune system.”

I have found that there are two sets of guidelines useful for parents who want to reduce the impact of the media of terrorism on their children.  The first set of guidelines concerns children under the age of seven, like David.

 There are three important guidelines for children under seven.  The first guideline for children under seven is to turn the TV off.  I stated to David’s father, Albert, “Turning the TV off can be one of the hardest steps for families.  But research indicates that for children under two, there is no positive impact of even educational TV, and the best solution is just to turn the TV off.  This is good advice for any child under seven as well.”  The second gudeline for children under seven is to take the television out of the child’s bedroom.  This may be initially the most upsetting step to your child.  However, it is also the step that makes the most sense.  If David has a TV in his room, you cannot monitor how much TV or what kind of TV he is watching.”  In addition to turning the TV off and taking the TV out of the child’s bedroom, a third guideline for children under seven is to choose educational television for the hours when the child is permitted screen time.  I stated to Albert, “parents who reported that their children primarily watch educational programming report that the media has much less of a negative impact on their children.”

Regarding children ages seven to ten, like Nellie, there are four guidelines regarding television viewing.  The first guideline for children ages seven to ten is to set limits.  According to the Center for media and Family Studies, a safe amount of screen time, including TV, video games, and computer use (except for homework) is no more than ten to twelve hours per week.  Of course, in homes with multiple children, parents must balance the guidelines for each child with a routine that makes sense for the entire family.  However, do you, as I do, usually encourage families to watch as little television as possible, regardless of children’s ages?  A second guideline for children ages seven to ten is to watch the news together.  I stated to Leroy, “One of the best thing you can do for Nellie concerning the news is to watch it with her.  That way you are right there to see what she is taking in, answer any questions, and change the channel if you feel it is necessary or that Nellie is becoming distressed.”  In addition to setting limits and watching news together, a third guideline regarding television viewing for ages seven to ten is to talk.  I stated to Leroy, “By talking to Nellie about what she sees, you can help shape her developing media literacy.  That is, her understanding of how different forms of media shape the stories she sees and the information she takes in.”  Finally, the fourth guideline for children ages seven to ten is to encourage alternate activities.  While parents may not, and perhaps should not, eliminate television from their homes, I encourage parents to help their children develop alternate forms of amusement, such as reading, sports, or crafts.  Often, I find it useful to remind parents that the best way to encourage better entertainment choices is to model better entertainment choices.

Think of your Nellie or David.  Would reminding their parents of these age-dependent guidelines be useful for him or her?

On this track, we have discussed the impact of September 11, 2001 on children, and a technique for reducing post traumatic stress as a result of media exposure.

On the next track, we will discuss four aspects of the long-term effects of terrorism on children.  The four aspects we will discuss are: the effects on preschool children, on middle and high school students, on elementary students, and on middle school students in communities distant from the terrorist event. 

QUESTION 1
How much screen time is appropriate for children between the ages of two and five? To select and enter your answer go to Answer Booklet.