A tiny battery-operated votive. A second thought as a social worker prepared the first activity of the day at a camp designed for kids recovering from Hurricane Michael.
The votive is what kids wanted. Not the stress balls. Not the pipe cleaners. Not any of multiple other sensory choices for tension relief. They wanted the votives.
The votives represented power, something they had learned they could no longer take for granted.
Hurricane Michael strikes
Hurricane Michael struck the Florida Panhandle on Oct. 10, 2018, making landfall between Mexico Beach and Tyndall Air Force Base in Bay County. It was the first Category 5 hurricane to affect Florida since Hurricane Andrew in 1992. Seven Floridians died of direct causes, 43 more deaths have been tallied so far due to indirect causes, and property damage was extensive.
PlayBig, a recreation and therapy center for children of all abilities, has a location in Marianna, Fla., one of the towns affected by Hurricane Michael. Its staff began seeing existing clients expressing signs of trauma about the storm. They were talking about it incessantly, revealing details about their disrupted lives. One family consisted of a mom who had a newborn about two weeks post-storm and had no place to live when she returned home except a shed. She also was parenting an 11-year old with autism and several behavioral challenges.
PlayBig’s neighbor in Marianna, Covenant Care, received grant funding from Johnson & Johnson. The two agreed to create daylong camps to help children affected by the storm with their emotional recovery process. Rachel Scharlepp, LCSW, explained how the camps were structured.
Each camp was a one-day intensive camp, with activities for children and separate activities for parents. In one case, the options for venues were so slim due to extensive building damage that the camp was held in a church fellowship hall which still had a missing roof.
What the children did
The children had a sensory table at the beginning of the day to choose items for a survival kit. After the sensory table, the kids moved into the first activity of the day, preparing graphic narratives of their stories. Graphic narrative is a technique common to several art therapy approaches and especially common in art therapy.
During the graphic narrative activity, children were instructed to draw pictures and encouraged to tune into their brain, their body and their feelings.
Then they narrated their stories; this narration phase is important because narrating the stories is done in third person -- that places the events in the past and tells the brain and body that it’s over. It provides psychological distance, as in “this happened to Jane” rather than “this happened to me.” It provides a safe distance.
The third component of the playgroups was “re-presentation.” The therapists presented the stories back to the participants in the group setting. Reading the stories back provides normalcy and the reassurance of a compassionate witness. Scharlepp says the children participating, who would typically have been extremely playful, active and loud, became silent and still as the therapists re-presented the stories.
The children who became so quiet included twin 5-year-olds with severe autism who had been extremely dysregulated. They became present with the powerful, resonant stories. “We couldn’t have orchestrated it any differently or better,” says Scharlepp.
Hearing the stories presented back, for the children who authored them, provided closure. It allowed the difficulty of their hurricane-based experiences and the upheaval that followed to be a piece of history rather than something the child was still living and re-living. The final page of each story is, “THE END. I SURVIVED.” The re-presentation phase is a time when, rather than being told “it’s OK” or being lectured about hope, the children are given the sense that “my body and brain can let this shift to a past event instead of something actively alive in me.”
These are children who otherwise wouldn’t have gravitated to each other. It was powerful that they could do this for each other, showing respect for each others’ work, said Scharlepp.
As mentioned previously, the camps involved grounding techniques at the beginning. Items available to the children included stress balls, feathers, balloons, pipe cleaners, clay, bubble gum -- all items intended to help kids be more present. The items were all laid out for the children to explore on a table.
Monica Koetters, the Covenant Care children's support manager, had a votive battery-operated light -- she just happened to have them left over in a box from a bereavement camp she had conducted. One child found the votive, and every child wanted that item the most. It represented power, one of the consistent and taken-for-granted components of their lives that was no longer something they could count on. For the parent groups, too, power was the overwhelming theme. For both groups, getting power back was a milestone.
- School showed up in many children’s stories. When the therapists first started working with the children, kids from Bay County would refer to “night school,” confusing the therapists. The district had initiated school shifts because so many schools had been permanently closed, so some children went to school in the morning and others at night. This meant mixtures of age groups in schools. Beloved, trusted teachers and established friends were not present. Although the schools did try to do some fun activities and help families, the routine was disrupted and very different from what children had depended upon.
- Relocation was another recurring theme. Many families evacuated. The kids, for the most part, did fine with the relocations, as they expected those to be different. The bigger challenge was when they returned home -- it didn’t feel like home. The return home was a big part of their stories.
- Sounds factored heavily into many children’s stories, such as the participant who described a “tornado with teeth.” They often chose to highlight sensory pieces of their experiences.
- Storm prep was another common theme. Preparing to evacuate, or to try and stay.
- Pets were also a favorite topic among the children.
What the parents did
While the children were in the playgroups, the parents had their own groups. First, the therapists did some basic psychological education. They explained the instinctual trauma response and also taught about the effects of stress.
Save the Children was a partner for the parent component. The organization had given PlayBig a grant to open its doors in Jackson County more rapidly after the storm caused damage. A debriefing about how the grant money had been used mentioned the Journey of Hope for Caregivers curriculum. PlayBig got training on how to use the Journey of Hope curriculum with the adults while using the Instinctual Trauma Response model on children.
The adults, Scharlepp said, had very little hope left. So much time had elapsed since the storm, with very little change. Rather than marketing the opportunity as “for the parents,” the focus was on getting children to come to the playgroups, after which the parents could be served. They wouldn’t necessarily come on their own and make the sacrifice of time/resources to take care of their own needs.
At the end of the day, after the Journey of Hope component, the therapists would debrief and explain how their children responded to the playgroups and the activities. They also explained how partents could support them at home as the children brought home their books and their grounding materials.
“Don’t tell them ‘it didn’t really happen that way,’” the parents were advised. They were coached on how to respond, and some were pulled aside for referrals.
The parenting group was a mixture of mothers and fathers. For some, they came because there aren’t many activities going on in the area and they just needed something for their kids to do. Others came with the explicit goal of getting help for their kids. In some cases, the draw was the food.
Usually, dads don’t bring kids to treatment, so the number of dads and the number of dads without partners was significant. There was a variety of socioeconomic status -- professionals, lower-income and stay-at-home parents.
The Graphic Narrative technique ended up being a tool the children learned to use to cope with other life events, in part because it is aligned with children’s tendency to draw as part of their storytelling. Their camp experience gave them a little structure around how to do that. They mimicked the process with other life changes, such as changing schools or being concerned about the whereabouts of their friends.
Two different communities responded in two different ways. Playgroups were held in Bay County and Jackson County. Bay County is where Hurricane Michael came ashore. It is a more transient county -- catering to tourists, home of a military base -- a place with more movement in and out and a median household income of $50,283.
Jackson County, also severely affected by the storm, is characterized by a more static population. People have lived there for generations, passing down family businesses heavy on agriculture, with an emphasis on self-reliance and hard work. By comparison, it has a median household income of $36,944.
It was important to the success of the playgroups that PlayBig and Covenant Care were already part of the life of Jackson County. The close-knit people can tend to be stoic and wary of outside help. Organizations who came in after the storm experienced more difficulty being accepted.
A systems-based look at the aftermath of Hurricane Michael
It’s important to set aside expectations
Traumatized providers need help themselves. Scharlepp noted providers in Bay County had the opinion that they were already treating these children for trauma (so additional help such as a playgroup would be unnecessary). However, the providers themselves weren’t in a good place emotionally, so an outside group to help take the pressure off was important. The providers were also demonstrating the heightened defense mechanisms common among trauma survivors. The outside help was essential to providing a relief valve and additional resources.
Asked where, five years from now, she sees the children and parents who participated in the playgroups, Scharlepp said she hopes the playgroups have helped them build resilience to withstand whatever else is ahead for them. She hopes they can sustain the waiting period, continue to be connected to each other and themselves. Instead of just surviving, she hopes they’ll be able to grow.
Takeaways for social workers involved with clients after disaster
Covenant Care representatives contacted the parents several weeks after the daylong camps were conducted. The parents reported noticeable changes in the children.
The playgroups, being only a day long, were designed to specifically address Hurricane Michael. They didn’t allow for the type of long-term therapy that could address multiple issues. PlayBig made referrals for children who needed more extended services.
Trauma resulting from a single event, such as Hurricane Michael, cuts across every conceivable dividing line.
“I built my career on helping people with trauma. The more common trauma is complex and interpersonal -- not a single event -- it travels in families and neighborhoods. There’s a certain set of characteristics common across those. For example, many mothers and children in that situation experience abuse and violence in the community, with generationally similar stories,” said Scharlepp. “This natural disaster didn’t discriminate at all. Children who have grown up in an environment with systemic trauma often develop coping mechanisms, are accustomed to getting help, wouldn’t be surprised to say 'I have been abused' and have others in the community say 'me too.'
"With Hurricane Michael, this was the first time some of these families had experienced something so massively out of their control. The trauma and emotional insult happened all at the same time, throughout the entire system. It was the first formative event for some families -- the first time they had to learn simple coping skills such as talking about what happened."
Children with histories of trauma, on the other hand, were possibly more accustomed to events that mimic displacement and a lack of resources, along with parents under intense stress.
The hits kept on coming. Even with insurance coverage, there still wasn’t material to be used to make repairs. Electricity didn’t come back on based on who was more affluent. Whereas having “family land” would in other circumstances be an asset, the lack of mobility and the families’ entrenchment in their communities framed the hurricane’s aftereffects in a different way.
“Before the storm, I would have said these families would be better equipped for trauma,” said Scharlepp, “but they weren’t used to exercising those resilience muscles. It’s not a good time to try to exercise them when you’re drowning. Recovery looks different. The outcomes will be different. The immediate ability to move forward and support each other is different depending on the community.”
As another hurricane season progresses
One of the enduring lessons of the experience PlayBig and Covenant Care gleaned from conducting these daylong camps and working with survivors of Hurricane Michael is the need to meet people where they are emotionally (and -- sometimes -- physically). Despite plenty of funding, widespread publicity and a scalable model, the groups have tended to remain at around 10 children (and their parents).
People living in tents a year after a storm don’t see things the same way a social worker who hasn’t been directly affected by a storm does. They have been in survival mode so long that life has lost its perspective. These playgroups, hopefully, are a tiny step on each family's own journey of hope.
Paula Kiger edits SmartBrief's nonprofit sector newsletters and co-manages @SBLeaders on Twitter. She worked extensively in Florida's quasi-governmental children's health insurance program that became a national model, has served as a United Nations Foundation Shot at Life Champion leader, has proofread professionally and has extensive social media experience. You can find her at her blog Big Green Pen, on Instagram, at LinkedIn and on Twitter.