Helping Teens Cope

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Responding to Stressful Events: Helping Teens Cope

Adolescents may be strongly affected by natural or human-caused disasters such as earthquakes, health emergencies, terrorist attacks or acts of war. Even indirect exposure to such events through media coverage may challenge their coping skills. Teens are generally more aware of and interested in world events than younger children. They are also able to imagine frightening events in more detail, and may become very interested in or upset by images of destruction.

Teens are already dealing with the many physical, social and emotional changes of adolescence. As they struggle to develop their own identity and values, they typically question and "try on" attitudes that range from cynicism to idealism. Catastrophic events can undermine their belief that the world is a safe place, their sense that adults and institutions can be relied upon, and even their confidence that life is meaningful and that there is hope for a better society.

It is normal for teens to have feelings of worry, confusion, sadness, or fear when disaster, terrorism or war are the main focus of the news. They need the adults in their lives to pay attention to their feelings and reactions.

It is important to know that:

• Teens can cope with stressful situations, and you can help them.
• They will express their feelings in different ways, both directly and indirectly. Some of their behaviours may puzzle or worry you are likely to pass before long.
• One of the most important steps you can take to help teens is to make sure that they know they are safe and that you will be there for them if they feel upset.
• The way you handle the situation will have a big impact on how teens will handle it. Pay attention to your own reactions and take positive steps to take care of yourself. (For some hints on how to do this, check out another brochure in this series, "Taking Care of Ourselves, Our Family and Our Community.")

Some Reactions to Expect

In general, teens are resilient. Most are strong, sensible and have good social support systems that will help them cope. They tend to respond well to tragic events, often looking for ways to help. Others may appear to ignore, play down, or "tune out" disturbing events. Nevertheless, a major stressful event can have a number of effects on teens. Here is a list of some common reactions:

• Worries, fears, and anxiety about their safety and the safety of family and friends
• Fear of other violent events or war
• Negative ideas about and mistrust of others, particularly those of different backgrounds
• A significant increase or decrease in time spent with friends or doing usual activities such as music, sports, and school
• Increase in disruptive behaviours, for example arguing, defiance, angry outbursts
• Increased crying, sadness or depressed feelings
• More difficulty concentrating or paying attention
• Problems at school: poorer grades, behaviour problems or more absences from school
• Teens may be less active and seem tired, or be more active, impatient and agitated
• Problems sleeping – either sleeping too much or not enough
• Problems eating – either eating too much or not enough

Teenagers who appear withdrawn and isolated, and who isolate themselves from family and friends, can be experiencing emotional difficulties. Adolescents need to feel competent and in control. However, they may be concealing feelings that are difficult to express. They struggle to be independent from the family and are torn between the desire for increased responsibility and their dependence on family and adults.

Don't over-react. Many of these behaviours, including a certain amount of moodiness and arguing, can be normal features of adolescence, which is a period of great change and challenges. You should, however, pay attention to behaviours that are new and disturbing. Make use of the suggestions in this pamphlet. If you show understanding and support, the unusual behaviours are likely to disappear within a short period of time. If the behaviours are dangerous or seriously disruptive, or if they don't improve after a few weeks, parents, family members or teachers should seek help.

How to Help

Teenagers often behave as if they are invulnerable. They may pretend not to be affected or concerned in an effort to remain "above it all" and "cool." Don't let this fool you. They may be scared, confused, worried and in need of your help.¹

Here are some suggestions on how to help them cope:

Grief and Loss. Grief includes shock, denial, anger, numbness, sadness, and confusion. Grief is a normal response to loss of all kinds including death and disasters. Teens need to know that grief is not permanent, and that people deal with it in healthy ways. We may be changed by these events, but we learn that we are strong, we can cope and we will be OK.

• Talk with your teens about grief and loss. This will help them to understand and accept their own thoughts and feelings and to know that grief will end and they will be OK.
• Explain that it can take time to get over a loss.
• Encourage them to be patient with themselves and with others.

Honest Reassurance. Offer reassurance based on the real steps that are being taken to address the situation, not on wishful thinking. Don't tell your teens that "this will all be over soon,"¹ or that "something like this could never happen in Canada". Although it is unlikely, no one can guarantee that no disasters or terrorist acts will occur. Admit that there are things you just don't know. However, don't hesitate to say, as often as necessary, that many people are working to ensure everyone's safety, and that there is little chance anything will happen to them.

Listen to what they have to say about the events and how they perceive them. Listen patiently. Provide them, as best you can, with factual information and help them distinguish opinion from fact. Try not to lecture or interrupt them.¹

Humour. Especially among their peers, teens may crack jokes about tragedies in "an unconscious effort to distance themselves from their fears"¹ and from the emotional shock of disaster. This is a normal reaction. Discourage disrespectful jokes while not cutting off lines of communication. There will be less of a problem if teens have the chance to discuss their thoughts and feelings with you in an atmosphere of respect.

Anger and Revenge. In response to acts of terrorism or war, some teens may feel angry and want revenge. Rage and a desire for vengeance are often based on feelings of threat, helplessness and vulnerability. Young people may get the message from peers or the media that they are "supposed" to feel angry and vengeful, that this is the attitude that will win approval and acceptance. Turn the conversation to the underlying feelings, tell them how you feel and discuss positive options other than revenge.

You may need to stop aggressive behaviour. If this behaviour is severe or persists, you may want to seek professional help.

Affection. Be patient with teens and with yourself. Give your family time to cope. Find simple, daily ways to show teens that you love them ? hugs, words of praise, fun time together.

Comforting friends. If teens have friends who have been directly affected by a tragedy, help them find ways of comforting these friends.1 They may need help to know how to offer comfort and support. They may avoid talking to these friends out of fear of causing more pain. On the other hand, they may identify too closely with their friends' pain and spend too much time with them. Balance and keeping up with normal routines is essential.

TV Coverage. You may want to help teens limit their exposure to news coverage of stressful events. Teens should not be shielded from the facts about catastrophic events but watching too much coverage of these events can put them in an emotionally overloaded, anxious state.1 Watch TV news coverage together and talk about what you are seeing, hearing, and feeling.

Terrorism and War. Teens, like most adults, will likely not have a good understanding of the complex situations that lead to terrorist attacks and armed conflict. Discussing world events and exploring different ways of understanding them will help teens put the events into context. This should help them feel less upset and vulnerable. It should also help to avoid simplistic responses like scapegoating or racism.

Maintain Family Routines. Maintain family routines, particularly around sleeping, eating and extracurricular activities (e.g., sports, faith services, music, dance). This does not mean pretending nothing has happened. Make time in your schedule to talk about the situation and plan how to respond positively. Maintaining routines is an important way of ensuring that basic needs are met.

Decision making. If teens are quite upset by these events, it may not be a good time for them to make important decisions. Encourage them to take the time they need to think things over.

Appropriate adult behaviour and responses. Tell teens what you think and feel about the events so they can understand them better. They will gain confidence to deal with their own feelings if you show them that you have strong feelings and that you can cope with them in healthy ways. Talk to teens' friends about their responses to the situation. This can help them.

Vulnerable Teens. Stressful events and an ongoing climate of uncertainty and worry can have a greater impact on teens who are vulnerable. This may include teens who have experienced serious bullying, difficult family separations, deaths in the family, family violence, sexual assault, a traumatic refugee experience, clinical depression, an anxiety disorder or other mental illness, a history of drug/alcohol abuse, self-injury or suicide attempts. Some vulnerable teens may experience a return or worsening of mental health problems or unhealthy behaviours, up to and including suicide attempts.

Helping Activities for Teens

Teens need to participate in activities that help them feel better. They may find some of these activities useful:

• Relaxing Activities. Encourage relaxing activities such as reading, listening to music, taking a walk, riding bikes, etc.
• Diaries. Some teens benefit from writing their thoughts and feelings in a diary.
• Recreational Activities. Teens need to return to previous fun activities. Vigorous physical activities and sports help reduce stress, make people feel more alert, happy and energetic.
• Volunteering helps teens grow up caring, confident, and responsible. It will also help them deal with events in a positive way. Suggest they call the volunteer bureau in their community to find out more about, for example, helping elementary children with reading and homework, visiting senior citizen centres, assisting at an animal shelter, working with Special Olympics.
• Fundraising. Organizing a fundraising event (for example, a carwash) to aid those in need is one way of channelling concern, compassion and energy in a positive way.
• Peer Group Activities. Encourage activities where teens can get together with their friends to discuss what happened, share their thoughts and try to make sense of events.

When to Seek Help

Teens are amazingly flexible and resilient and their parents and teachers are capable of helping them deal with the situation. However, getting additional help is a good idea if a teen shows significant changes in behaviour in the weeks or months following stressful events. Some of these changes could include:

• Behaviour problems at home or school
• Learning problems
• Angry outbursts
• Ongoing withdrawal from usual social activities or being with their friends
• Frequent nightmares or other sleep disturbances
• Physical problems such as nausea, headaches, weight gain or loss
• Feeling very anxious or afraid
• Ongoing sadness or depression
• Hopelessness about life or the future
• Increased risk-taking or problems with the law
• Abuse of alcohol, street drugs, medicines or solvents
• Suicidal thinking or behaviour

Some teens may be more at risk for a persistent or strongly negative response, or even for suicidal behaviours. Be particularly watchful and prepared to seek professional help if there are signs of poor coping.

Following a stressful event, some teens have found it helpful to talk with a health professional such as a physician, a psychologist, a social worker, a nurse or a psychiatrist who can help them understand and deal with how they are feeling.

Acknowledgments

This document was revised by the Mental Health Support Network of Canada, a network of professional and voluntary associations concerned about mental health and the stress arising from extreme stressors.

Much of the information in this document was developed following the September 11, 2001 terrorist attacks on the United States using information put together by Health Canada with input from the Canadian Medical Association, Canadian Psychological Association, Canadian Psychiatric Association and the Canadian Public Health Association.

Mental Health Support Network of Canada, Members:

• Canadian Association of Occupational Therapists
• Canadian Association of Social Workers
• Canadian Healthcare Association
• Canadian Medical Association
• Canadian Mental Health Association
• Canadian Nurses Association
• Canadian Paediatric Society
• Canadian Pharmacists Association
• Canadian Psychiatric Association
• Canadian Psychological Association
• Canadian Public Health Association
• Canadian Red Cross
• The College of Family Physicians of Canada
• Public Health Agency of Canada

Coping Resources in Your Community

Please use this space to list the names and telephone numbers of key resources and programs in your community (including friends and family you can call to talk things over).

¹ Carleton Kendrick, "Helping Teens Cope with the September 11 Tragedy" (familyeducation.com)

This pamphlet has been published by the Public Health Agency of Canada, Ottawa, Ontario K1A 0K9.

It can be reproduced freely for non-profit educational purposes or as part of a public awareness initiative, provided that full acknowledgment of the source is made. For more information about the psychosocial dimension of emergency preparedness, see the Personal Services manual at:http://www.phac-aspc.gc.ca/emergency-urgence/index-eng.php)