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Ocala CEP highlights tiny horses helping Ocala residents that experienced traumatic events

Ocala CEP highlights tiny horses helping Ocala residents that experienced traumatic events

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OCALA, Fla. (WCJB) – Residents of Ocala, who have experienced traumatic events, are getting a little help.

Our friends from the CEP share with us how tiny horses are bringing therapy to those in need.

RELATED STORY: Ocala CEP highlights HCA Florida’s Comprehensive Stroke Center’s acceptance of patients

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Teachers often struggle to address mass traumatic events in class

Teachers often struggle to address mass traumatic events in class
students
Credit: CC0 Public Domain

After the Paris attacks of 2015—a series of attacks in which gunmen opened fire on nightspots and a concert hall in Paris—a U.S.-based high school teacher of French described her failure to discuss the attacks in class as a “lost opportunity.”

“I was working through my own feelings and did not know how to approach it,” she told us in a survey after the attacks. “I only talked about it when the students brought it up and I kept conversations short.

“I think I should have been more open, honest, and offered more opportunities for students to process and take some action, even if it was a moment of silence, to honor the victims and help the families and survivors,” the continued. “I let my fear of not knowing what to do guide me and I regret it.”

Such feelings are by no means uncommon among schoolteachers after a mass traumatic event has occurred, as we have learned as researchers who specialize in student mental health and well-being.

This teacher was just one of almost 100 U.S.-based teachers of French whom we surveyed after the 2015 Paris attacks. We also surveyed about 150 Massachusetts teachers following the 2013 Boston Marathon bombing.

The National Association of School Psychologists recommends that teachers make time to talk to students about high-profile acts of violence, including attacks against schools, such as the May 2022 massacre at Robb Elementary School in Uvalde, Texas. However, the teachers whom we surveyed regularly told us that initiating these conversations is difficult.

In response to our surveys, the teachers wrote about the challenges of entering their classroom the morning after a crisis. Here is what they told us:

1. There is no typical way that students will respond

Psychologists are clear that, after a mass trauma, a wide range of feelings and responses is normal.

For teachers, this means that in a classroom of 25 students, there might be 25 different reactions. Students may also differ in their knowledge and understanding of what happened in the event. Whereas parents can focus on just their own children, teachers need to navigate complex conversations with many students at once, realizing that some students may be deeply affected, while others have little reaction.

For example, after the Boston Marathon attack in April 2013, a teacher wrote about the challenges of anticipating how her students would respond: “Because the students I serve have trauma histories and emotional disabilities, it is very difficult to determine the impact of the events in April on students, as so many other factors play a role.”

2. There is no script to address trauma

Conversations about crises are unpredictable. Teachers don’t know what topics and questions students will raise and are often left to find their own materials. One teacher wrote about preparing to return to school following the Boston Marathon attack: “I spent a lot of time and energy working on a plan for my class on my own, but I know that other teachers who did not have the luxury to do so, or who were less experienced teachers, were much more worried about going into school than I was.”

Other teachers commented on their uncertainty entering the classroom. A teacher of middle and high school French wrote after the Paris attacks: “ had many students ask me about the attacks and I spoke with them privately about the tragedy but said that I didn’t feel comfortable discussing the events as an entire class. If I had more resources or time or training to address these events with teens I would love to be able to without the fear of offending someone or having a student say something insensitive.”

3. Students are not the only audience

While students are the focus of teachers’ attention, families may have strong opinions about if or how schools talk about mass trauma. Even when school staff members know how to navigate conversations with students based on and developmental considerations, families may have their own opinions about what is appropriate to discuss in school.

An elementary school French teacher wrote about her concern that she would provide more information than parents would like: “I told them that if they had questions, they should talk to their parents, because I wanted to respect the parents’ wishes as far as how much the kids knew.”

An science teacher wrote a similar response after the Boston Marathon attack: “I was also always fearful that one who knew all about the attacks would start talking about it with students who had no idea what had happened and I would be stuck trying to mediate the situation, wary of what parents would say if students come home talking about the event after parents had decided not to expose their child to it.”

4. Events are linked to broader social, political and cultural contexts

As teachers prepared to discuss a traumatic event, they said they also needed to be ready to discuss the context of the event. For example, a middle and high school teacher of French wrote that she “experienced strong conservative political reactions from students,” which she said she wasn’t expecting. “I expected to help them grieve, but I felt unprepared to navigate a debate on gun control in one class and bombing Syria in another. … I tried to offer counterpoints while simultaneously being unaware of how far I can push before getting into hot water.”

5. Teachers are affected, too

Often teachers live and teach in communities directly affected by traumatic events. Or, as with the Uvalde, Texas massacre, teachers may themselves feel scared or affected by events. For example, an eighth and ninth grade French and Spanish teacher wrote after the Paris attacks that she, “as an adult, was much more traumatized than the kids.” “To me it was another 9/11 moment,” she said. “I was the one feeling lost, shocked and upset.” A first grade teacher similarly wrote after the Boston Marathon attack: “Most of the students wanted school to resume as normal—they wanted consistency and something familiar. It was the adults that needed the most help comprehending, processing and dealing with the events.”

When we asked teachers how their schools can better support them, two messages came across clearly. First, leadership is essential. Several teachers noted the importance of school leaders meeting with staff to discuss their feelings and prepare to respond before resuming school. They also discussed the importance of school leaders sending out communications to educators and families, explaining how the school will respond.

Second, teachers want to know what to say. An April 2022 study found that only five states required future teachers to receive training in how to respond to trauma. Teachers expressed that they want training and guidance in how to discuss traumatic events with students, including how to open the conversation, how to respond to difficult questions, and how to support throughout the discussion. For example, a fifth grade teacher wrote after the Boston Marathon attack: “Training! We have no training on this. We get emails from our superiors that tell us to address the events, with not much training on how to do it. I feel like I’m good at this type of thing—but not all teachers in my are. … The result is that some kids get their needs met by their teacher and some don’t.”


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Your Good Health: Traumatic medical events can lead to PTSD

Your Good Health: Traumatic medical events can lead to PTSD

Dear Dr. Roach: I work with a group for people with a type of cancer resistant to chemo or radiation, and many of the members have had to have numerous, life-altering surgeries, including amputations. A member asked whether others had symptoms of PTSD and said two therapists told her that PTSD could not be caused by medical issues. But I have read a few articles saying that it can be induced by trauma from medical procedures and illnesses. Can it?

T.M.H.

The term “post-traumatic stress disorder” is used informally by nonprofessionals to describe many things, from anxiety to unpleasant tasks. When used in its proper medical sense, it is a complex reaction to psychological trauma, and may have physical, intellectual, emotional and behavioral symptoms. Among the most important diagnostic features of PTSD are intrusive thoughts, nightmares and flashbacks of traumatic events, and these lead to poor function at work or in personal relationships.

A discussion of the formal diagnosis of PTSD is beyond the scope of this column, but to qualify it must include a traumatic event; intrusive symptoms such as flashbacks; a change in behaviour to avoid reminders of the trauma; unpleasant changes in mood or thought; and unpleasant symptoms, such as irritability or poor sleep. It also may include behaviour changes as a result of the trauma.

Your question is about the type of trauma that can lead to PTSD. While we often think of extreme singular events, such as those faced by military personnel or first responders, the trauma in people diagnosed with PTSD may be a series of multiple events, not one particularly horrible one. Sexual assault and mass displacement from famine or warfare are other traumatic events that commonly trigger PTSD.

Medical causes account for approximately 6.5% of PTSD in a recent study. Heart attack, stroke and a stay in intensive care for any reason are the most reported traumatic medical events associated with PTSD. Life-altering surgeries such as amputations certainly could trigger PTSD, and the therapists who denied this were simply wrong.

Dear Dr. Roach: My husband is a diabetic, with neuropathy, retinopathy and high blood pressure. His issue is that he is always “cold to the core” and sweats profusely on his head anytime he eats or drinks. The doctors he sees can’t figure out why. It has greatly impacted his quality of life. Have you heard of such a thing?

M.R.

Yes, this is called “gustatory sweating,” and it is a special type of autonomic neuropathy found in people with diabetes. The word “gustatory” means “having to do with eating,” while “autonomic” refers to the vast part of the nervous system that is not under conscious control.

Among many other functions, the autonomic nervous system controls complex actions like temperature (maybe feeling “cold to the core” is because of this), heart rate, most breathing and gastrointestinal function.

Diabetes, especially if not well controlled, often damages nerves over many years. Neuropathy and retinopathy (damage to the retina at the back of the eye) tend to occur about the same time. Many people are familiar with the numbness and pain of the feet and sometimes hands that can happen with longstanding diabetes, but the autonomic system can be affected as well. Constipation and slow stomach emptying are other common symptoms of autonomic neuropathy.

The topical use of glycopyrrolate on affected areas can be a safe and effective treatment.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu