What to Expect After Trauma:
Feelings of anxiety, fears, and worries about safety of self/others or re-occurrence of violence
Increased levels of distress, irritability, moodiness or defiance
Changes in sleep, appetite and/or behavior
Decreased concentration and/or attention
Withdrawal and/or lack of interest in usual activities
Angry outbursts and aggression and/or hate or anger statements
Absenteeism from school or work and/or Changes in school or work performance
Increased somatic complaints (e.g., headaches, stomachaches, aches and pains)
Recreating the event (e.g., talking, thinking or playing repeatedly about the event)
Increased sensitivity to sounds (e.g., sirens, planes, thunder, loud noises)
Statements and questions about death and dying
Regression in children’s behaviors (e.g., baby talk, bedwetting, tantrums)
Discomfort with feelings, particularly those associated with revenge or vulnerability
Negative impact on issues of trust and perceptions of others, particularly of those that are “different”
Denial of impact
Increased risk for substance abuse, including drinking

What Can Help?
Relaxation exercises such as deep breathing, meditation, and visualization
Balance physical exercise, adequate rest and good nutrition.
Walk away from difficult situations to calm down. Return later and try a new approach.
Keep other incidents in perspective. Try not to overreact to small setbacks or minor crises.
Set realistic goals regarding what and how much you can do right now.
Take one day at a time.
Be good to yourself.
Continue to find ways to have fun. Take a walk, call a friend, listen to music, or create a picture.
Read books, listen to music, take a walk, ride bikes, etc.
Use your sense of humor.
Identify and be willing to use your support system. Avoid isolation. Have someone available to vent.
Reinforce ideas of safety and security.
Avoid overexposure to the trauma. Limit exposure to the news and other media about the tragedy.
Maintain normal routines of sleeping, eating, and other activities (e.g., sports, church, dance).
Bedtime routines should include safely tucking children in at night.  (Young children may want a night light again.)
Avoid unnecessary separations of children from important caregivers.
Increase patience with others and with yourself.  Give you and your family time to cope.
Find ways to emphasize to friends and family, especially children that you love them.
Write your thoughts and feelings in a journal.
Address children’s acting-out behavior quickly and firmly with limit setting.
Delay making big decisions.
Take action and get involved, volunteer/work to make a difference.
If you or your family feel too overwhelmed, seek professional help.

Therapy appointments are available in our offices near Pittsburgh in Wexford, Robinson Township and Squirrel Hill.