Grief counseling of students questioned in new study

When a student dies, even the most bustling school can feel like a mausoleum.

Grief professionals come in, information assemblies are held and young people are encouraged to discuss their emotions in groups or one-on-one meetings with counselors.

But asking students to relive or recollect a tragedy could hurt more than help, according to a new commentary published in the Canadian Medical Association Journal.

Psychological debriefing could actually contribute to post-traumatic stress disorder rather than stave it off, researchers from Dalhousie University write.

Popularized in the 1970s and 1980s and now institutionalized at many schools, psychological debriefing is a single-session intervention that involves reliving the trauma and talking about emotional reactions.

The paper, which concludes there is no evidence to say psychological debriefing works, adds to a growing consensus in the medical community that forcing these interventions on grieving students could aggravate their stress.

Recent studies mentioned in the paper show the approach neither prevents the disorder nor reduces anxiety.

In fact, some analyses show that those who had the intervention showed stronger signs of psychological distress than those who didn’t partake in it, notes Stan Kutcher, the Sun Life Financial Chair in Adolescent Mental Health at Dalhousie University and co-author of the commentary.

“When people are put into a situation and then asked to relive, remember and sometimes even re-enact their feelings and thoughts, it actually makes things worse for them,” by engraining that trauma in their minds, he says.

After the event — such as the Bathurst, N.B. crash that killed seven teenage basketball players or the Dawson College shooting in Montreal — a young person usually goes through a three- to seven-day period of normal stress response, he says. Too often, those normal responses — such as insomnia, a feeling of depression and anxiety — are mistaken as red flags for mental-health troubles down the road.

“You want to make sure the school goes about its regular business and doesn’t shut down, doesn’t bring all the kids into an assembly, doesn’t have to deal with grief counseling,” he says, adding that parents, teachers and school administrators should keep an eye on troubled students and offer further support for students who are expressing symptoms of stress after a longer period of time has passed.

Ideally, schools would offer interventions that support “a sense of safety, calmness, a sense of self and community efficacy, connectedness and hope,” Kutcher and his co-authors write.

The authors also raised concern that psychological debriefing has been marketed to schools that have purchased manuals and paid for training programs, says Kutcher.

“The unfortunate thing about this is that although it sounded like a good thing, people who started doing it started to think ‘hmm … I’m finding the opposite results.’ “ That discovery, he said, spurred the type of independent research cited in the journal’s commentary.

But parents and teachers shouldn’t take the recommendation to drop psychological debriefing as a call to be laissez-faire, says Katy Kamkar, a clinical psychologist with the Psychological Trauma Program at the Center for Addiction and Mental Health.

“In the beginning after a very upsetting traumatic event, of course support is important. And if there’s professional help (available), why not?” she says. “At the same time, you want that professional help to be evidence-based.”

The study comes at a time when schools across the country have moved away from the debriefing approach, preferring open access to counseling instead.

In 2004, the Toronto District School Board began revamping its methods of support to traumatized students, says David Johnston, its senior manager of professional support services.

“We don’t have people trained in critical-stress debriefing models — that’s not the model we employ,” he says. “We want to create an environment of safety and an environment of support in a school. We don’t force counseling on kids.”

Letting students voluntarily share their grief is often the best strategy to help them come to terms with it, says Phillip Hay, instructor and registrar with the Kelowna College of Professional Counseling.