Speaking of Psychology - How to support children after traumatic events, with Robin Gurwitch, PhD

Episode Date: September 17, 2025

From hurricanes to wildfires to gun violence, trauma and disaster touch the lives of millions of children each year. Robin Gurwitch, PhD, discusses how disasters affect children’s mental health, how to support children and teens in the aftermath of disasters, and how parents can talk to their children about traumatic events in the news. Learn more about your ad choices. Visit megaphone.fm/adchoices

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GoogleFi Wireless is not subject to data traffic deprioritization during times of high network usage. In recent years, there's been a worldwide increase in disasters, mass violence, and terrorism around the world. These events often come with loss of life, leaving many children experiencing both trauma and grief, which take a toll on their development. Disasters leave many children struggling with mental health conditions such as depression, anxiety, and PTSD, as they also struggle with their grief. Furthermore, when the grief is due to an event that is widely covered by media, children and their families often have difficulty navigating their personal recovery and healing separate from that of the community. So what do we know about children's experiences of trauma and grief?

How does such events influence their development both in the near term and beyond? How can parents, caregivers, and therapists help children who have lived through floods, wildfires, hurricanes, war, and other traumatic events? What can be done for parents and other caregivers who themselves are suffering as they try to help their kids recover and thrive? Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I'm Kim Mills, coming to you from Denver at APA 2025, the National Convention of the American Psychological Association. My guest today is Dr. Robin Gerwitch, an emeritus professor in the Duke University Department of Psychiatry and Behavioral Sciences and the Center for Child and Family Health. She is a recognized expert in understanding and supporting children in the aftermath of trauma and disasters.

Since the Oklahoma City bombing in 1995, Dr. Gerwitch has focused much of her clinical work, training, and research on improving the outcomes and increasing resilience in children who have experienced. trauma or lived through crises, including terrorism, natural disasters, and stressors related to military deployment. She has served on state and national committees and task forces, including the National Commission on Children and Disaster's Subcommittee on Human Services Recovery. Dr. Gerwitch is one of the first people we at APA reach out to after disasters to help us advise families and children who are trying to cope. Dr. Gerwitch has co-authored book chapters, scientific journal articles, and public education materials on the topics of trauma, resilience, psychological first aid, terrorism, disasters, and preparedness. Dr. Gerwitch, thank you for joining me today at APA 2025.

It is my pleasure to be with you today, Kim. So you've worked with and studied children affected by everything from terrorism to natural disasters. What are some common emotional responses you see in kids after traumatic events? So when we think about these disasters, whether it's terrorism or whether it is natural disasters, we need to recognize that children will have a variety of responses. And they start as young as infancy and go all the way through the child age span, all the way up to that 18-year-old, 19-year-old. We see challenges in sleep problems.

We see problems related to interactions with the people in their lives, whether it is irritability with their parents and having more meltdowns and being more defiant to being more clingy and withdrawing. We also see children as they get older, have more conflict with their peers, or feeling that they're being bullied when they never were before or actually beginning to bully when they didn't do that before. We may see problems in terms of school performance. And I think sometimes parents, if they don't know that, and teachers too, if I don't know that learning is going to be impacted, then I don't understand why I can't give 50 problems when 25 could do when I'm really struggling

after a disaster. So sometimes we see a dip in school grades, and that's to be expected, and it should pop back if we give them the emotional support that they need. There's a small number, Kim, I think this is just fascinating, that actually the grades get better. And who calls school and says, hey, please, I need mental health services. My kids' grades have improved tremendously, right? But if you think about disasters, they're out of our control. And if I study all my free time, I can control that. And it's that control that ends up being leading to better school grades. But there's a cost.

Usually as my school grades go up, I'm not getting together with my friends. I'm not wanting to go to dance or soccer. I'm not wanting to do other activities. And so there's a cost. So we should be equally worried. Right. It's not a good sign. It's not a good sign.

And I think we see behavior changes, as I said, you know, we see children after these events, both terrorism as well as natural disasters, school shootings, other kinds of tragic events. And we see problems with attention, problems with concentration. We see more active behaviors. We see irritability and mood swings. and we've been conditioned by the pharmaceutical industry. If your child is showing all these things, talk to your doctor, talk to him about free samples of Adderostrater, ors, orther, ritalin, the problem is that those kinds of behaviors

are exactly what we see with children that have experienced these events. And then you have children that truly have ADHD that also have experienced disasters. So we as psychologists need to step up and say, hey, hey, let's wait a second. Let's make sure that we're looking at true ADHD and not reactions to an event that just took place. So psychologists really have a critical role to play to help educate not only families and do better jobs with assessment, but to educate our physician partners and to educate education systems so they're not referring an entire classroom of third graders for ADHD evals. So we do see some of that.

And the best treatment for trauma for kids is psychotherapy. Let's talk a little bit more about those treatments because you've been instrumental in developing and adapting parent-child interaction therapy and other treatments. So how do those models work? Why are they so effective? So, yes. There have, there are, I think about when I entered this field more decades ago than I want to think about how little we knew about interventions and where we are in 2025. And psychologists have really led the way on scientifically backed interventions. And we know now that whether you are an infant or a teen or anywhere in between, there are effective treatments. We have the science to back that up.

My particular area when I'm looking outside of the universal like psychological first aid is parent-child interaction therapy or PCIT. It is magic. It truly is the most magical treatment on the face of the planet. And I can say that because I've got the mic. PCIT has more than 400 scientific journal articles, book chapters, randomized trials on its effectiveness. And we know from many of those studies that it is extremely effective for children who have experienced trauma. Now recently, I've been working with a colleague, Dr. Christina Warner Metzger, another wonderful psychologist to create a trauma module specific to PCIT, to give parents skills and ideas and

language that they can use when they see their child engaging, for example, in building buildings up and knocking them down in that post-traumatic play. Or they start crying because they're scared because it is storming outside and they've just been through floods. So we've worked on that were in the midst of a multi multiple sites collecting data before we sort of push it out bigger but one of the things that was interesting the very first cohort that we looked at trying this was in new south wales australia and it was a naturalistic study started everybody got into the study because the children had had trauma part way through the study had to put a pen in things because most of the families had to evacuate because of fires that hit New South Wales.

They came back, started up again, had to put a pin in it, floods, came back, started again, COVID. Oh, Lord. So then you start saying, you can't really talk about what's doing what? And what we've learned is this is not unusual. We have done several other places, not as bad as New South Wales, but we're collecting information, and sure enough, they come in with one trauma, and halfway through, we look again, and the majority of kids have had another trauma.

And PCT is very short term. It averages around 20 to 25 sessions. So we have to make sure that as psychologists, we don't just start at where we were at the beginning. We keep looking all the way across. And we've looked at PCIT for trauma. We've looked at adapting it for our military during the wars. There were so many families with young children that were deployed. It was creating stress and strain on relationships.

So we looked at how to improve those relationships. And that's one of the cornerstones of PCIT. Another program that we are trying to gather more and more science behind it, We've got some. I think it's called child-adult relationship enhancement or care. It is similar to MI. You don't send somebody to motivational interviewing therapy, but the tools of MI help make anything you do better.

And care is a set of skills based on strong, strong, scientifically backed parenting programs, but it's not therapy. It's a set of skills. and how do we give adults, any adult, from school bus drivers to daycare teachers, to soccer coaches, to parents, to caseworkers for foster children, skills that they can interact with children to make the children feel safe, reduce distress, reduce the need for more intensive treatment. And we're seeing really nice gains from a program that is four hours long. And so we're hoping recently through grant funding as part of the National Child Traumatic Stress Network, we've been able to adopt the care program specifically for disasters.

So complementing psychological first aid, complementing skills for psychological recovery. And if they do need that intensive level of treatment, complementing those treatments. And we've now provided respond with care after the, you know, shooting with the Super Bowl celebration in Kansas City to floods in Asheville, North Carolina, to a shooting in East Lansing, Michigan. So many different places, the Highland Park Parade. So we're finding that the uptake has been good because really what parents want to know, what carers want to know, grandparents, teachers, other adults, what do I do?

What do I do? Give me something I can do to reduce the worries and concerns with my children. Because we have to recognize that the cares are equally distressed. And if I'm distressed, I have a harder time helping my child on their journey after these events. So how do we provide both? And if we add what you talked about at the very beginning, thank you so much because sometimes when we talk disasters, people don't include grief. I mean, to us, we're like, okay, well, of course grief. But that is not what you will typically find. It's not even always collected. And grief is a different thing. I can be resilient. I can bounce back with the right emotional supports, with the right strategies for coping. I can bounce back and move forward. You don't bounce back from grief,

Nor should you. Grief changes us. We learn to heal. So how do we help children heal from grief? How do we help them incorporate that into their new history, their new narrative? And are there special interventions then for dealing with grief where those look like? There are wonderful interventions that are grief specific and those would be at the top of the pyramid. But there are also all these universal and second tier approaches that we can incorporate with a grief lens. How do we superimpose that? How do we talk to families about these are the kind of reactions you are likely to have with grief and your children are going to have some of the same?

And they overlap quite a bit with basic trauma reactions. So I don't know if the sleep problems are because of grief or because of the sleep problems. the disaster, I just know there's sleep problems and what do we do about it? Right. And so how do we help children understand grief? And I think as we, when we talk about grief to recognize that as children get older, sometimes it creates distancing from peers because I lost my mother and I don't know how to engage with friends who have their mothers or my friends don't talk to me because they don't know what to say to me because I've lost my mother. So just when I need my peers, they're not there. And I go to find support for my family, but they're grieving too.

And so we talk to families about everything from what to expect from yourself and to give yourself a little bit of compassion and also how to support your children all the way to do I take my child to a funeral. If it's a community-wide event, it is in the public, eye. And that's a whole different kettle of fish, so to speak, because no two families are going to grieve the same way, yet the spotlight's on them. And yet sometimes the media would really like just one answer, how should all these families manage grief? And they're not the same. Right, right. We're going to take a short break. And when we return, I'll talk to Dr. Gerwitch about how parents can talk to their children about disasters and tragic events.

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What should they be doing? Sure. I think one of the things that is something we all recognize now is media is 24-7. It never stops. So we strongly encourage that families talk to their children, even if it's not in their community. Right? There was a horrible flood in Texas, and many children died and people lost their lives. Tell me what you've heard about it.

It was a camp. I mean, kids would know all about that. I'm a camper, and I go and we... camp on the river and now I'm scared. Right. It may be a school shooting. It didn't happen in my community, but my children I'll go to school. And Jonathan Comer, wonderful contributor to APA, did a great study looking at, is it better

to talk to your children or not after the Boston Marathon bombing? And John and his colleagues found when you talk to children, they're less likely to develop mental health distress than when you don't. So sometimes what we need to do, even if it's outside of our community, is to say this horrible thing happened, tell me what you know about it. That allows you to first listen and hear where are they coming from? And you will hear misinformation because social media also is great grist for rumor mills. But you will have misperceptions, misinformation, misattributions that you can hear and begin to

gently correct. You can check in. I feel like a psychologist. How did that make you feel? But we should validate those feelings, not try to talk them out of it. The child says, I'm really, really angry. And we say, oh, you shouldn't feel angry. Then what makes us think they're ever going to talk to us about anything again if you can't validate me?

Right. Those are their feelings. They're real. So listen, I think is really important. Make sure that they know you are available to talk to them. But have that conversation. Don't assume that because they're so young, they won't know. That first grader is on a school bus with children that are much older and they're going to be talking about it. It's a kind of inoculation. I mean, what you're doing here is building resilience, right? By getting kids ready, prepared. really talking through disasters even when they haven't touched them personally because children are afraid. They are. They may be angry or they may be worried or they may be anxious or they may be multiple. You know, a big plug to Inside Out movies. It teaches us that you can have more than one emotion at the same time. There's a throwaway line in Inside Out 2 where joy and sadness are talking. and joy tell sadness we will always be together because any time that joy is there, sadness is too.

And when there's sadness, joy can be there also. And so recognizing there can be multiple emotions that kids will have, but you are exactly right. We're setting the stage. If you can talk to your children about the really hard, ugly stuff, you've just increased the likelihood that they are going to come talk to you when they're feeling peer pressure, when they're disappointed because they didn't make the baseball team, or when they're scared about a book report, or when they're getting pressure to do things that they feel would be uncomfortable.

If I can set it up at the very beginning, gosh, my carer will talk about anything with me, I've just increased the likelihood they're going to come to me when those kinds of events occur. So let me switch gears for a minute and ask, how do factors like race, socioeconomic, or disability intersect with trauma, both exposure and recovery? Great question, because I think we do need to go there. Because if we don't talk about it, again, we're not going to be able to understand or address it. We know COVID showed us in neon lights that more. marginalized populations, people of color, people with lower socioeconomic status, were less likely to receive services, have access to services, and they were more likely to have worse outcome from the pandemic.

And we see that oftentimes happening. So we really do need to recognize that, but we also have to recognize that there are cultural issues too that we need to consider. I mean, I've been to Florida, North Carolina, and Tennessee following Haleen. They're very different cultures. If I'm going to L.A. to address things there, they're going to be very different than North Carolina. So we have to take not only ethnic considerations, but culture, where we are, where we are in this country, and we need to to make sure that we are talking to the people from those communities. We need to listen and learn from them so that when we go in to provide support, to provide trainings, to provide

consultation and services, we're meeting them where they are. But yeah, we do see that individuals, that racial differences, SES differences, have different outcomes. It's often because they don't have the same access to services. We also see that there is still, I mean, I would love to say, gosh, we've been doing psychology for a long time. There's no stigma around mental health. That would be a lie. There's still stigma.

And so we also know that certain groups and minority populations are one that are less likely to avail themselves to mental health services. So how do we better support? One of my colleagues talks about go where they are. If you're working with black communities, go to the barbershops. Don't expect them to come to you. So we need to think about that.

How do we look to make sure we're addressing those concerns? And then I'm sorry, we have to layer on. There are reasons that we may be more hesitant. If I'm black and I think about the long history from the Tuskegee studies to other things, gee, I don't know why I should just trust you. I would go ask for help from you, yeah. So we have to recognize historical trauma plays a role too. So there are multiple factors at play that we need to consider when we are responding. and I have found in a really positive way that because of things like psychological first aid,

which is just emotional support and strategies for coping, I can sort of help open the door to hear some things that may be helpful down the road. If you still have challenges, here are services that can help you. Yeah. So when I started this podcast, I talked about the increase in disasters we're living through today. And you began this work in 1995, as you said with Oklahoma City. So I just want to close by asking you, are we getting any better at this? I mean, you've learned a lot in all of the years of work that you've done.

You've come up with new concepts and therapies. But are they taking hold in the community at large? Are we getting better at helping people through these incidents? I think we are. And yes, I actually believe in climate change, and I think that we are seeing many, many more disasters because of climate change and places that never experienced hurricanes or getting hurricanes or snow or getting snow. I mean, we're topsy-turvy. And we have made such huge strides in disaster mental health. And I think that is one point I would really want to make is disaster mental health is not the same as traditional mental health services.

So if you are in the mental health field, please seek out training in disaster mental health, what that is like and how you can support survivors after disasters. And disasters is any event that overwhelms an ability for us to cope. So they can be natural terrorism. They can be man-made. they can be whatever. But we've come a long way. There are many, many more treatments across the age span. There are many, many more providers that truly do understand this.

We now have Division 56 of APA, the Trauma Psychology Division, and within that, there's special work being done in disasters. So we have that in APA. That wasn't there a couple of decades ago. So we're making huge, huge strides. And so I think we still have a ways to go. I don't want us to stop. We're looking at, you mentioned, racial disparities.

We need to look at religious disparities. Anti-Semitism right now is off the charts. How is that impacting that community's ability to feel safe in the world that they inhabit? So we have to create a bigger tent and invite more people in and really encourage the current generation of psychologists as well as the coming generations of psychologists to enter into the disaster mental health world. It's different, but it is incredibly rewarding. And we as disaster mental health professionals have learned, too, if we're not taking care of, care of ourselves when we're doing this work, we're not going to be much use to anybody. So we've learned a lot about the importance of self-care in this journey over the decades.

Well, Dr. Gerwit, I want to thank you. And thank you for the very important work that you do. Thank you for having me. You can find previous episodes of Speaking of Psychology on our website at speakingofpsychology.org or on Apple, Spotify, YouTube, or wherever you get your. podcasts. And if you like what you've heard, please follow us and leave a review. If you have comments or ideas for future podcasts, you can email us at speaking of psychology at APA.org. Speaking of psychology is produced by Lee Wynerman. Thank you for listening. For the American Psychological Association, I'm Kim Mills.