Interventions and Responding to Psychological Needs: Application of PREPaRE in Idaho
By Ginny Armstrong, Danette Gneiting, and Jennifer Horne
In the cold of winter, a beloved coach’s child dies. In the quiet hours of an early spring morning, a very young teen’s life ends too soon. On a warm fall afternoon, a tragic car accident claims the life of a sophomore girl, leaving the driver, a senior, to cope with her death and his life. These tragedies affected not only the families and close friends of those lost, but also peers, school staff, and even the community. In October 2008, our school district’s Safe and Drug Free Schools program sent five representatives to a PREPaRE training in a nearby Idaho town. These representatives included one high school counselor, one middle school counselor, two elementary counselors, and a high school administrator. The group became the district crisis intervention team. Until that time, our district had not had a clear crisis intervention plan for mental health professionals. PREPaRE provided a workable model that we had the unfortunate opportunity to utilize within months of our initial training.
Death of a coach’s child. The first situation in which the PREPaRE model was used was a school-level crisis that involved the sudden death of a coach’s child. Assistant coaches, players, faculty, and students who also knew the coach and family outside of school were affected. This crisis was handled by the administration and counselors within the school, one of whom had attended PREPaRE training. It involved informing those affected, providing triage and psychological first-aid, and responding to individual needs.
Death of a junior high student. The second crisis impacted several schools and occurred about 6 months after our PREPaRE training. Early one spring morning, the principal at a junior high school received a visit from the police informing her that a seventh-grade student died in an apparent suicide in the very early morning hours. The student had younger siblings that attended an elementary school and family who worked in the school district.
The school’s counselors notified a member of the district crisis intervention team. Four members of the team, all counselors, recruited two more school counselors to assist. Upon their arrival at the junior high, the crisis team, building counselors, and administrators met to develop a plan of action based on the PREPaRE model. At that point, the student’s closest friends and teachers were identified along with the ripples of students who would likely be impacted. Faculty and students who had recent deaths or suicide related issues in the past were also identified. Within half an hour of receiving the information, the principal and assistant principal informed every adult, including all certified and classified staff in the building, of the student’s death, speaking with each one individually or in small groups.
As the students who were identified as being closest to the deceased student arrived at school, they were invited to a conference room and informed of their friend’s death. They remained in the conference room with a counselor while another counselor contacted their parents. Parents were informed of the death and asked to come to the school. Upon their arrival, parents met with a counselor and were given a handout from PREPaRE entitled “Recommendations for Helping Children Cope With Crises” (adapted from the National Institute of Mental Health, 2001). The students and parents were reunited and spent some more time talking with a counselor before departing for home. Sign-in logs were used to track every student visited.
Because it occurred early in the morning, the general population of students had no knowledge of the death. Aides, teachers, and administrative staff monitored the hallways before school and between classes to monitor “the talk” among students. The intervention team worked closely with Jenny Griffin, Eastern Idaho Suicide Prevention Action Network (SPAN) president, to develop an announcement that was made in every seventh-grade class just before lunch. It was important and significant that the students received factual information from an adult and that the adults provided the exact same information. Members of the intervention team made the announcement at the same time, with a teacher and either a counselor or administrator present in the room. Teachers were notified ahead of time that an intervention team member would be coming to their room to make the announcement. They were also given permission to step outside the room if they felt the need. The teacher and counselor or administrator closely monitored students’ responses and need for psychological intervention. Some students knew the young teen that died, some were merely acquainted, and some did not know the student at all. A handful of teachers needed to leave the room after the announcement was made and the supporting administrator or counselor stayed with the students until the teacher was able to return. Counselors were posted in the faculty room throughout the day to provide emotional support for staff.
Counselors were also available in two conference rooms where water, snacks, tissues, adequate seating, and space were available for groups. Five offices were provided to counselors for individual counseling for those who needed more immediate, indepth support. Counselors ate lunch in the cafeteria with the seventh-grade students to monitor reactions, direct students in need to the conference rooms, and provide additional support. Counselors recorded the name and triage risk level of each student they worked with. There were a total of 35 students who went home from school that day using the same process used for the closest friends of the student.
At the end of the day, the school administration, counselors, and intervention team responders met to debrief and plan for the following day. An announcement was developed for eighth- and ninth-grade teachers to read to their morning classes, plans were made for the intervention team to return the following day to assist as needed, issues or concerns were discussed, and a “check in” with each person was completed.
At the elementary school, the younger siblings were not in attendance. An intervention team member offered support to the counselor at that school and the junior high administration informed the elementary administration. The family members working in the district were provided substitutes and supported at their schools by administration and colleagues. On day two and throughout the days that followed, these supports continued as needed.
Death of a high school student. The following school year, a car accident claimed the life of a high school student and altered the life of another who was driving the car. Similar procedures were followed using the PREPaRE model. The grade level, the circumstances surrounding the death, and the different school environment affected the level of psychological intervention required. Even though some students wanted individual support or to go home, many more needed only a safe place at school to grieve with their peers.
These crises brought to our attention that we were better prepared to handle these events then we realized. From the PREPaRE training we completed only months prior, we were able to offer guidance and direction to administration, the counselors who had not been PREPaRE trained, teachers, and staff. We had the needed materials for record keeping and handouts for parents and knew the procedures to follow. The affected schools were grateful for outside support from counselors who were not as emotionally connected so that we could be the scaffolding support for those adults who were themselves in crisis.
This winter we will be training all of the counselors in our district in the PREPaRE model. Every school has its unique needs; therefore justifying that each school be trained to cope with the individual crises that arise. Some crises will not need outside support, some will, but regardless, they’ll be “PREPaREd.”
National Institute of Mental Health. (2001, September). Helping children and adolescents cope with violence and disaster. Bethesda, MD: National Institute of Mental Health, National Institutes of Health, U.S. Department of Health and Human Services. [NIH Publication No. 02-3518] Retrieved May 28, 2005, from www.nimh.nih.gov/publicat/NIMHviolence.pdf
Ginny Armstrong, Danette Gneiting, and Jennifer Horne are school counselors in Idaho Falls, ID, and have recently become PREPaRE workshop trainers.