Traumatic recollections of the event, efforts to suppress them, and persistent states of anxiety and arousal with occasionally bizarre symptoms can occur, sometimes weeks after the event. Adults commonly underestimate the effect of such events on youth, and parents may unwisely discourage the child from recounting his observations and feelings. Treatment Treatment may involve individual, group, or family therapy. Reassuring the child or parents that it is logical to be stressed by severe events can be supportive, as can obtaining and amply exploring the child's narrative of the event with its attendant distress. After adequate discharge of emotion, the child should be encouraged to suggest, in language appropriate to his background and maturity, how a different handling of events might have resulted in a better outcome, thus allowing for closure and offering hope for the future.
Antidepressant drugs are sometimes helpful if distress persists.
Early group support can minimize subsequent PTSD and should include a detailed reconstruction of the event by the group, adequate venting of emotion, acknowledgment of typical responses to disaster, and emphasis on appropriate factual understanding of terrifying events. The distress of rescuers and treating personnel may be intense and can be relieved by systematic debriefing, where events and their emotional consequences are supportively reviewed by the participants. Substance use has penetrated younger populations, including preadolescents. Daily use of marijuana and experimentation with a variety of compounds vary from year to year, but alcohol remains the principal substance of abuse. Heroin, cocaine, crack cocaine, crystal methamphetamine, and other stimulant abuse is less common but significant.