Post-Crisis Therapy: Is It for Everyone?

Julie Lynn, a camp counselor who heroically guided 15 children to safety during the recent shooting rampage at the North Valley Jewish Community Center in Granada Hills, has had trouble sleeping for something she wasn’t able to do amid the chaos.

In a split second, Lynn had to choose between helping a fellow counselor who had run into the room, shot and bleeding, or rushing the children out of the building.

She grabbed the kids. Although someone else came to the other counselor’s aid, Lynn was haunted by feelings of guilt for leaving her wounded colleague. But Lynn chose not to share those feelings with the many therapists who were brought in to counsel the camp staff.

“It felt good they had people who wanted to help us, but I actually had no interest in talking to them,” Lynn, 20, said in an interview. “I felt like there are these strange people to talk to.” Instead, she said she felt more comfortable speaking with some college friends and “felt a lot better.”

She’s not alone in her reluctance to seek help from mental health professionals following the traumatic shootings of Aug. 10. Another staff member told her he left a group counseling session “to go to the bathroom and didn’t go back.” Others, she says, “didn’t see the need to talk and didn’t want to.”

It has become almost as routine as the media barrage that accompanies today’s explosions of violence or major disasters: Armies of psychologists, social workers and other mental health experts stream in to assist witnesses and victims. Many communities have emergency counseling teams at the ready; others call in outside specialists.

Coping Strategies Vary Among People

But does all this on-scene “debriefing,” which encourages talking as a way of coping with the emotional aftermath, actually help wounded psyches heal any better?

There are no simple answers, and even less hard data.

Michael Mantell, a San Diego psychologist, has written one of the few published studies on debriefing. He found that among police officers involved in a traumatic incident “those who talked about it had far fewer symptoms six months later than those who held it in and didn’t talk about it.”

George Bonanno, a psychologist at Columbia University in New York City, doesn’t believe in a blanket approach.

“It just forces one way of dealing with a problem on everybody. In general, I’m very critical of the idea that after a traumatic event or a serious loss people necessarily need therapy,” Bonanno says. His research into how people cope with adversity shows “rather conclusively” that people who don’t feel a need to express their feelings “do just fine. People have very different ways of coping with these things.”

Some initially shun assistance while in shock and don’t need someone to talk to until later. When their assistance is sought, counselors can offer valuable reassurance that sleeplessness, jitters and guilt are normal reactions.

After the Columbine High School shootings in Littleton, Colo., anecdotal evidence Mantell heard suggests “the kids were not talking to the counselors. They were talking to religious leaders and among themselves. There were a lot more counselors there than counseling going on.”

Marleen Wong, director of mental health services for the Los Angeles Unified School District, agrees that not everyone responds to a one-size-fits-all approach.

“You just can’t indiscriminately pull everyone together and say, ‘We’re going to do this group counseling,’ ” says Wong, who was part of a U.S. Department of Education team that traveled to Columbine after the shootings in April.

Wong describes the method she employs as neither counseling nor therapy but “guided discussion,” which gives victims a forum for talking if they wish to. Her sessions provide information about how to prepare for the emotional and physical aftermath of trauma.

Forcing people into group counseling sessions amounts to “torturing” those not comfortable with participating, even if they’re experiencing typical feelings of guilt and vulnerability, she says.

Lynn, of Woodland Hills, had such feelings after her harrowing experience.

She was little more than a week from finishing her third summer at the Granada Hills day camp when 16-year-old Mindy Finkelstein was shot in the leg and came rushing into her arts and crafts classroom.

“We stared at each other,” she recalls. “I think I might have stayed to help her, but there was a whole table of kids. I said, ‘Everybody get out!’ ” Then she guided a group of 5- and 6-year-olds out a back door and into a nearby convalescent home. One of the children she brought to safety was 6-year-old James Zidell, who had been shot in the foot. A co-counselor stayed with Finkelstein as more gunfire rang out.

Acting on instinct, Lynn tried to keep the little ones from getting alarmed. When some of them remarked about “red paint” on their sneakers that she recognized as Mindy’s blood, she played along, telling them: “We’re all going to wash the red paint off our shoes.” The mother of one little girl later approached her to say: “Thanks to you, she had no idea what was going on.”

At her parents’ suggestion, Lynn met with a private psychologist two days after the shootings. Her parents sat in and learned some emotional and behavioral warning signs to look for. Karen Lynn, 52, an attorney for a state court, says her daughter seemed depressed at first, “but as time goes on, she seems more able to do her usual stuff.”

Experts agree that for children involved in a traumatic incident, keen observation and calm parenting are crucial.

Children Sometimes Reenact the Event

That’s especially important because young children often frighten adults by reenacting the upsetting episode.

“They’ll be running around the playground or backyards with a make-believe Uzi, shooting people. They’ll pretend they’re the aggressor,” Mantell says.

Parents may mistakenly try to stop the playacting but should allow it because it’s a healthy response, Mantell says.

LAUSD has several levels of response to the violence that affects children on and off school grounds.

Every school has a crisis team that can respond to incidents like a student suicide, campus shooting or sudden death of a teacher or student. When bullets from a street shooting pierced a second-floor library and left Figueroa Street Elementary School teacher Alfredo Perez with neurological damage, the district responded to the widespread shock and trauma with ongoing help for students, staff and parents.

One person who responds to such scenes nationwide is Nancy Bohl. As director of the Counseling Team in Southern California, Bohl leads a 22-person group associated with the International Critical Incident Stress Foundation in Ellicott City, Md. Her team went in after the explosion of TWA Flight 800, the bombing of the federal building in Oklahoma City and the school shootings in Littleton, Colo., and Springfield, Ore.

Bohl says debriefing “provides a safe harbor for the kids to be able to talk if they need to. Some won’t need to; some will.”

Crisis counselors try to evaluate youngsters’ body language and responses to questions to determine whether they need individual follow-up. They also provide parents and teachers with printed material that describes symptoms of psychological suffering, such as nightmares, separation anxiety, new fears, or changes in eating and sleeping.

Victor Welzant, a therapist in Towson, Md., says results are better when the crisis intervention is organized, rather than a scattershot effort by well-meaning therapists. He also says timing makes a difference.

“Coming in within the first couple of hours may not allow you to have the same kind of information and assessment that coming in a day later would allow you to have,” Welzant says.

Welzant also believes kids should have the option of private therapy as well as intervention tailored to their level of development.

“What’s important is being able to recognize early which children are showing symptoms and difficulty and having services available should they need them.”

Bonanno expressed particular concern that debriefing could be damaging to young children, who, by nature, are suggestible.

With the Granada Hills shootings, “it may be for many children the event was really just a lot of excitement. They know something bad happened, but they’re really not sure what it was,” he says.

But during debriefing, “it’s possible to plant an idea in the child’s mind they are in danger when they may not have thought that themselves. Children have very vivid imaginations. We need to be careful about giving children too much negative imagery upon which their imaginations can run wild.”

Wong says the key to preventing such an effect is keeping in mind the No. 1 rule of crisis counseling: Do no harm.