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By Robert Hull

As parents, children, and communities struggle to come to terms with the events in Newtown last week, it is important for educators and parents to be aware of just how deeply children can be affected by violence.

Community violence is very different from other sources of trauma that children witness or experience. Most trauma impacts individual students or small groups, whereas the violence that was experienced in Newtown affected the local community and the entire nation. The lack of warning and the unexpected nature of these kinds of events, combined with the seemingly random nature of the attack, contribute to a change in individuals’ personal views of the world, and their ideas about how safe they and their loved ones actually are. The world comes to seem more dangerous, people less trustworthy.

Exposure to trauma can impact several areas of children’s functioning. Teachers may notice that students who have experienced trauma appear to be shut down, bored, and/or hyperactive and impulsive. Interpersonal skills might be impacted, which can lead to social withdrawal, isolation, or overly aggressive behavior. Students might appear confused or easily frustrated. In addition they might have difficulty understanding and following directions, making decisions, and generating ideas or solving problems.

Family members and educators are often at a loss in how to support students following an event such as what happened in Newtown. The following are guidelines on helping students exposed to community violence:

• Teachers and family members should attempt to maintain the routines and high expectations of students. This directly communicates to children that they can succeed in the face of traumatic events.
• Reinforcing safety is essential following unpredictable violence. Remind children that the school is a safe place and that adults are available to provide assistance.
• Do not force children to talk. This can lead to withdrawal and downplaying the impact. A neutral conversation opening can be stated in this way: “You haven’t seemed yourself today. Would you like to share how you are feeling?”
• Teachers can model coping mechanisms such as deep breathing, relaxation and demonstrating empathy.
• Being flexible is a must following traumatic events. Teachers should allow students to turn in work late or to postpone testing.
• Educators should increase communication with parents in order to provide support that recognizes a specific child’s vulnerabilities.

There are several websites that can provide additional information on supporting students who have been exposed to violence. These include:

• The National Child Traumatic Stress Network
• The National Association of School Psychologists
• The National Center for Children Exposed to Violence

Robert Hull is an award-winning school psychologist with over 25 years of experience working in some of the most challenging of educational settings, and was for many years the facilitator of school psychology for the Maryland State Department of Education. Currently he teaches at the University of Missouri. He is the co-editor, with Eric Rossen, of Supporting and Educating Traumatized Students: A Guide for School-Based Professionals.

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Edna Foa is a Professor of Clinical Psychology in Psychiatry at the University of Pennsylvania and Director of the Center for the Treatment and Study of Anxiety.  Her most recent book, Prolonged Exposure Therapy for PTSD: Emotional Processing of Traumatic Experiences, was written with Elizabeth Hembree and Barbara Olaslov Rothbaum. The guide gives clinicians the information they need to treat clients who exhibit the symptoms of PTSD.  Recently Foa was name by Time Magazine as one of the most influential people in 2010.  Below she reacts to the honor.

My first reaction was that of disbelief when I learned that I had been selected for Time Magazine’s list of the 100 most influential people in 2010. I thought someone was pulling my leg. I called my husband and shared the news with him, he thought I was pulling his leg. My youngest daughter said: “get out of here, you must be joking”. But of course, we all know that the email was genuine. First, I was stunned. After all, I am not a rock star, not a head of state, not even a famous athlete. And then I was delighted. Isn’t it wonderful that someone at Time recognized the importance of the work we, clinical psychology researchers, do to help PTSD sufferers. I felt quite honored to represent our field.

As clinical scientists we know that we have a lot of powerful treatments. But we also are painfully aware of how difficult it is to make these treatments widely available. The treatments that we have for anxiety disorders are particularly efficacious and yet most clinicians do not deliver them. For many reasons it is hard to get mental health clinicians to adopt new treatments. As a result, countless individuals with anxiety and other disorders experience needless suffering that could be decreased or terminated via the application of the effective treatments we developed.

The cost of bad treatment reaches beyond individuals. Institutions and society as a whole suffer from what is a public health issue. For example, the VA, the military and insurance companies all have a stake in individuals receiving the most effective treatments for psychological disorders. And yet, there have been very few effective initiatives requiring practitioners to learn and deliver the best psychological treatments.

And so I hope that Time Magazine’s recognition of my work is in essence recognition of the tremendous importance of not only developing effective, evidence-based treatment, but more importantly, disseminating them among mental health professionals. The wars in Iraq and Afghanistan have brought home the awareness of how important it is to deliver effective treatments to the many soldiers who return from these wars with posttraumatic stress disorder (PTSD). I strongly believe that PTSD is not only a mental health disorder; it is also a societal problem. It is the responsibility of our society to help PTSD sufferers as a result of being injured at work, raped in our schools, physically assaulted in our streets, or experiencing the horror of war. We know that effective treatments for PTSD such as Prolonged Exposure (PE) can help patients regain their lives in as few as 10 sessions over the course of 5 weeks. It is no long