School Shootings: How to Respond

Psychological first aid (PFA) may help "victims" become "survivors."

Posted Feb 24, 2018

On February 14, 2018, a gunman shot 31 students at Marjory Stoneman Douglas High School in Parkland, Florida. Seventeen were killed and fourteen more were wounded. The "Valentine's Day Massacre," as it is now being called, became the world's deadliest school shooting. While the debate rages about how to prevent such atrocities, as surely we must, we must also think deliberately about how best to respond when such incidents do occur. Psychological crisis interventions such as psychological first aid (PFA) #RAPIDPFA (Everly & Lating, 2017) may help "victims" become "survivors." Most importantly however care must be taken not to turn "survivors" into "victims" (Everly, 2009; Everly, McCormack, & Strouse, 2012). 

Pixabay
Source: Pixabay

In the wake of the shooting in Parkland,  we heard, once again, the all too familiar declaration, "Grief counselors were dispatched." While it is certainly wise to recruit external support services to assist in such overwhelming incidents, simply putting out a call for well-meaning volunteers is insufficient. The impromptu "Y'all come" approach is risky at best. Yet in my experience over almost four decades it is all too common. Let's take a look at a more deliberate approach to responding to school violence and other incidents, both strategically and tactically.

STRATEGIC RECOMMENDATIONS

1. Every school must have a disaster mental health/psychological crisis intervention plan. It should utilize two sets of resources: internal school resources, and external community resources. 

2. Internal school resources should consist of two further elements: resources at the target school, and resources within the school district.

3. Once these resources are identified, formal crisis intervention teams should be created. They should consist of school counselors, teachers, staff, and school leadership. All team members should be specifically trained in psychological first aid (Everly & Lating, 2017) regardless of their specific professional backgrounds. It's important that all team members follow the same protocols. Standardized training  increases the reliability of interventions. Cogent and consistent messaging is essential.

4. Ongoing training and rehearsal is essential to retain response capability.

5. Regarding external community resources, ideally these resources would come from the community that is familiar with the school and the community at large. Police agencies, fire departments, hospitals, local Red Cross, and local critical incident stress management teams typically have pre-existing well-trained psychological crisis intervention teams that may be of assistance. It is important that "mutual aid" agreements be created between the school and such agencies PRIOR to any incident.These agreements serve as operating guidelines when an incident occurs.

6. The school has an obligation to review the credentials of external agencies to increase the likelihood they too will be following the same intervention protocols. Licensure in a mental health discipline does not ensure adequate training in psychological first aid.

Wikimedia Commons
Source: Wikimedia Commons

TACTICAL RECOMMENDATIONS

1. During or immediately after any incident, school authorities should utilize appropriate social media platforms to inform all appropriate parties as to the status of the incident. There is no such thing as an information vacuum. If the school's authorities are not communicating, someone else is. And thus the rumor mill gains control of messaging.

2. "Safe" venues for acute psychological crisis intervention should be established for those adversely affected. They should be staffed with security personnel and only those interventionists who have been vetted to have received adequate training in psychological first aid. This is not "therapy." Nor is this the time for therapy. Crisis intervention has been shown to be superior to therapy in the acute phase of incidents such as violence (Boscarino, Adams, & Figley, 2011). That said, arrangements for follow-up counseling should be arranged in advance of an incident. States typically have pro bono counseling projects through state psychological, psychiatric, and social work societies.

3. Upon return to school, an incident-specific assembly should be held. Here is a formula for specific topics to be addressed (Everly, 2000). Discuss: What happened. What/ who caused it. Current and anticipated effects (it's especially important to discuss depression, grief, survivor guilt, and posttraumatic stress). Actions currently being taken relevant to the incident. Actions being taken to prevent similar incidents in the future. A similar assembly/ town hall meeting can be held for parents wherein the topics would include helping children in times of crisis.

4. Following the assembly, students should return to homerooms (or the equivalent) to have small group discussions of the topics addressed in the assembly.

5. Crisis intervention services should be available for all students at all times school is is session and immediately after school for about a month, or as long as needed. 

6. Memorial services should be provided, as appropriate.

In sum, the y'all come "catch-as catch-can" response to school violence is no longer acceptable. The science of psychological crisis intervention and psychological first aid has progressed such that standard of care practices are emerging to the benefit of all. Until such time as we can prevent school violence, we must be prepared to respond so as help "victims" become "survivors" who can enter the abyss of violence and emerge on the other side never having to define themselves and the rest of their lives by the experience (Everly, 2009).

References

Boscarino, J., Adams, R., & Figley, C. (2011). Mental Health Service Use After the World Trade Center Disaster:Utilization Trends and Comparative Effectiveness. Journal of Nervous and Mental Disease, 199, 91-99. 

Everly, G. S., Jr. (2000). Crisis Management Briefings: Large group crisis intervention in response to terrorism, disasters, and violence. International Journal of Emergency Mental Health, 2, 53-58.

Everly, GS, Jr. (2009). The resilient child. NY: DiaMedica.

Everly, G.S., Jr. & Lating, J.M. (2017). The Johns Hopkins Guide to Psychological First Aid. Baltimore: Johns Hopkins Press.

 Everly, GS, Jr, McCormack, D, Strouse, DA (2012). Seven characteristics of highly resilient people.International Journal of Emergency Mental Health, 14, 2, 137-143.