Introduction

This chapter deals with preventive intervention aimed at reactive psychopathology in children that arises as a result of exposure to traumatic events. Over the past decade awareness of the extent to which children and adolescents are exposed to traumatic experiences has increased. Such experiences include interfamilial violence, sexual abuse, neighbourhood/community/religious/political violence, war-related uprooting, terrorism encounters, natural disasters, technological disasters, fatal road accidents, terminal illness and death. Evidence suggests that most people will experience a traumatic event at some time during their lives, often while they are still quite young (Freedy & Hobfoll, 1995; Horowitz, 1996; Kilpatrick & Resnick, 1993; Leavitt & Fox, 1993; Meichenbaum, 1997; Saylor, 1993). Extremely stressful life events are now recognized as widespread, and our knowledge of reactions by children and adolescents to trauma has substantially increased (Leavitt & Fox, 1993; Van der Kolk, McFarlane & Weiseath, 1996; see Yule, Perrin & Smith, chapter 9, this volume). The frequency of traumatic events in the lives of children and young people is reason enough for the assertion that preventive measures (e.g. identification and early intervention) are critical.

Special attention is given in this chapter to trauma experienced collectively. Exposure to traumatic events often causes adverse stress reactions in children and adolescents, and many become preoccupied with their experiences and have involuntary intrusive memories. Most recover under favourable conditions. The extensive literature documents the typically short-lived negative response to natural and human-made disasters. In some instances, however, the transient stress reactions can develop into more severe chronic problems (Norris & Thompson, 1995).