Resources in Response to the Robb Elementary School Shooting

In response to the Robb Elementary School shooting in Uvalde Texas, the National Child Traumatic Stress Network has developed resources to help children, families, educators, and communities navigate what they are seeing and hearing, acknowledge their feelings, and find ways to cope together. These resources include:

• Talking to Children about the Shooting
• Helping Youth After a Community Trauma: Tips for Educators (En Español)
• Talking to Children: When Scary Things Happen  (En Español)
• Talking to Teens about Violence (En Español)
• Tips for Talking to Students about Violence
• Coping After Mass Violence: For Adults
• For Teens: Coping After Mass Violence(En Español)
• Helping School-Age Children with Traumatic Grief: Tips for Caregivers (En Español)
• Helping Teens with Traumatic Grief: Tips for Caregivers(En Español)
• Helping Young Children with Traumatic Grief: Tips for Caregivers (En Español)
• Guiding Adults in Talking to Children about Death and Attending Services
• After a Crisis: Helping Young Children Heal
• Age-Related Reactions to a Traumatic Event
• Once I Was Very Very Scared – children’s book for young children 
• After the Injury—website for families with injured children
• Health Care Toolbox—website for pediatric health providers working with injured children
• Pause-Reset-Nourish (PRN) to Promote Wellbeing (En Español) (for responders)

Psychological First Aid 

The NCTSN also has resources for responders on Psychological First Aid (PFA; En Español). PFA is an early intervention to support children, adolescents, adults, and families impacted by these types of events. PFA Mobile and the PFA Wallet Card (En Español) provide a quick reminder of the core actions. The PFA online training course is also available on the NCTSN Learning Center.

Additional PFA resources for schools include:

• Psychological First Aid for Schools (PFA-S) – Field operations guide
• Providing PFA-S: For Health-Related Professionals – handout
• Providing PFA-S: For Principals and Administrators – handout
• Providing PFA-S: For School Support Staff – handout
• Providing PFA-S: For Teachers - handout

From the National Mass Violence and Victimization Resource Center

• Transcend (mobile app to assist with recovery after mass violence)
• Rebuild your Community: Resources for Community Leaders
• Media Guidelines for Homicide Family Survivors
• Timeline of Activities to Promote Mental Health Recovery
• Self-Help: Resources for Survivors
• E-learning Courses: Trainings for Clinicians
• Resources for Victim Assistance Professionals

From the Center for the Study of Traumatic Stress at the Uniformed Services University

• Grief Leadership: Leadership in the Wake of Tragedy
• Leadership Communication: Anticipating and Responding to Stressful Events
• Coping with Stress Following a Mass Shooting

A disaster event such as this is unexpected and often brings out strong emotions. People can call or text the SAMHSA Disaster Distress Helpline’s toll-free number (1–800–985–5990) and receive immediate counseling. This free, confidential, and multilingual crisis support service is available to anyone experiencing psychological distress as a result of this event. People who call and text are connected to trained and caring professionals from crisis counseling centers in the network. Helpline staff provide confidential counseling, referrals, and other needed support services. 

Mass Violence

• Mass Violence/Community Violence—This part of the SAMHSA Disaster Behavioral Health Information Series resource collection focuses on incidents of mass violence, community violence, and terrorism and their effects. Resources discuss common reactions to incidents of mass violence, tips for coping, and ways to support children and youth in coping.
  https://www.samhsa.gov/resource-search/dbhis?rc%5B0%5D=type_of_disaster%3A20549
• Coping after Mass Violence—Written for parents and families, this National Child Traumatic Stress Network (NCTSN) tip sheet provides information about common reactions to mass violence and self-care tips for those living in communities where an incident of mass violence has taken place. The tip sheet also includes external resources for individuals seeking further support.
  https://www.nctsn.org/resources/coping-after-mass-violence
• Improving Community Preparedness to Assist Victims of Mass Violence and Domestic Terrorism: Training and Technical Assistance (ICP TTA) Program—Funded by the Office for Victims of Crime within the U.S. Department of Justice, the ICP TTA program works to equip U.S. communities to respond effectively to incidents of criminal mass violence and domestic terrorism. The program's website features a resources page (https://icptta.com/resources), which offers vetted resources to help emergency managers, victim service professionals, and others make victim services part of emergency operations plans, as well as a trainings page (https://icptta.com/trainings), which includes freely available trainings to help build local capacity.
  https://icptta.com
• Parent Guidelines for Helping Youth after the Recent Shooting—In this 3-page tip sheet released shortly after a shooting, the NCTSN describes how such an event may affect children and teens as well as parents and other caregivers. The tip sheet lists reactions common among people of all ages, offers coping tips for caregivers, and suggests ways for caregivers to support children and youth in talking about and managing their reactions.
  https://www.nctsn.org/resources/parent-guidelines-helping-youth-after-recent-shooting
  
  This resource is available in Spanish at https://www.nctsn.org/resources/guia-para-los-padres-para-ayudar-los-jovenes-despues-de-un-tiroteo-reciente.
• Psychological Impact of the Recent Shooting—This document from the NCTSN lists reactions people may have to a shooting and related experiences (such as loss of loved ones and disruption of routines). It describes grief reactions, depression, and physical reactions, and it highlights ways to cope effectively with reactions to a shooting. https://www.nctsn.org/resources/psychological-impact-recent-shooting  Remembering—National Mass Violence Victimization Resource Center (NMVVRC)
  This web page describes how communities typically respond in grief after an incident of mass violence and offers guidance for community leaders in supporting communities through this process. Information and downloadable resources focus on communities remembering tragic events, incident anniversaries, and memorials.
  https://www.nmvvrc.org/community-leaders/rebuild-your-community/remembering 
• Survivors and Witnesses After Traumatic Events—A product of Voices Center for Resilience, a nonprofit formed after the attacks of September 11, 2001, this tip sheet for the public provides basic information about common effects of exposure to acts of violence, civil unrest, or terrorism. It identifies steps disaster-affected individuals can take in the immediate aftermath of crisis, common reactions to disasters, and tips for coping and asking for help.
  https://voicescenter.org/tip-sheets/trauma/survivors
• Talking to Children about the Shooting—In this tip sheet, the NCTSN provides suggestions to parents and other caregivers for talking with their children in ways that help them to make sense of and cope with their reactions to a shooting. The tip sheet also identifies reactions common in children and teens to shooting incidents.
  https://www.nctsn.org/resources/talking-children-about-shooting
• Tip Sheet for Youth Talking to Journalists After Mass Violence—This NCTSN tip sheet describes how talking with journalists may affect youth who have survived an incident of mass violence. It lists the rights that youth and families have (for example, they have the right to ask what the interview questions will be in advance of agreeing to an interview). It also identifies signs that reporters are doing their job well, so that readers know what to expect.
  https://www.nctsn.org/resources/tip-sheet-youth-talking-journalists-after-mass-violence 
• Tips for Parents on Media Coverage—In this tip sheet, the NCTSN explains the effects that media coverage of a violent incident may have on children and teens and suggests ways for parents and other caregivers to help children and teens manage reactions to media coverage and the violent event. The tip sheet also includes tips for families with involvement in a violent incident.
  https://www.nctsn.org/resources/tips-parents-media-coverage-shooting  
• Unexpected Challenges for Communities in the Aftermath of a Mass Violence Incident—This tip sheet from the National Mass Violence Victimization Resource Center lists some unexpected issues a community may encounter after experiencing a mass violence incident. The document also provides suggested solutions for managing these challenges and prioritizing a community’s safety and recovery. http://nmvvrc.org/media/301cm3if/tipsheet2.pdf

Resources for Children, Youth, Parents and Other Caregivers, and Schools

• Children and Adolescents—Several sections of the SAMHSA Disaster Behavioral Health Information Series (DBHIS) resource collection focus on the common responses and needs children and adolescents may have during and after disasters. These sections include resources that highlight the unique needs of children and adolescents in and after disasters, as well as how adults who work with children, and parents and other caregivers, can offer support to children and adolescents in coping. Following are SAMHSA DBHIS sections related to children and adolescents:

Resources intended for children: https://www.samhsa.gov/resource-search/dbhis?rc%5B0%5D=audience%3A20195

Resources for adolescents: https://www.samhsa.gov/resource-search/dbhis?rc%5B0%5D=audience%3A20192

Resources about children and disaster: https://www.samhsa.gov/resource-search/dbhis?rc%5B0%5D=populations%3A20575

Resources about adolescents and disaster: https://www.samhsa.gov/resource-search/dbhis?rc%5B0%5D=populations%3A20151

• Children and Disasters—Part of the Disaster Survivors portal (https://www.samhsa.gov/dtac/disaster-survivors) at the SAMHSA Disaster Technical Assistance Center website, this web page describes how children and teenagers may experience disasters differently from adults, offers tips for disaster planning for families, identifies common reactions to disasters in children and teenagers, and provides suggestions for adults for helping children and teenagers cope after disaster. Links to related resources are also provided.
  https://www.samhsa.gov/dtac/disaster-survivors/children-and-disaster 
• Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers—This SAMHSA tip sheet can help parents, other caregivers, and teachers recognize and address problems in children and teens affected by a disaster. The tip sheet describes reactions that are common in young survivors at different ages, as well as how to help children cope with these reactions.
  https://store.samhsa.gov/product/tips-talking-helping-children-youth-cope-after-disaster-or-traumatic-event-guide-parents/sma12-4732
• Understanding Child Trauma—This web page from SAMHSA presents statistics on child trauma, which may be experienced as part of a natural or human-caused disaster, and lists signs of traumatic stress in children and youth. It also offers tips for parents and other caregivers for helping children and youth to cope with trauma. Links are also provided to downloadable infographics in English and Spanish provided by the SAMHSA National Child Traumatic Stress Initiative.
  https://www.samhsa.gov/child-trauma/understanding-child-trauma 
• Psychological First Aid for Schools (PFA-S) Field Operations Guide, 2nd Edition—Developed by the National Child Traumatic Stress Network (NCTSN) and the National Center for Posttraumatic Stress Disorder, this guide defines PFA-S, a model school communities can use to support students, their families, and staff immediately after a natural or human-caused disaster. Appendix C of the guide includes handouts for responders, parents and families, and students after a disaster.
  https://www.nctsn.org/resources/psychological-first-aid-schools-pfa-s-field-operations-guide
• SchoolSafety.gov—Provided by the U.S. Departments of Homeland Security, Education, Justice, and Health and Human Services, this website features information and resources that K–12 school personnel, parents and caregivers, and law enforcement can use to explore school safety topics and recovery from a disaster or other emergency affecting a school. The Recovery section of the site at https://www.schoolsafety.gov/respond-and-recover/recovery offers a range of resources on recovery for school communities.
  https://www.schoolsafety.gov

• After a Crisis: How Young Children Heal—This tip sheet from the NCTSN describes how young children may respond to disasters and other crises and suggests ways for parents and other caregivers to support them in coping. The tip sheet uses the word SAFETY as a memory aid for readers, with each category of tips beginning with a letter in the word.
  https://www.nctsn.org/resources/after-crisis-helping-young-children-heal
• Age-Related Reactions to a Traumatic Event—In this information and tip sheet, the NCTSN provides an overview of how children and adolescents may react to a traumatic event, including a natural or human-caused disaster that they experience as traumatic. This resource describes reactions typical within specific age ranges and offers tips for families, doctors, and school personnel to help children and adolescents cope.
  https://www.nctsn.org/resources/age-related-reactions-traumatic-event
• Childhood Traumatic Grief: Information for Mental Health Providers—This NCTSN tip sheet provides an overview of the grieving process for children and explains childhood traumatic grief for professionals providing services to children. The resource includes signs of traumatic grief and tips for supporting the child in recovery.
  https://www.nctsn.org/resources/childhood-traumatic-grief-information-for-mental-health-providers
• Childhood Traumatic Grief: Youth Information Sheet—In this 2-page resource, the NCTSN describes grief in children and teenagers and explains childhood traumatic grief, which has some different signs and symptoms from other grief. Tips are provided for coping with traumatic grief.
  https://www.nctsn.org/resources/childhood-traumatic-grief-youth-information-sheet

• Creating Effective Child- and Family-Focused Disaster Behavioral Health Messages on Social Media—In this approximately 40-page toolkit, the NCTSN provides guidance for professionals serving disaster-affected communities, as well as child-serving mental health organizations, in using social media to communicate with the public through all phases of disaster. The toolkit presents an overview of social media platforms; information about developing social media posts; and key communication considerations by phase of disaster, including in the aftermath of disaster and during long-term recovery.
  https://www.nctsn.org/resources/creating-effective-child-and-family-focused-disaster-behavioral-health-messages-on-social-media
• Help Kids Cope—This free mobile app provides information to help parents and other caregivers, teachers, counselors, and others to talk about disasters with children. The app features tips and checklists to help with disaster preparation; information about how children typically respond to disasters; and links to books, activities, and other resources for children. Developed by the NCTSN and other organizations, the app runs on iPhone, iPad, and iPod Touch, as well as Android devices.
  https://www.nctsn.org/resources/help-kids-cope

• Helping School-Age Children with Traumatic Grief: Tips for Caregivers—After children lose someone they love in a disaster or other event, they may go through traumatic grief, particularly if the death was sudden or frightening. In this tip sheet, the NCTSN explains how school-age children may experience traumatic grief and suggests ways for parents and other caregivers to support them in moving through and coping with this type of grief.
  https://www.nctsn.org/resources/helping-school-age-children-traumatic-grief-tips-caregivers 
• Helping Young Children with Traumatic Grief: Tips for Caregivers—In this tip sheet, the NCTSN explains how young children may experience traumatic grief, which can arise after a disaster or other event in which the child lost a loved one. The tip sheet lists ways in which young children may go through and express traumatic grief and offers suggestions for parents and other caregivers to support children in coping.
  https://www.nctsn.org/resources/helping-young-children-traumatic-grief-tips-caregivers 
• Helping Your Child Cope With Media Coverage of Disasters: A Fact Sheet for Parents—Provided by the Disaster and Community Crisis Center at the University of Missouri, this fact sheet explains how media coverage of disasters may affect children and adolescents. It also offers strategies to help parents address these effects, including monitoring and placing limits on consumption of media, explaining disaster coverage, and helping children develop coping skills.
  https://dcc.missouri.edu/assets/doc/products/disaster_media_factsheet_for_parents_dcc.pdf
  
  The fact sheet is available in Spanish at https://dcc.missouri.edu/assets/doc/products/DCC_Media_Parent_SPANISH.pdf.
• Helping Youth after Community Trauma: Tips for Educators—In this 1-page tip sheet, the NCTSN identifies 10 ways youth may react to community traumas such as natural or human-caused disasters and suggests ways for educators to respond to these reactions and support youth in coping. The tip sheet also advises educators to find professional mental health support for youth—and for themselves—as needed.
  https://www.nctsn.org/resources/helping-youth-after-community-trauma-tips-educators  
• Once I Was Very Very Scared—This book for young children introduces several animal characters (e.g., squirrel, turtle, dog) who have gone through traumatic experiences, including disaster trauma, and are experiencing different reactions. It can be used by parents and other important adults in the lives of children to talk about difficult and traumatic experiences and support children in coping. The book is available in several languages other than English.
  https://piploproductions.com/stories/once
• Psychological First Aid: Adults Working with Children and Teens—Provided by the New York State Office of Mental Health, this information and tip sheet describes for parents and other caregivers how disasters may affect children and factors that can shape how children react to disasters. It identifies steps parents and other caregivers can take to support children and teens in coping after a disaster.
  https://www.omh.ny.gov/omhweb/disaster_resources/pfa/adults_children.pdf
• PFA: Parent Tips for Helping School-Age Children after Disasters—This handout lists reactions children may have to disasters, ways parents can respond helpfully to these reactions, and examples of things parents can do and say to support their school-age children after a disaster. The handout is part of the PFA Field Operations Guide.
  https://www.nctsn.org/resources/pfa-parent-tips-helping-school-age-children-after-disasters  
  
  The handout is also available in three languages other than English:

Chinese: https://www.nctsn.org/resources/pfa-parent-tips-helping-school-age-children-after-disasters-chinese   

Japanese: https://www.nctsn.org/resources/pfa-parent-tips-helping-school-age-children-after-disasters-japanese

Spanish: https://www.nctsn.org/resources/pfa-consejos-para-padres-como-ayudar-ninos-de-edad-escolar

• Psychological First Aid: Teachers and Educators—Designed for personnel at schools that have experienced an incident of violence or a natural disaster, this tip sheet describes how teachers and educators may experience disasters and how PFA can help. PFA is an evidence-informed, modular approach that can be used to assist disaster survivors. The tip sheet offers ideas for teachers to take care of themselves and support others in the school community in coping and healing after disasters.
  https://www.omh.ny.gov/omhweb/disaster_resources/pfa/teachers_educators.pdf
• Recovery From Large-Scale Crises: Guidelines for Crisis Teams and Administrators—In this tip sheet, the National Association of School Psychologists (NASP) describes what to expect in schools after disasters and other crises and how school crisis teams and administrators can support the school community in coping and recovery. NASP identifies steps administrators and crisis teams can take at different points after the crisis, from immediately after the crisis to more than a year later.
  https://www.nasponline.org/resources-and-publications/resources-and-podcasts/school-climate-safety-and-crisis/school-violence-resources/recovery-from-large-scale-crises-guidelines-for-crisis-teams-and-administrators
• Resilience and Coping Intervention (RCI)—This intervention can be used to help children and adolescents cope with disasters and other forms of community trauma. RCI is designed for groups of 5 to 10 people and can be delivered in one or several sessions. RCI groups can be implemented in programs based in schools and other settings and led by teachers, counselors, or other professionals who have been trained in the intervention.
  https://dcc.missouri.edu/rci.html 
• Responding to Stressful Events: Helping Children Cope—This brochure contains information on helping children cope after disaster. It highlights common reactions in children in specific age ranges and describes how parents and other caregivers, families, and teachers can provide support. The brochure was developed by the Mental Health Support Network of Canada, a coalition of Canadian associations focused on mental health and stress management.
  https://www.canada.ca/en/public-health/services/reports-publications/responding-stressful-events/helping-children-cope.html
• Responding to Stressful Events: Helping Teens Cope—Developed by the Mental Health Support Network of Canada, this brochure advises parents and other caregivers and teachers on how they can support teenagers in coping with disasters. The brochure describes common reactions to disasters in teenagers, ways adults can respond that may be helpful, and activities for teens that may help them in coping.
  https://www.canada.ca/en/public-health/services/reports-publications/responding-stressful-events/helping-teens-cope.html

General Disaster Response and Recovery Information

• Tips for Survivors: Coping With Grief After a Disaster or Traumatic Event—In this tip sheet, SAMHSA defines and describes grief, discusses ways of coping with grief, and explains complicated or traumatic grief. The tip sheet also offers relevant resources for additional support.
  https://store.samhsa.gov/product/Tips-for-Survivors-/SMA17-5035 
• Tips for Survivors of a Disaster or Other Traumatic Event: Managing Stress—This SAMHSA tip sheet gives stress prevention and management tips for dealing with the effects of a disaster or trauma. It identifies common reactions to disasters and other traumatic events, lists tips to manage and lower stress, and highlights signs of the need for professional support.
  https://store.samhsa.gov/product/Tips-for-Survivors-of-a-Disaster-or-Other-Traumatic-Event-Managing-Stress/SMA13-4776
  
  This tip sheet is also available in Spanish at https://store.samhsa.gov/product/Tips-for-Survivors-of-a-Disaster-or-Other-Traumatic-Event-Managing-Stress-Spanish-Version-/SMA13-4776SPANISH. A similar tip sheet is available in Punjabi at https://store.samhsa.gov/product/Tips-for-Survivors-of-a-Traumatic-Event-Managing-Your-Stress-Punjabi-Version-/NMH05-0209PUNJABI.
• Coping with a Disaster or Traumatic Event—At this web page, CDC emphasizes the importance of effective coping after a disaster and getting professional help if needed for reactions that are difficult and intense. Links are provided to additional information about managing your emotional health as a survivor and about supporting your children in coping.
  https://emergency.cdc.gov/coping/index.asp
  
  This information is available in Spanish at https://emergency.cdc.gov/es/coping/index.asp.
• The Impact of Disaster and Mass Violence Events on Mental Health—Intended for mental health and substance use disorder treatment professionals, this online article from the National Center for Posttraumatic Stress Disorder (PTSD) summarizes research on common reactions to disasters. The article identifies common reactions in disaster-affected communities and describes how reactions increase and decrease in communities over time, as well as highlighting risk factors for longer term reactions. 
  https://www.ptsd.va.gov/professional/treat/type/violence_trauma_effects.asp
• Managing Grief after Disaster—Written for mental health and substance use disorder treatment professionals, this online article from the National Center for PTSD contains information on bereavement, grief, and traumatic grief. It also covers complications of bereavement, risk factors for these complications, and treatment of people experiencing bereavement.
  https://www.ptsd.va.gov/professional/treat/type/manage_grief_disaster.asp
• Online Clinical Trainings—Provided by the National Mass Violence Victimization Resource Center, this web page includes descriptions and links to trainings focused on treatments for trauma and posttraumatic stress disorder in children and adults. Treatments for which trainings are provided include trauma-focused cognitive behavioral therapy, cognitive processing therapy, and prolonged exposure.
  https://www.nmvvrc.org/vsps-clinicians/online-clinical-trainings
• Bounce Back Now—Bounce Back Now is a free mobile app available through the Google Play and App Stores. It is intended to help people with coping and resilience after a natural disaster or incident of mass violence. Once users have created an account, they can complete regular questionnaires to assess mental health, access education and coping tools, and put together a plan for improving emotional health. There are also parenting tips for helping children and teens in coping with the emotional impacts of a disaster.
  https://www.bouncebacknow.org
• Mass Disasters, Trauma, and Loss—This booklet from the International Society for Traumatic Stress Studies discusses common reactions to disasters, factors that make people more likely to experience reactions for longer periods, and steps survivors can take to cope effectively after a disaster. Signs of the need for professional mental health assistance are also provided.
  https://istss.org/ISTSS_Main/media/Documents/ISTSS_MassDisaterTraumaandLoss_English_FNL.pdf
  
  The booklet is available in three languages in addition to English:

Arabic: https://istss.org/ISTSS_Main/media/Documents/ISTSS_MassDisasterTraumaandLoss_Arabic_FNL.pdf

Chinese: https://istss.org/ISTSS_Main/media/Documents/ISTSS_MassDisasterTraumaandLoss_Sch_FNL.pdf

Spanish: https://istss.org/ISTSS_Main/media/Documents/ISTSS_MassDisasterTraumaandLoss_Spa_FNL.pdf  

• PFA: Tips for Adults—Part of the Psychological First Aid Field Operations Guide, this handout identifies common reactions in adults who have experienced a disaster, suggests responses, and offers examples of things to do and say to cope with the reaction. These suggestions and examples include a breathing exercise for relaxation, prioritization of responsibilities that feel overwhelming, and tapping into existing relationships for support.
  https://www.nctsn.org/resources/pfa-tips-adults
  
  This resource is available in Spanish at https://www.nctsn.org/resources/pfa-consejos-para-adultos.  

The SAMHSA Disaster App allows disaster behavioral health responders to navigate resources related to pre-deployment preparation, on-the-ground assistance, and post-deployment resources.  Users can also share resources from the app via text message or email and quickly identify local mental health and substance use disorder treatment services. https://store.samhsa.gov/product/samhsa-disaster