HJBR Nov/Dec 2021

58 NOV / DEC 2021 I  HEALTHCARE JOURNAL OF BATON ROUGE CHILDREN’S HEALTH phone calls or Facetime, is especial- ly important when the environment seems so unpredictable. Helping chil- dren or teens find one person who they enjoy talking to can be an espe- cially important buffer for stress and anxiety. Self-care: Caregivers and providers are often consumed with ensuring children are healthy, happy and safe, but that can come at a cost when it involves putting their own health andwell-being aside. The best thing we can do for our children is to make sure that the “adult helpers” are getting the support they need and taking care of themselves, including making time to reach out to friends and family, exercising, eating healthy, getting enough sleep and find- ing a safe space to talk about their own stress and emotional reactions. Although most children and adoles- cents will demonstrate resilience and may even grow and learn important lessons from stressful life events, some youth will require more than just parental support. Specific “red flags” that may indicate the need for a more thorough evaluation and possibly therapeutic intervention include functional impairment. For younger chil- dren this can look like behavioral regres- sions or significant changes in behavior like extreme aggression or extreme fear to the point where a child refuses to leave a caregiver’s side. For older children, this can involve trouble getting out of bed in the morning, constant tearfulness or extreme withdrawal, excessive risk-taking behav- iors, alcohol use or drug use, and/or any expression of a wish to hurt themselves or end their life. Healthcare providers are ideally suit- ed to assist with the identification of “at- risk” youth and timely referral for mental healthcare. Early evidence-based inter- ventions for youth exposed to trauma and/ or loss can make all the difference in pre- venting long-term mental and behavioral health problems and fostering resiliency for years to come. Trauma and Grief resources are avail- able online at https://mmhpi.org/work/ trauma-grief-center/resources/. n REFERENCES Dodd, C.; Hill, R.; Oosterhoff, B.; Layne, C. M.; & Kaplow, J. B. “The Hurricane Exposure, Adversi- ty, and Recovery Tool (HEART): Developing and validating a risk screening instrument for youth exposed to Hurricane Harvey.” Journal of Family Strengths, 19, no. 1, (2019): 1-28. Jaycox, L.; Cohen, J.; Mannarino, A.; Walker, D.; Langley, A.; Gegenheimer, K.; Scott, M.; Schonlau, M. “Children’s mental health care following Hurri- cane Katrina: a field trial of trauma-focused psy- chotherapies.” Journal of Traumatic Stress, 23, no. 2 (2010): 223-231. Kaplow, J.B.; Saunders, J.; Angold, A.; Costello, E.J. “Psychiatric symptoms in bereaved versus non-bereaved youth and young adults: A lon- gitudinal, epidemiological study.” Journal of the American Academy of Child and Adolescent Psy- chiatry, 49 (2010): 1145-1154. Oosterhoff, B.; Kaplow, J. B.; Layne, C. “Links be- tween bereavement due to sudden death and academic functioning: Results from a nationally representative sample of adolescents.” School Psychology Quarterly, 33, no. 3 (2018): 372–380. Osofsky, H.; Osofsky, J.; Kronenberg, M.; Bren- nan, A.; Cross Hansel, T. “Posttraumatic stress symptoms in children after Hurricane Katrina: Predicting the need for mental health services.” American Journal of Orthopsychiatry, 79 (2009): 212-230. Verdery, A.M.; Smith-Greenaway, E.; Margolis, R.; Daw, J. “Tracking the reach of COVID-19 loss with a bereavement multiplier applied to the United States.” Proceedings of the National Academy of Sciences, 117, no. 30 (2020): 17695-17701. Julie Kaplow,PhD,ABPP, is executive director ofThe Trauma and Grief Center (TAG) at Children’s Hospital NewOrleans and executive director ofTheTAGCen- ter atThe Hackett Center for Mental Health in Hous- ton,TX.The overarching mission of each of the TAG Centers is to raise the standard of care and increase access to best practice care among youth who have experienced trauma and bereavement. “Early evidence-based interventions for youth exposed to trauma and/or loss can make all the difference in preventing long-term mental and behavioral health problems and fostering resiliency for years to come.”