Supporting Caregivers

June 11, 2008

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  <span class="field-credit">
    Maya Alexandri for Mercy Corps  </span>
    Mercy Corps' Griffen Samples teaching a Comfort for Kids workshop. Photo: Maya Alexandri for Mercy Corps

Today Griffen Samples, Mercy Corps' Senior Technical Advisor, conducted a Comfort for Kids training at Sichuan Normal University. Comfort for Kids is one of Mercy Corps' youth psychosocial methodologies. It has an impressive track record, having been used to alleviate childhood trauma in the aftermath of 9/11, in the wake of Hurricane Katrina and following the 2007 earthquake in Peru.

The Comfort for Kids methodology combines a trauma training workshop with an interactive workbook that helps children tell their story of the disaster in a safe context moderated by an adult caregiver. The workshop introduces the framework of the "Pillars of Security," which are the people, places, routines and rituals that anchor our everyday lives.

After a disaster, the task for caregivers is to re-establish these four pillars of security for children, so they can feel safe enough to resume their day-to-day lives. The workshop also assists caregivers in identifying normal, age-specific trauma responses that children may exhibit.

As a supplement to the trauma training workshop, Comfort for Kids also includes a workbook, adapted to be context-specific and culturally relevant for each disaster in which the methodology is used. "My Earthquake Experience: 5/12 Wenchuan Earthquake," a Chinese-language workbook for use by children in Sichuan, has been produced in record time thanks to extensive collaboration between Mercy Corps, the Children's Psychological Health Center, the China American Psychoanalytic Alliance and dedicated volunteers.

Today's training was attended by more than forty psychologists and psychology graduate students, many of them who have been counseling children in Dujiangyan, one of hardest-hit areas. In Dujiangyan, the earthquake reduced much of the city to rubble, and hundreds of students died when schools collapsed. Consequently, the trainees had been confronting tough questions and difficult behaviors from traumatized children.

One theme that surfaced repeatedly during the training was the question of how to discuss death with children. During a break, Professor Zhang Rili — a renowed psychologist on the Sichuan Normal University faculty — spoke forthrightly with Griffen about the issue.

Whether to tell children that their parents have died, Professor Zhang speculated, might depend on the age of the child. Griffen agreed that answers to children's questions must be age appropriate but, from her perspective, age-appropriateness must be balanced against the imperative to tell the truth. Being evasive or untruthful can undermine trust between the child and the caregiver. Moreover, Griffen emphasized that not knowing what has happened can be worse than the truth.

Professor Zhang agreed, but she clarified that she'd encountered two distinct situations with children. First, some children ask, "Where are my parents?" In that situation, Professor Zhang agreed that telling the children that their parents had died was likely appropriate. But some children don't ask. "Do you volunteer the information?" the professor wondered.

Griffen responded that children often ask for information when they're ready to receive it. But she also highlighted the importance of preparing children by asking them questions. "Do you know where your parents are? Do you want to know? Should we try together to find out where they are?"

Accepting Griffen's suggestion to prepare a child for difficult information with gentle questions, Professor Zhang further shared that — after hearing that their parents are dead — some children had then asked her if they would die.

"What's the appropriate age to tell children that they're mortal?" the professor asked. Griffen reflected that kids know people die.

"Death is not in our control," she said. "What's in our control is making a safe space for children, so that they can build a ‘new normal' existence after the earthquake."

Both Professor Zhang and Griffen agreed that, with respect to discussing death with children, the question was one of timing. Referring to the Comfort for Kids guidelines, Griffen offered that "My Earthquake Experience" recommends that children be asked if they know their parents' whereabouts about a month after the disaster.

As the participants' survey responses to the training made clear, the attendees valued the Comfort for Kids methodology in meeting the challenge of answering these tough questions of timing and child readiness to confront and accept death in the aftermath of the earthquake. They identified the "My Earthquake Experience" workbook as the most useful aspect of the training.

The participants could hardly have failed to notice that, on pages 14 and 16 of the workbook, is a series of questions both straightforward and heartbreaking: "My Earthquake Experience" asks children to check a box if their mother or father died in the earthquake.