Celeste Ibarra, mother of 9-year-old Aubriella Melchor, has witnessed her daughter deteriorating since the May 24 shooting at Robb Elementary School.
Aubriella hid in a bathroom stall as the gunman walked past and began shooting.
Now, Ibarra said her daughter hardly eats or sleeps, and when she does sleep, she has nightmares of the gunman coming after her. She said she still hears the echoes of the gunshots, still sees his feet and the AR-15 rifle sweeping past the bathroom stall where she hid.
While most parents do not have as direct a connection to the Uvalde mass shooting as Ibarra and her daughter, parents across San Antonio and South Texas are struggling to speak to their children about the horrific event, even while grappling with their own difficult emotions.
But there is a model, backed by decades of research, that can guide parents to help children process their reactions in a way that doesn’t cause lingering negative effects.
Using what is known as a “trauma-informed” approach means acknowledging the harms trauma can cause and encourages listening, connection and healing. The goal is to make someone who has experienced trauma, either directly or through the news, feel safe and supported enough to process their feelings.
It can help parents and families, but it also can help teachers and other caregivers, workplaces seeking to support employees and in health care settings.
Helping children process their emotions around a traumatic event is critical. Adverse childhood experiences can actually change the brain development of children, said Belinda Garcia-Rattenbury, executive director of University Health’s Institute for Trauma-Informed Care, resulting in long-term physical and behavioral health problems.
The institute, which opened its doors in 2020, aims to prevent those long-term impacts by training health care and other organizations in Bexar County to use a trauma-informed approach to care. When the COVID-19 pandemic hit, the work of the institute became even more relevant, as the entire community found itself dealing with various traumas, including loss of life, income and basic stability.
The institute defines trauma as “a response to a disturbing event that is challenging to cope with. Trauma can cause feelings of helplessness, a lack of self-awareness, and the inability to effectively process emotions and experiences.”
Traumatic experiences can include physical, emotional and sexual abuse, neglect, living with someone with mental health or substance use disorders, poverty, racism, violence in the community, war and terrorism.
People who have experienced trauma are more likely to struggle with mental illness, drug addiction, heart and liver disease, asthma and suicide attempts. Many face early death.
With help, however, the worst long-term effects of trauma are preventable, said Garcia-Rattenbury. A trauma-informed approach includes listening more and talking less, focusing on making connections and supporting healing.
University Health was wrapping up a month of trainings, documentary screenings and other events to raise awareness about the importance of trauma-informed care when tragedy struck in Uvalde, underscoring the need for its training.
Many people, not just in Uvalde, will need help and support for a long time to come, said Garcia-Rattenbury.
“What we’ve started here in our community … is an awareness, education, understanding … with the community and Uvalde, she said.
It’s going to take diligent effort by the entire community to keep an eye out for behavior changes among students, teachers and parents, she said, and to acknowledge their pain. The sooner trauma is recognized, the sooner the effects can be addressed.
Talking to kids
Randy McGibeny, a licensed counselor and chief operating officer with ChildSafe, described what a trauma-informed approach to talking to children looks like.
ChildSafe is trauma-informed certified, working with children and families who’ve been victims or witnessed abuse or other trauma.
Speaking to children clearly and honestly is critical to helping them process their feelings, he said, even though “it’s a very traumatic experience and an emotional thing to talk about.”
Children who see traumatic events on the news can suffer from secondary post-traumatic stress, which can present similarly to children who have experienced first-hand trauma, said McGibeny said.
Caregivers may not want to expose children to hard topics of violence and death, he said, but it is important to have those conversations.
McGibeny said to approach the subject as a conversation, by asking questions — and to make sure to validate the child’s feelings, whatever they may be. He suggested starting by asking the child what they know. Next, he recommends clearing up any misconceptions.
Then explain what happened, in an age-appropriate way.
“Seven-year-olds — you’re not going to say, ‘Hey, there was a gunman who walked into the classroom and shot 19 children and two adults with an AK-47,’ and ‘This is what an AK-47 does to the body,'” he acknowledged.
For a young child, the conversation might sound more like this, he said: “’There’s just not good people in the world and somebody decided to do a very bad thing, and they went in and they hurt 19 children inside of a school.’”
Because schools are often a safe space for children and a resource to families, it is essential to reassure children that schools are safe. McGibeny said he would emphasize that mass shootings in school environments are very rare.
When it comes to conveying that schools are a safe space, McGibeny said he would ask questions like, “What do you think about school? How do you feel about school … or going back to school?” Not all at once, he said, but as a conversation starter, letting the child respond as much or as little as they wish to at the moment.
“The goal here is trying to get to a point where you’re rebuilding what their vision is of a safe school,” he said.
Watch for signs
Children who do not directly experience trauma may be able to process their feelings more quickly and completely than those who have suffered firsthand — but only if a parent or caregiver understands that they may be suffering.
A trauma-focused treatment model developed in response to the 2012 massacre of 20 young children and six adults at Sandy Hook Elementary School in Newtown, Connecticut, helped parents of children not directly involved in that shooting recognize that their children were suffering from post-traumatic stress disorder, McGibeny said.
The treatment, called Child and Family Traumatic Stress Intervention, is a brief cognitive behavior therapy that aims to quickly identify trauma so it can be treated.
“We shouldn’t be afraid to sit down with our children and have these very difficult conversations,” McGibeny said. “There is no wrong way to talk to a child as long as you’re talking to the child and that child feels safe.”
As summer progresses, it’s important to look out for specific behaviors in children that may signal problems, said Ashley Jesse, licensed professional counselor supervisor with the Children’s Bereavement Center of South Texas, who specializes in grief, PTSD and trauma.
The center recently launched a $2.4 million fundraiser so it can expand its services in Uvalde with a permanent center and full-time staff. It is currently working out of a temporary space in the small town, much as it did after the shooting in Sutherland Springs in 2017.
“Having trouble eating or sleeping; not wanting to do things that you’ve typically done; wanting to avoid people, places or things that remind you of the trauma — basically where you’re having trouble functioning in day-to-day life — that can be a sign that there are some post-traumatic symptoms,” Jesse said.
Hyperalertness and hypervigilance, or constantly not feeling safe, are also critical symptoms, she said.
It’s also important to recognize changes in parents’ and caregivers’ own behavior, she said. Adults must take care to recognize and deal with their own feelings so they can help their children.
The goal, said McGibeny, is to move children — and adults — from being victims to survivors of their trauma, and that’s why it’s so important to address and treat adverse life experiences as early as possible.
For those seeking help, counseling services and support groups are available through both the Children’s Bereavement Center and ChildSafe.
Education reporter Brooke Crum contributed to this report.
