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Disasters are ‘situations or events that create a serious disruption in the functioning of a community and overwhelm its capacity to deal with the widespread loss and destruction created by the event’ (Overstreet et al, 2011, p. 52). In Australia natural disasters, such as floods and bushfires, are almost an annual event. Providing support and therapeutic services to communities following a natural disaster are vital for people’s recovery process and eventual return to stable living.
In determining an appropriate dramatic experience, it is important to understand the needs of the particular client group and, when working with a group, to understand the specific dynamics of group-work in therapy. For the purposes of this essay a hypothetical group of children who have experienced a natural disaster in Australia resulting in trauma will be the example. Mass trauma events cause ‘disruption and devastation for many individuals and families worldwide…[and]…the needs of children are particularly compelling, given their developmental fragility and unique vulnerability’ (Pfefferbaum et al, 2014, p. 79). The results of substantial research show that ‘across five Australian natural disasters, using a range of screening instruments…8-12% of students self-reported severe or very severe Post Traumatic Stress Disorder symptoms that would warrant further assessment’ (McDermott and Cobham, 2014, p. 5), demonstrating an important need for therapeutic services to be available for children following a natural disaster.
The group would run over ten weeks and there would be a maximum of twelve group members aged between ten and twelve years-old. It would be a closed group, where new members would not be able to join after the group had begun. The ten-week program would consist of dramatherapy (including elements of Playback Theatre and Psychodrama) designed to allow healing to take place. Specific goals would be outlined, which could then be monitored by the Dramatherapist. This monitoring, combined with group feedback and follow-up by the Dramatherapist once the program is complete, would form research and evidence as to whether or not the dramatherapy had worked.
Background
During or following a natural disaster, ‘children are one of the most vulnerable populations because their neuro-psychological systems are subject to permanent changes and their coping skills are not developed enough to manage catastrophic events’ (Baggerly and Exum, 2007, p. 80). For this reason, it is particularly important that children are supported following a natural disaster and offered age-appropriate therapy that assists them in processing the trauma, and building coping skills to move forward and resume activities from their life before the disaster.
There is good evidence that providing services to children following a natural disaster is very much needed in Australia. Research has identified that ‘approximately 5-15% of children experience significant mental health symptoms following disaster exposure…[however]…in the Australian context, only 1 in 5 to 1 in 7 of those who may benefit actually receive a service’ (McDermott and Cobham, 2014, pp. 2-3). With only around twenty percent of children receiving the therapy and support they need following a natural disaster, there are many children who will not be provided the opportunity to get the assistance they need to recover. This will also continue to have an impact as these children may experience further mental health issues into adulthood as a result of unresolved grief or trauma in childhood. This could significantly reduce their quality of life and also be very costly and draining on mental health resources in years to come.
A further need for children to receive the support they require following a natural disaster is that children are very aware of the events in their lives even if they choose to minimize them to protect adults, or do not have the language to express themselves. As they are advancing in their cognitive abilities, ‘children of school age are capable of concrete operations and can apply logic to understand events, to appreciate the seriousness of an event, and to consider the potential effects of an event’ (Pfefferbaum et al, 2014, p. 81). With adults focussing on survival, and providing basic needs for their family again, children may not be heard by parents or teachers who are themselves traumatised and prioritising what their own families, and the community, need in order to stabilise.
Along with the trauma of experiencing a natural disaster, children often lose their social support immediately following the disaster. Schools may close, roads can be cut off and families are coping with instability, grief and sometimes homelessness resulting in the temporary loss of friends, teachers and extended family in their lives. The loss of social support may contribute to ‘resource spirals’ where the continued loss of support and resources can contribute to a child’s distress, therefore the ability to provide social support in a post-disaster environment appears to be extremely important in reducing the negative effects of the disaster on children’s mental health (Overstreet et al, 2011, p. 58). For this reason, participating in a therapy group can mitigate the effects of isolation and the loss of social supports that are normally in place.
Aims of the Proposed Program
In working therapeutically with a group of children who have experienced trauma following a natural disaster, the main aims of the program would be for:
• The children to have a therapeutic intervention to facilitate them in processing their trauma
• The children to gain a skill-set to develop strengths, resilience and coping mechanisms
• The children to learn safety skills to better protect themselves following the trauma
• The children to experience social support from other group members
• The children to develop social skills from participating in a group
Group-work Theory
It is necessary to understand the dynamics of group-work so that the sessions can be planned according to the stage the group is up to in the process. A theorist by the name of Bruce W. Tuckman identified a sequential-stage theory of how groups evolve throughout the process of working together (Johnson and Johnson, 2003, p. 28). Tuckman identified “five stages: forming, storming, norming, performing and adjourning…[and that]…at each stage groups focus on specific issues, and this focus influences member’s behaviour” (Johnson and Johnson: 2003, p. 29). An understanding of these stages will impact on the choices made for each session when planning a program.
References
Baggerly, J. and Exum, H. (2007) Counselling Children After Natural Disasters: Guidance for Family Therapists, The American Journal of Family Therapy, 36:1, 79-93.
Jennings, S. (Ed.) (1995) Dramatherapy With Children and Adolescents, East Sussex: Routledge.
Kasiram, M. and Khosa, V. (2008) Trauma Counselling: Beyond the Individual, International Social Work, 51:2, 220-232.
Langley, D. (2006) An Introduction to Dramatherapy. London: Sage Publications Ltd.
McDermott, B. and Cobham, V. (2014) A stepped-care model of post-disaster child and adolescent mental health service provision, European Journal of Psychotraumatology, 5:1, 1-10.
Overstreet, S., Salloum, A., Burch, B. and West, J. (2011) Challenges Associated with Childhood Exposure to Severe Natural Disasters: Research Review and Clinical Implications, Journal of Child and Adolescent Behaviour, 4:1, 52-68.
Pfefferbaum, B., Noffsinger, M., Wind, L. and Allen, J. (2014) Children’s Coping in the Context of Disasters and Terrorism, Journal of Loss and Trauma, 19:1, 78-97.
Thompson, E., H. (2011) The Evolution of a Children’s Domestic Violence Counselling Group: Stages and Processes, The Journal for Specialists in Group Work, 36:3, 178-201.
Weber, A. M. and Haen, C (Eds.) (2005) Clinical Applications of Drama Therapy in Child and Adolescent Treatment, New York: Brunner-Routledge.
