A guide to help schools prepare and respond to a critical incident

Introduction

This guidance aims to help schools prepare for and respond to a critical incident. It outlines some of the key issues and areas for consideration which may arise in the event of a critical incident.

What is a critical incident?

A critical incident is any incident or sequence of events which overwhelms the normal coping mechanisms of the school. (NEPS, 2016)

Critical incidents are sudden, unexpected and unpredictable. They fall outside the range of normal experiences, potentially affecting a large number of people and causing high levels of personal distress. Critical incidents vary and may cause disruption to the school day. A critical incident affecting school may include (but is not limited to):

• The death of a member of the school community through sudden accident, murder, terminal illness or suicide.
• Serious accident involving pupils or staff members on or off the school premises.
• A event witnessed outside of school (such as a serious accident or assault).
• A significant event in the community, e.g. terrorist incident or transport accident.

Preparing for a critical incident

Due to the unpredictability and possible impact of these events, schools and other education settings should be prepared to cope with an incident. Therefore settings should develop plans and procedures so that staff can act quickly and appropriately following an incident. This can ensure clear routes of support in the event of a critical incident and mitigate against the possible impact.

It is strongly recommended that schools produce a plan which represents best practice in managing and coordinating an emergency response. This may include information about key roles and responsibilities, lines of communication and contact details, essential tasks, procedures for information gathering, sharing and management and sources of further guidance and support. Consideration will need to be given to how the plan is shared, tested and reviewed. The process or preparing for a critical incident may highlight areas for further training.

How can educational psychologists support?

Surrey Educational Psychology Service has extensive experience working with settings to manage critical incidents and assist the return to normal working. The level of response will be determined between the school, the EP service and other services involved and may depend on the severity of the incident and levels of training and experience within the school. EPs may provide the following support to settings experiencing critical incident:

• Planning - Working proactively, assisting with critical incident planning and reviewing the setting's support plan and providing advice and training.
• Assessment and Identification - Supporting staff to assess the likely impact of the incident on the school community, prioritise actions and help in the identification of vulnerable pupils and staff, school resources and cultural or religious implications surrounding the incident and how they may be addressed.
• Information and Support - Advice/support to Head/Senior Management Team, advice/support to staff members around supporting pupils and attending parent meetings arranged by the setting to brief them on the possible reactions/symptoms.
• Signposting - Signposting to additional resources and support services as appropriate.

Research suggests that direct communication with unknown staff may generate more stress for some of those involved and direct work is most effective when delivered by familiar adults. Thus it is important to note that EPs do not work directly with children and young people during a critical incident.

How to access educational psychologist support

In the event of a critical incident, please contact the Principle EP or the Area Senior EP, ideally by phone.

Principle Educational Psychologist, Susan Harris - Email: Susan.harris@surreycc.gov.uk or Telephone: 01483 518152

North East

• Nadia Wilkinson - Nadia.wilkinson@surreycc.gov.uk
• Kirsty Quinn - Kirsty.quinn@surreycc.gov.uk
• Telephone number: 01372 833588

South East

• Louise Lombardi - Louise.lombardi@surreycc.gov.uk
• Sue Peters - Susan.peters@surreycc.gov.uk
• Telephone number: 01737 737777

North West

• Nicola Mollet - Nicola.mollet@surreycc.gov.uk
• Laura Wilby - Laura.wilby@surreycc.gov.uk
• Telephone number: 01483 518130

South West

• Chloe Gibson - Chloe.gibson@surreycc.gov.uk
• Alix Diemont - Alix.diemont@surreycc.gov.uk
• Telephone number: 01483 517179

Responding to a critical incident

• Implementing the contingency plan
• Breaking the news to school staff
• Breaking the news to pupils
• Identifying individuals who may be vulnerable
• Tips for supporting Individual pupils showing emotional distress
• Organising support meetings

Implementing the contingency plan

In the event of a critical incident, key personnel will need to act promptly in implementing the critical incident plan. This may include responding to any immediate risk or threat (For example, evacuation or first aid), notifying emergency services, mobilising key staff members in the contingency plan and notifying the parents/carers of any pupils involved.

Surrey County Council's Emergency Management and Resilience Team and the Area Schools Support Service provide immediate support during an emergency. This includes liaison with Local Authority teams and external agencies (such as the Head of Risk Management, the Police and other emergency services) to ensure that settings receive the best possible help and advice. The 24/7 Duty Officer for the Surrey County Council Emergency Management and Resilience Team can be contacted for school emergencies on: 07831 473039 (please note, this number is for emergency use only and should not be released to the public.

Breaking the news to school staff

Where possible, school staff should be informed first, ideally in a group where questions can be asked and all staff receive the same information. Even if staff are aware of the incident, it is advisable to hold a meeting to clarify information and ensure staff are aware of the school position, response and are signposted to further support – this helps to avoid rumour and conjecture. Be mindful of also informing staff members and adults who may not be present at the initial meeting (for example, part-time staff, lunchtime supervisors, etc.)

Breaking the news to pupils

Breaking the news to children and young people can be a difficult task but also presents an opportunity to be clear about the facts that are known and to emphasise the strengths within the school community. The Educational Psychology Service can provide support and advice on sharing information about a traumatic event with pupils of different ages and with additional and special educational needs, based on the specific circumstances involved.

It is important to inform pupils of a critical incident as soon as possible, ideally in small groups ensuring a safe space for expression and open discussion. Where possible, school staff should make the announcement simultaneously. School staff also need to be mindful that information may already be circulating on social media and therefore it may be necessary to address rumours or misconceptions. The following should also be considered when breaking the news to pupils:

Who should tell the child/children?

• Someone who they know and trust
• Someone who can maintain contact with the child in the time ahead
• Someone who has an understanding of how children respond to trauma
• Someone who allows the child to express their feelings.
• Someone who is confident speaking to the group
• Someone who has an understanding of how children respond to trauma
• Someone who respects children's confidentiality
• Staff should be able to decline this task if they do not feel able

Where should they be told?

• In a familiar setting with safe and comfortable surroundings
• If a child is being told on an individual basis, ensure this is a private setting.
• When informing groups of pupils, a classroom may be more appropriate than a large hall
• If appropriate, a whole school assembly can be held to demonstrate the sense of shared trauma/loss within the school community, but possibly not in the immediate aftermath

How should the news be given?

• Use clear, accurate language and terminology, taking account of the pupils' needs and backgrounds. Avoiding euphemisms such as "lost" which might confuse younger children
• Begin by preparing the pupils for some very difficult/sad news
• Provide factual and consistent information to all pupils
• If on an individual or small group basis, the adult should provide opportunities for the child to show emotional responses, ask questions and talk through what they have heard.
• If the news is being shared in larger groups or as whole school, ensure pupils have an opportunity for questions and discussions in smaller groups afterwards
• Try to give expression to the emotions that individuals may be experiencing (for example, shock/disbelief) and explain that strong and difficult feelings are a normal part of the process of coming to terms with this sort of experience.
• With opportunities for the adult to establish the child has understood the news they have been given
• Explain what arrangements the school has in hand for coming to terms with what has happened.

Adapted from E Brown (1999)

Example:

"I've got some very sad news to tell you today that might upset you. There is a serious illness called meningitis. Sometimes people with meningitis get better but sometimes people die from it. Some of you will have known that Jane Smith in year 4 was suddenly taken ill last week. I have to tell you that Jane died in hospital yesterday.

Like me, many of you will find it hard to believe that this has happened. It is obviously a very big shock for us all. Jane was such a happy girl who got on well with everybody. We will all miss her.

It is important for you to know that strong and perhaps difficult feelings are part of the normal process of coping with this sort of situation. It will help to talk about what has happened and about your thoughts and feelings. Please do take the opportunity to talk to your family, friends, teachers and adults in school. This is likely to be a difficult time for us as a school community and we should all try to support each other. Please come and talk with me if you have any questions or if you just want to talk."

How to respond to difficult questions?

• All staff need to be aware of what can and cannot be shared with pupils
• Prior to notifying pupils, school staff may try to predict difficult questions and consider developing scripts for responding
• If questions cannot be answered this should be acknowledged, for example: "We don't know the answer to that yet, but we will let you know as soon as we know."

Identifying individuals who may be vulnerable

It is important to acknowledge that critical incidents may act as a trigger for extreme emotional response for pupils and school staff, even if they are not directly involved. It is important to consider who may be vulnerable and thus may require additional support or guidance.

Colour code (green: low risk, yellow: medium risk, red: high risk) according to the following criteria and degree of concern:

• Directly involved
• Witnesses
• At greatest risk as part of incident
• Siblings/relations
• Close friendships
• Any perceived culpability/responsibility
• Being blamed / scapegoated
• Displaying emotional distress
• Previous bereavement/trauma
• Pre-existing EBD/mental health issues
• Pre-existing home instability / stress
• Learning difficulties
• Culture and/or language issues

Tips for supporting Individual pupils showing emotional distress

• Be accepting and allow the pupil to express their emotions. Ask open ended questions (for example, "How are you today?") or just sit with them if this is what you feel is appropriate. Avoid touching or hugging but try to be as natural and unembarrassed as possible. Have some tissues to hand. It might be appropriate to use reflective listening (i.e., repeating back to the child what they have said) and/or summarise what they have said. This gives an opportunity for the child to elaborate and/or modify what they have said as well as an opportunity to hear a perspective on their own experiences. Sometimes it is helpful to give a name to the emotion that you are hearing being expressed (for example, "That sounds very sad", "Did you feel angry then?").
• You might have to explain your limits of confidentiality (i.e., confidentiality can be maintained except where you believe that the pupil is at risk or there are issues relating to a possible criminal act).
• Don't forget that knowing what to say is far less important than being able to listen in a sympathetic and supportive manner. If it seems appropriate to offer advice, then strategies for the pupil that you might want to suggest could include:
  - Talking to their family and friends.
  - Crying and expressing their emotions in a suitable safe context.
  - Maintaining normal routines.
  - Eating normally.
  - Taking physical exercise.
  - Maintaining normal sleep patterns.
  - Carrying on seeing and being with friends.
  - Listening and playing music.
  - Being creative through art, drama, music, etc.
  - Maintaining interests and pastimes.

• As part of such sensitive support, it will be important to ensure that the pupil can continue to seek support from you but without them becoming dependent. If appropriate, agree to a set number of sessions at a set time and place where you can be confident of not being disturbed. (In terms of your own safety and accountability, ensure that parents and relevant staff are aware of any such arrangements).
• Using a visual aid such as an outline of a hand, ask the pupil to identify 5 individuals (e.g., staff, peers, family, other adults) who they feel they could approach as part of their support network to help them feel safe. Ask them to test it out. If all else fails, what else could they always have 'up their sleeve'? (for example, Childline).
• Liaise with parents/carers as appropriate.
• Consider liaising with colleagues to differentiate work outcomes/homework, etc. or arrangements for managing the pupil's emotional distress in class.
• Be aware that holidays, Christmas, birthdays and the anniversary of the event that has caused distressed can mark points of particular emotional vulnerability.
• Taking into account other agencies or professionals who may be involved, consider providing pupil with information about youth counselling and information services/other community support as appropriate.
• Consider involving staff from the Children and Young People's Service (for example, the Link Educational Psychologist).
• Where an individual pupil is experiencing persistent and intrusive thoughts, dreams or flashbacks and avoidance of features associated with the distressing event in conjunction with the physical, cognitive, emotional/behavioural symptoms described below in the process of grief for at least 1 month, then serious consideration should be given to accessing specialist child mental health services. Referral can be made to Child and Adolescent Family Services by the family via their GP or by the Educational and Health professionals.

Finally, do not underestimate the emotional demands of this sort of work or the confusion that might arise from any of your own unresolved issues. Ensure that you have the opportunity to talk through any form of support that you provide for an individual pupil with a trusted colleague.

Organising support meetings

Communication with staff and pupils

• It is important that familiar adults are identified to communicate with groups of staff or pupils promptly following an incident.
• Staff providing the information should stick to known facts, and deliver any information in an age-appropriate manner avoiding any euphemisms. It is especially important for staff to acknowledge feelings of regret, anger, sadness and confusion as part of modelling a normal human response.
• Staff should be vigilant and respond consistently to examples of inaccurate stories, blame or scapegoating.

Managing a support meeting

• The first principle is do no harm
• The support meeting is not counselling or therapy (indeed some research shows that counselling can be harmful immediately following a critical incident).
• The support meeting provides an opportunity to normalise reactions and share information about an incident. It is important that groups of pupils or members of staff with similar levels of exposure to an incident are identified.
• There is a risk that bringing together a group with a mixed experience can potentially exacerbate traumatic responses.

Staff behaviours that facilitate support meetings to whole class or to smaller groups

It is expected that teaching staff are skilled communicators with children and that existing pastoral skills will be used in any debriefing session with pupils. This would include:

• Provide the space for everyone to speak
• Provide non-judgemental comment
• Summarise and clarify any misunderstandings
• Reassure pupils that their reactions are understandable and normal
• Promote examples of good coping skills and connect networks of support
• Keep a focus on next steps and moving forward
• Note any specific actions and keep a log of who was involved in the debriefing, including any children who seemed particularly affected
• Consider age-appropriate methods for children to express themselves (for example, drawing, play, reading a suitable story, circle time approaches may help children experience a sense of control over an experience)
• Some people find it hard to verbally express how they feel. Some, particularly younger children, may wish to draw their feelings.

Format for a support meeting

In most cases it would be best if two members of staff conduct the support meeting together. The framework outlined below may provide a helpful structure:

• Provide an introduction and explain any ground-rules.
• Establish the facts. (Exercise caution when discussing any situation under police investigation. Keep to facts that are in the public domain. Schools are often assigned a Police Liaison Officer who can advise, and the SCC Press Department should also be consulted.)
• Stress the importance of listening to others and keeping confidences.
• Provide an opportunity to explore thoughts and reactions connected with the incident. Some of the group will find it easy to talk, others may remain silent. The facilitator will sensitively ensure that no one dominates the discussion, and will try to encourage everyone who wants to speak has an opportunity to do so.
• Provide some information to summarise what has been said and normalise the experience.
• Include an opportunity for children to ask any questions.
• Before closing the meeting agree any specific actions and explain what might happen next.

Useful questions/phrases:

• Let us explain why we're together as a group (include the ground-rules).
• Let us have a turn in explaining, what happened, what you were thinking and how you reacted.
• What would you as a group like to happen next?
• If you need further support do you know whom to ask?

The session should end with pupils being strongly encouraged to go to next lesson or else to go back to an area that has been set aside for them. It may be helpful for a member of staff to sit with them. Secondary pupils often prefer to sit with and support each other for a little while. Identify any particularly distressed/vulnerable pupils, in order to share information with staff.

The process of grieving

Grief is a normal and necessary reaction to loss. It is defined as 'the anguish experienced after significant loss'. It is often distinguished from bereavement and mourning in that not all bereavements will result in a strong grief response. Grief often includes psychological distress (American Psychological Society), however the majority of children and young people will have a normal grief response and can be supported by familiar, warm, responsive adults who are attuned to their needs.

It is important to remember that there is no formula or timeframe for grieving. Everyone reacts differently to loss and the way someone experiences grief may be influenced by a range of factors (for example, age, cultural background, religious beliefs, pervious experiences). There are many models of grief aiming to illustrate the process and understand the process and function of grief. Although the process of grief is different for each individual based on their experiences, grief tends to incorporate a series of predictable stages. The following model, known as the Kubler-Ross model, may be the most widely known. Kubler-Ross has applied these stages to a range of significant life events, such as the death of a loved one, divorce and the onset of illness as well as tragedies and disasters. Please note grief is not a linear process, the steps do not necessarily happen in the order noted below and individuals may not go through each stage.

Below are some behaviours that may be noticed at home or in school during each stage. It is possible, especially in the early stages to go through this cycle repeatedly – every day expecting to see someone who is no longer there, or letting morbid thoughts prevail before rallying again. The main thing to look out for is a change in the young person's behaviour. Bear in mind that people react at different rates – some will have an immediate reaction; others may take some time to react. Others try to cope by 'burying' their sadness, in which case they may suddenly react when another sad event occurs. Remember to be on the lookout at the time of anniversaries – birthdays or the anniversary of the death, or when there is other bad news. Always be ready to listen.

Shock and denial

"I feel fine", "This can't be happening to me", "This isn't true"

The first response to news of the death of someone close is shock. A child may react with silent withdrawal or an outburst of crying and screaming. A very young child who does not quite understand what is going on may feel a painful sense of confusion rather than shock. Denial is often a necessary process to survive the immediate aftermath of loss, helping individuals to absorb and understand what is happening. The bereaved may act and talk as if the dead person is still there or might return. This is not due to a childish misunderstanding of the nature of death; some form of denial is experienced by many adults as well as children in the early days of bereavement. Denial can often shield the child or young person from becoming completely overwhelmed with grief.

Anger

"How can this happen to me", "Life is not fair", "Who is to blame"

As individuals adjust to their new reality, they are likely to experience extreme emotional discomfort. There are many emotions that underpin the anger stage, it can often involve waves of intense frustration, irritation, resentment and anxiety. The bereaved may be angry at the at the departed for leaving them or themselves for missing opportunities lost for ever, feelings of guilt due to unresolved issues or negative feelings about the lost person or anxiety about the changed situation which may bring new responsibilities. The anger may be directed at those they feel are responsible for their grief, for example, the deceased, the bereaved themselves, family and friends, support services, or God. Expressing anger enables individuals to express emotion without revealing their vulnerability, however they may be perceived as unapproachable by others in moments when they need comfort, connection and reassurance.

Depression ad detachment

"What's the point?", "Why should I even bother?", "Why go on at all?"

As individuals come to terms with what has happened, we look at the reality of our situation. As the initial panic and emotional fog begins to clear, individuals start to feel the loss more abundantly. Individuals often feel overwhelmed, helpless, hopeless and empty. During this stage you may notice children and young people becoming withdrawn and isolating themselves, becoming less sociable and reaching out for support less.

Dialogue and bargaining

"I'll do anything to see them again", "If only I...", "What if I..."

Whilst coping with loss, individuals can feel so desperate that they are willing to do almost anything to alleviate or minimise the pain. The normal reaction to feelings of helplessness and vulnerability is often to try and regain control whereby individuals cling to a desperate yet false hope. It is common for guilt to coincide with this, with individuals focussing on personal faults or regrets. Individuals may plead with God, or the universe, or may obsess over an alternative 'what if' scenario that could prevent or have prevented whatever is causing their grief.

Acceptance

"I'm going to be OK"

During this stage, individuals begin to accept their new reality and believe they will be okay, although they will still feel the pain of loss. They start to come to terms the fact that their life will never be the same but it is possible to live a new reality. The child or young person begins to re-enter reality and their emotions begin to stabilise. During this period of adjustment and readjustment, the child or young person will have good and bad days but the good days will begin to outnumber the bad.

Growing around grief

An alternative way of viewing grief is the idea of growing around grief (Tonkins,1996). This model suggests that grief initially consumes all areas of our lives but over time the bereft person grows around their grief with it remaining the same size and intensity. This model acknowledges that grief doesn't always disappear over time, although grief stays the same, it no longer dominates life. For many bereft people, the idea of moving on or forgetting can be problematic and thus this model helps integrate the loss into their lives and validates these intense feelings. The bereft person will engage in everyday activities, have new experiences, meet new people and begin to find moments of joy, as these become more frequent the grief is no longer all-encompassing. A bereaved pupil may find this model useful, either if they are feeling overwhelmed by their grief or feeling guilty got moving on with their lives or having fun. The grief has not diminished but has become part of the bereaved pupil's new life.

Tonkin's model of grief

How children and young people cope with grief

Children and young people experience the same range of emotions as adults during loss but these may only be shown occasionally and for brief periods or it may come in all-encompassing waves. They are often unable to verbalise emotions and so express their feelings through their behaviour. Reactions to loss can be classified in to four categories: physical, emotional, cognitive and social – examples of typical responses they may be evident are listed below:

How a child or young person grieves can depend on a variety of factors, for example, age, gender, developmental stage, personality, family circumstances, level of support around them. Children have different levels of understanding and reactions at different ages and stages of development. It is important to have an understanding and awareness of how children and young people understand death and possible reactions. Some behaviours, such as increased hyperactivity, distractibility or an inability to concentrate could be misinterpreted as ADHD.

The inability to perceive and comprehend death may lead to grief reactions in which general distress, regression, separation anxiety or sleep disturbances are often encountered. Whereas, those who have a clear perception of death will more commonly express their feelings through existential questions, anxiety, difficulties in studying, feelings of isolation or risky behaviour.

The table below offers a broad description of a child's understanding of death according to their developmental stage – of course this is dependent on their experiences and cognitive/language ability.

Note: Magical thinking describes a child's tendency to create creative, implausible theories for events in their lives. Children can create theories that are within their comprehension or ability to control.

Supporting children through bereavement

Whilst schools may observe the phases of grief described above, more generally pupils may lack concentration, experience tiredness in school or show more immature behaviours (for example, sucking thumb or physical clinging). Teachers will need patience in managing withdrawn behaviour, irritability or increased nervousness and anxiety.

When supporting pupils, show that you are concerned and willing to discuss the bereavement. Make opportunities for the child to have a private discussion, for example, through staying behind to help with a task. However, if the child does not want to talk, respect their right to privacy. The child may not want to express their feeling at all, or may prefer to use painting, drawing or unstructured play.
If the child does want to talk:

• listen with full attention
• avoid emphasis on advice or interpretation
• basic counselling skills will be helpful, such as simple acknowledgement of what has been said, reflecting back what the child has said, naming the emotions you hear, and summarising briefly what has been said
• answer questions as accurately and honestly as you can
• try to give the message that the feelings of bereavement are natural and normal

Some people may not feel they are the 'best person' to do this kind of thing, but if they are trusted by the child, and have a pre-existing relationship, then they may be more useful than a more experienced, but unfamiliar, adult. However, if the teacher, for whatever reason, would rather not attempt to engage the child, then the management team in the school must be sensitive to this and offer someone else.

Academic support

Try not to single out the child for special privileges – they need to feel part of their peer group and should be expected to take part in the normal activities of school and classroom. At the same time, allowances may have to be made in terms of the quantity and quality of work expected of the child. Helpful modifications of academic requirements might include adapting assignments in light of the pupils' ability to focus, changing the focus or timing of a lesson or excuse the pupil if the topic may be a reminder and rescheduling or modifying tests. Changes in the home environment and routines may also make it difficult to complete homework (Schonfeld and Demaria, 2018).

Peer support

The pupil's friends may benefit from a discussion to help them explore the best ways of being supportive. The goal of these discussions is to provide sufficient accurate information, dispel rumours, gives peers the opportunity to ask questions, offer concrete advice and practical suggestions (e.g. discuss ways to start a conversation with someone who is grieving), provide a safe environment for peers to share thoughts, feelings, experiences and fears and signpost to support available in school and at home (Schonfeld and Demaria, 2018). Ensure that other members of staff are aware what has happened, so that the pupil is not unnecessarily upset by a chance remark.

Managing grief triggers

In order to help grieving pupils feel safe school staff can support them to prepare and plan for grief triggers. This may include identifying a safe space for them to go until they are ready to re-engage, establish a procedure for them to leave the classroom if they are feeling overwhelmed (this may be through a hand signal, a note or a key phrase), identifying an adult who they feel they can speak to and allowing the child to call a parent or family member if needed (Schonfeld and Demaria, 2018). Long term, remembering special days (such as a birthday or the anniversary of the death) and important transitions may be helpful. It may be a particularly difficult day, but teachers can acknowledge the loss, whilst at the same time helping pupils to realise how far they have come.

When to refer for further support

Where an individual is experiencing:

• persistent and intrusive thoughts, dreams or flashbacks to do with the distressing event;
• avoidance of features associated with the distressing event; and / or
• physical, cognitive, emotional/behavioural symptoms as noted above, for at least 1 month then serious consideration should be given to accessing specialist child mental health services. You will obviously want to discuss this with the family and referral can be made to Child and Adolescent Family Services and/or to a specialist support organisation.

Supporting adults through bereavement

The initial concern following a critical incident is to meet the needs of the pupils. All staff play an important role in establishing a school climate that supports grieving children and young people. Thus it is important to be aware of the toll on staff members and to recognise and address the needs of all school staff (for example, including office staff, lunchtime supervisors). Supporting grieving and emotionally vulnerable children and young people can trigger a range of reactions in school staff. It can be distressing to witness the distress of children as they grieve. The expression of these emotions and grief can remind adults of losses and traumas in their own lives. It is also important to note that after a critical incident school staff experience many of the same emotions and reactions as the pupils.

School staff may become overwhelmed by the sudden and prolonged impact and need for their support and are at an increased risk of compassion fatigue. Compassion fatigue refers to the stress resulting from supporting a traumatised or suffering person leading to a decrease in a person's capacity to empathise with those who are suffering. From Schonfeld and Demaria (2018) and Hoffman et al. (2007)

Following a critical incident, whilst school staff are supporting pupils, it is essential to consider stress-management and staff wellbeing. School staff need to take care of themselves whilst helping others. The following suggestions may prevent burnout:

• Know your limitations and what situations you feel comfortable handling
• Know your own triggers for stress
• Understand when your own experience with trauma may interfere with your ability to provide support
• Recognise and heed the early warning signs of burnout
• Be clear about your role and work as part of a team
• Try and maintain normal daily routines
• Connect with trusted friends and family members who can support you and ask for help if needed
• Eat healthy food and drink plenty of water
• Try to get some restful sleep and take frequent rest breaks
• Maintain your typical exercise routine
• Give yourself permission to do things you enjoy
• Avoid excessive news coverage of the incident
• Do things that reduce stress for you (for example, go for a walk, meditate, read, listen to music)
• Take time at the end of this day to process or debrief the events of the day with colleagues. It is helpful to spend time with those who understand the stressors
• Use a buddy-system so colleagues can monitor each other's stress reactions
• Be kind and gentle on yourself and others

From Paine (2009)

The NHS provide information and suggestions for improving mental health and wellbeing. These include:

• Connecting with other people – such as having stay in touch with friends and family, lunch with a colleague, arranging a day out with a friend or putting 5 minutes aside to find out how someone really is.
• Being physically active – such as going for a walk at lunchtime, walking to work, taking the stair or organising a work sporting activity
• Learning a new skill – such as try learning a new word or to cook something new, work on a DIY project or try a new hobby
• Take notice/Giving to others – such as spending time with family and friends who need company, offering help, take notice of how your colleagues are feeling or acting
• Paying attention to the present moment – such as through mindfulness activities

A general change in behaviour may be a signs that a staff member is having difficulty coping and may require further support or signposting. This change could include an increase in absences, poor timekeeping, physical symptoms (headaches, constant tiredness), changes in performance (for example, not getting things done, out of character errors) or unusual displays of emotion (for example, increased irritability, anxiousness, tearfulness)

Children with Special Educational Needs

Children with Special Educational Needs (SEN) may well share the same depth of grief as others, although they may express their emotions and feelings differently. Some children with SEN may not grieve immediately or in the same way as expected by others. They may also not be able to communicate their grief or feelings of loss and as such their grief may not be recognised or supported (Clements et al., 2004). Children with SEN can require additional support and guidance to help them navigate through their grief.

Responses to loss

Although children with SEN are likely to experience a range of grief reactions similar to their peers, their reactions may not be as easy to identify. It is important to be able to identify and acknowledge their loss. Children with learning difficulties may have less vocabulary and tend to communicate their grief and express their feelings through behaviour rather than words, for example, an increase in frequency and severity of these maladaptive behaviours may indicate recognition that something has changed and they are attempting to comprehend and cope with that change. A variety of these responses are listed below:

• Aberrant behaviours
• Somatic complaints (for example, headaches or stomach aches)
• Relationship difficulties
• Social withdrawal
• Decrease in self-confidence and self-worth
• Increased compulsivity and ritualising behaviours
• Increased hyperactivity
• Intensified frustration
• Increase in acts of aggression
• Protest behaviours aimed at defending themselves
• Increase in repetitive behaviours such as self-stimulatory actions (for example, rocking, head banging, flapping)
• Self-injurious actions
• Suicidal statements

Adapted from Sormanti and Ballan (2011)

Supporting children and young people with SEN through bereavement

Although strategies noted earlier may be suitable for many children with SEN, it is important to consider further strategies or adaptations that may be required. SEN teachers are instrumental in planning and providing support during for pupils with SEN during crises (Clarke et al., 2014). The table below describes some common difficulties children with SEN may experience in regards to loss and suggests strategies to address these.

Adapted from Sormanti and Ballan (2011)

Tips for supporting children and young people with SEN through loss

• Recognise children with SEN experience grief although this may be expressed differently to their peers.
• Identify aggressive and self-harming behaviours, increased frustration and compulsivity, relationship difficulties, somatic complaints, and social withdrawal as possible behavioural expressions of grief. Anticipate an increase in self-stimulatory behaviours.
• Some children and young people with SEN are 'concrete thinkers' and find abstract concepts difficult to understand. Thus communication about death and dying should be multi-sensory and use a number of mediums to ensure understanding.
• Explore their understanding of death and provide cognitively appropriate materials to supplement the learning process. Explain the facts of death as clearly and simple as possible avoiding euphemisms.
• Provide information about the grief and mourning process – affirming a range of emotions, cognitions, behaviours and physical reactions as understandable responses to a profound loss. Visuals such as a 'feelings chart' may help with the identification and description of responses.
• Discuss the purpose of rituals, such as wakes, memorials, funerals and burials. Be explicit and specific regarding what the child should expect. The use of pictures, photographs or story books may help with increasing their familiarity and comfort with new words and activities related to death.
• You do not need to shield the child from the reality of death and mourning rituals, this may impede on the natural coping mechanisms and delay grief reactions.
• Consider offering activities that facilitate non-verbal expressions of grief, for example, art, dance, music, drama, yoga.
• Encourage school staff and family members to allow children and young people to participate in designing and implementing activities related to their loved one's death. Specific examples include post-death arrangements (e.g. choosing an outfit), ceremonial events (for example, handing out song sheets), acknowledgements of support and activities that facilitate the grief process (e.g. drawing pictures of memories, gathering mementos, creating memorials).
• Maintain children's routine to minimise change and associated 'secondary' losses. Familiar activities and daily schedules help facilitate a sense of safety and control.
• Support children's play and engagement in a range of creative activities such as gentle stretching, building or cooking, these can be natural outlets for anxiety and help children cope with difficult and confusing thoughts, feelings and situations in a constructive and safe way.
• Promote children's participation in a bereavement support group of bereavement-focused activity with non-SEN peers. Children with SEN can often be quite open with sharing their views and this may enable all group members to speak more freely. Whilst the child with SEN may take pride in knowing they have contributed meaningfully and supported others. Simultaneously, children with SEN may learn new expressions of grief and find comfort from those who have experienced a similar loss. Group facilitators need to identify and use appropriate modes of communication with the child.
• Provide parents/carers with ongoing support and guidance about the normative process of grief.
• Assess for potential complicated grief across time, particularly at six months after a significant loss whereby additional mental health support may be required.

From Sormanti and Ballan, 2011

Social and communication difficulties

For those with limited communication skills, their reactions may not be noticeable or even interpreted as grief responses and so enhanced monitoring is needed (Clements et al., 2004). Staff need to be mindful that all communication should be age- and developmentally-appropriate. Children and young people also require opportunities and support to communicate with those close to them about their loss. Visual, practical and multi-sensory methods may help children and young people to comprehend the situation and express themselves. Visual supports may include tactile objects/objects of reference, photographs, videos, coloured pictures, line drawing, symbols, written words, etc. Further ideas are presented below:

• Explain death within a life cycle, for example using insects, plants or animals to demonstrate the cycle
• Looking together at photographs of the person who has died and sharing memories
• Greetings cards sent to, or received by the parent/sibling who has died
• An item of clothing worn by the parent/sibling
• A cushion made from an item of remembered clothing
• Listening to the parent/sibling's favourite music
• A book made about the person who has died
• A candle lit on special days
• A comfort object can be an aid for getting through difficult moments, especially at school, such as a small comforter or a recognisable item of clothing that belonged to the person who has died
• Putting together a memory box of tangible reminders of the person who has died can give great comfort. This should be their personal collection of reminders of who that person was and what they meant to them. It also gives a child some control back in their lives as they choose what does and what does not go into their box. Children with special needs (they are children first and foremost) are particularly likely to feel the frustration of adults taking over at this time
• There are storybooks available for bereaved children, for example:
  Badgers Parting Gifts (Varley) which describes the sadness associated with the death of badger but also of the joy experienced by the other animals when recalling their many memories of times with their friend.
  Grandpa (John Burningham) – this book has very few words but tells the story of a girl's relationship with her grandpa, on the last page the grandpa's chair is empty signifying his death. The pictures can be used to elicit discussion about how they feel
• There are also many videos and animations suitable for bereaved children, for example, Small Creature by the British Heart Foundation which is designed to support children aged 3 to 11 who are dealing with grief, exploring emotions and possible ways to deal with those feelings.

Further information for supporting those with Special Educational Needs and Disabilities (SEND) and Autism spectrum disorder (ASD)

• Winston's Wish – provides additional information and resources for supporting bereaved children with SEND
• Gray's Guide to Loss, Learning and Children with ASD
• National Autistic Society – provides additional information and resources for supporting bereaved children with ASD
• Child Bereavement UK – provides additional information and resources for supporting bereaved children with SEND and ASD Information to help bereaved children with SEND
  Information to help bereaved children with ASD
• Down's Syndrome Association – provides additional information and resources for supporting bereaved children with Down's
• Mencap - provides additional information and resources for supporting bereaved children with learning disabilities

Faith perspectives and customs associated with death

Responses to death and the rituals and beliefs surrounding it tend to vary widely across the world. The various rituals and ceremonies that are performed are primarily concerned with the explanation, validation and integration of a peoples' view of the world. The following summaries provide a brief, general guide to belief and practice. In all situations it is wise to consult the family on their wishes.

Buddhism

• Buddhism holds to the concept of rebirth.
• Funerals are dignified but not sad.
• The body is usually cremated and the ashes scattered or buried – a tree may be planted where the ashes are scattered, as a symbol of the earth bringing forth new life, part of the cycle of life and death. Buddhists do not believe in God.

Christianity

• Christians believe in life after death, following the resurrection of Jesus.
• Bodies may be cremated or buried, and there may also be a memorial service.
• In Catholic churches, mass is said for the dead and candles may be lit, with prayers to help the soul on its path to heaven

Hinduism

• Hindus believe in reincarnation. The soul has to be born over and over again to achieve the purity which will allow it to return to its creator.
• Family advice should be sought on the procedures they wish to follow.
• This may include readings from the holy books and sprinkling of holy water.
• Members of the family will bathe and prepare the body for cremation, which should take place within 24 hours of death.
• The ashes will be scattered in a flowing river.
• 10 to 13 days of mourning are observed.

Islam

• Muslims believe that the soul leaves the body at the point of death and Muslim law decrees that the body belongs to Allah and must not be interfered with once the soul has departed.
• A dying patient may wish to be faced towards Mecca (south-east).
• Following death, ritual washing and prayers are carried out by Muslims/at the mosque.
• Burial should take place within 24 hours of death. (Cremation would prevent the soul from reaching heaven.)
• Men wear white as a sign of mourning and purity; women do not attend burials.

Rastafari

• Rastafarians celebrate life rather than death.
• Bodies will be prepared for burial by the family or an undertaker and attendance at funerals is not emphasised.

Judaism

• Jewish people believe that on death the soul returns to G-d (the name is never written in full.)
• Later the dead will be reborn and G-d will reign supreme.
• There are many regional differences in the customs surrounding death and the family should be consulted on their wishes.
• The last rites are carried out by the holy society, who wash the body and prepare it for burial, which should be within 24 hours – the eyes should be closed.
• The dead should not be left unattended.
• Cremation is not permitted.
• Two of the most important commandments in Judaism are to honour the dead and comfort the mourner.
• Mourning has 4 stages, which take place in the year following death.

Secular Humanism

• Humanists do not believe in God or an after-life.
• People live on in the lives of those who survive them.
• Funerals remember and honour the person who died.
• Ceremonial is kept to a minimum.

Sikhism

• A dying person may be comforted by the reciting of hymns.
• The family is responsible for all rites and ceremonies on death, and should be consulted on their wishes.
• Special regard should be given to jewellery and clothing, which may have special significance; hair is kept up in a knot.
• Sikhs are always cremated and the ashes scattered in flowing water.
• White is the colour of mourning.

Travellers

• Traditions and customs will differ from family to family, and each family should be consulted on their wishes.
• Keeping vigil and viewing the body are common. Burial is the usual practice.
• Funerals are important social events, and children or young people may be absent from school to attend a funeral.
• Traditionally, close family wear black for 12 months following the funeral.

Vietnamese

• The body is usually kept at home for 2 to 3 days following death for people to pay respects.
• At the funeral prayers will be said for the departed, who will be buried. The family altar will be wrapped in a white cloth for a month after the death.

Acknowledgements

"Concise guide to the customs of minority ethnic religions" (Collins et al)

"Death and bereavement across cultures" (Parkes, Laungani, Young)

"Guidelines on managing bereavement in schools" (Cambridgeshire County Council)

Resources and signposting

Books

Inclusion on this book list does not constitute a recommendation, as we are aware that members of the school community have different needs, and incidents can vary widely.

• Managing a Critical Incident
• Trauma
• Children with a terminal or life threatening illness
• Supporting bereaved children
• Suicide
• Early Years and Primary
• Late primary and early secondary
• Secondary
• Workbooks
• Teaching about death and bereavement in the curriculum

Managing a Critical Incident

'Wise Before the Event' – Coping with Crises in Schools
W Yule and A Gold
Calouste Gulbenkian Foundation
ISBN: 0-903319-66-7

There and back again
School shootings as experienced by school leaders
Albert H. Fein
ISBN-10: 0810845024

Order from Chaos
Responding to traumatic events
Marion Gibson
ISBN: 1861346972

Workplace Trauma
Noreen Tehrani
ISBN: 1583918760

A student dies – a school mourns
Ralph Klicker
ISBN: 1560327421

Handling death and bereavement at work
David Charles-Edwards
ISBN: 0415347254

School based crisis Intervention
Mellissa Allen Heath and Dawn Sheen
ISBN: 1-59385-151-0

Crisis Management and the school community
Mardie Whitle (Edt)
ISBN: 0-86431-624-0

Trauma

Post-traumatic stress
Stephen Regel and Stephen Joseph
ISBN-10: 0199566585

Post traumatic stress disorder
Patrick Smith, Sean Perrin, William Yule and David M. Clark
ISBN-10: 0415391644

Supporting traumatized children and teenagers
Atle Dyregrov
ISBN-10: 1849050341

Reconstructing early intervention after trauma
Roderick Orner and Ulrich Schnyder
ISBN-10: 0198508344

Children with a terminal or life threatening illness

Supporting the child and the family in paediatric palliative care
Erica Brown with Brian Warr
ISBN-10: 1843101815

When someone has a very serious illness
Children can learn to cope with loss and change
Marge Heegaard
ISBN-10: 0962050245

When I die, will I get better?
Joeri and Piet Breebaart
ISBN-10: 0872263754

Joe has Leukaemia
Clic Sargent
ISBN-10: 1848412460

Lucy has a Tumour
Clic Sargent

Chemotherapy, Cakes and Cancer
Megan Blunt

A parents guide to children's cancer
Macmillan Cancer Support

Cancer… what's the score
Clic Sargent

When your Mum or Dad has cancer
Ann Couldrick
ISBN-10: 0951753738
The Secret C
Julie A. Stokes
ISBN-10: 0955953928

Need to know cancer
Oliver Gillie
ISBN-10: 0431188424

Cancer and treatment: A guide for young people
Clic Sargeant

Supporting bereaved children

Grief in Children. A Handbook for Adults.
A Dyregrove
Jessica Kingsley (pub) 1990.
ISBN: 1-8530-2-113-X

The little book of bereavement for schools
Ian Gilbert
ISBN-10: 1845904648

An Intimate Loneliness: Supporting Bereaved Parents and Siblings
G Riches and P Dawson
Open University Press. 2000.
ISBN: 0-9523281-0-0

Children and Grief – When A Parent Dies
J W Worden
Guildford Press. 1996.
ISBN: 1-57230-148-1

Death and Loss – Compassionate Approaches In The Classroom
Oliver Leaman
Cassell. 1996.
ISBN: 0-304-33089-2

Grief in young children – a handbook for adults
Atle Dyregrov
ISBN-10: 1843106507

Loss, Change and Grief
E Brown
David Fulton Pubs.
ISBN-10: 1853464651

Childhood Bereavement
Developing the curriculum and pastoral support
Nina Job and Gill Frances
ISBN-10: 1904787142

Death and Bereavement (2)
Helping children understand
Desmond Spiers
ISBN-10: 0948664258

Effective Grief and Bereavement Support
Kari and Atle Dyregrov
ISBN-10: 1843106671

Supporting bereaved children and young people in school
The Child Bereavement Trust (Pack)

Remember me too
Child Bereavement in a nutshell
Simon Barton
Penhaligons Friends
ISBN-13: 978-0955075704

Talking about death and bereavement in school
How to help children aged 4-11 to feel supported and understood
Ann Chadwick
ISBN-13: 978-1849052467

The grieving teen
Helen Fitzgerald
978-0-684-86804-02

Suicide

Beyond the rough rock
Supporting a child who has been bereaved through suicide
ISBN-13: 978-0953912377

Suicidal Children and Adolescents: Crisis and preventative Care
S Rioch
ISBN: 0-9523281-0-0

Someone I love died by suicide
Doreen Cammurata
ISBN: 978-0-9788681-9-2

The power to prevent suicide
Ricky Nelson, Judith Galas
ISBN: 1-57542-206-9

Beyond the rough rock
Winston's Wish
ISBN: 0-9539123-7-X

Early Years and primary

Badgers Parting Gifts
Susan Varley
ISBN-13: 978-0006643173

I miss you – A first look at death
Pat Thomas
ISBN-13: 978-0750260824

When Uncle Bob died
Althea Braithwaite
ISBN-13: 978-1903285084

Dear grandma bunny
Dick Bruna
ISBN: 9781405219013

The Small Creature
Resource Pack by the British Heart Foundation

Someone has died suddenly
Mary Williams
ISBN-13: 978-1906409104

Always and forever
Alan Durrant
ISBN-13: 978-0552548779

Samantha's missing smile
Julie Kaplow and Donna Pincus
ISBN-13: 978-1591478096

Remembering Mum
Ginny Perkins and Leon Morris
ISBN-13: 978-0713644326

When Dinosaurs die
Laurie Krasny Brown and Marc Brown
ISBN-13: 978-0316119559

A place in my heart
Annette Aubrey
ISBN-13: 978-1848350045

Saying Goodbye to Daddy
Judith Vigna
ISBN-13: 978-0807572535

Grandpa
John Burningham
ISBN-13: 978-0099434085

Is Daddy coming back in a minute
Elke and Alex Barber
ISBN: 978-0-9574745-0-5

Missing Mummy
Rebecca Cobb
978-0-230-749514-1

Evie and the Man who helped God
Michael Foreman
ISBN: 1-84270-219-X

Late primary and early secondary

Milly's Bug Nut
Jill Janney
ISBN-13: 978-0953912346

Saying good-bye to a friend
Nicola Edwards
ISBN-13: 978-1841388366

What on earth do you do when someone dies
Trevor Romain
ISBN-13: 978-1575420554

The Cat Mummy
Jacqueline Wilson
ISBN-13: 978-0440868576

Drop Dead
Babette Cole
ISBN-13: 978-0099659112

The Scar
Charlotte Moundlic
ISBN-13: 978-1406335958

When a friend dies
Marilyn Gootman
ISBN-13: 978-1575421704

Secondary

Out of the blue – making memories last when someone has died
Julie Stokes and Pau Oxley
ISBN-13: 978-1903458716

Artichoke Hearts
Sita Brahmachari
ISBN-13: 978-0330517911

A taste of blackberries
Doris Buchanan Smith
ISBN-13: 978-0807212660

What is goodbye?
Nikki Grimes
ISBN-13: 978-0807212660

Michael Rosen's Sad Book
Michael Rosen and Quentin Blake
ISBN-13: 978-1406317848

A bit of a Hero
Gervase Phinin
ISBN-13: 978-1842709092

A monster calls
Patrick Ness
ISBN: 978-1-4063-1152-5

Lob
Linda Newberry
ISBN: 978-1-849-92049-0

Healing your grieving heart – for teens
Alan Wolfelt
ISBN: 978-1-879651-23-4

Workbooks

Muddles, Puddles and Sunshine
Diana Crossley
ISBN-13: 978-1869890582

Hope beyond the headlines
Supporting a bereaved child through murder or manslaughter
Winston's Wish
ISBN-13: 978-0955953910

Talking With Children and Young People About Death and Dying
M Turner
ISBN: 1-85302-563-1

When Someone Very Special Dies.
Marge Heegaard
ISBN-13: 978-0962050206

When something terrible happens
Children can learn to cope with grief
Marge Heegaard
ISBN-13: 978-0962050237

When Someone Has A Very Serious illness
Marge Heegaard
Woodland press
Workbook for 6-12 year olds
ISBN-13: 978-0962050244

Finding your own way to grieve
Karla Herbert
ISBN: 978-1-84905-922-0

Because someone I love has cancer
American Cancer Society
ISBN: 0-944235-32-8

Supporting teenagers through grief and loss
Anna Jacobs
ISBN: 978-0-906531-59-1

You don't understand – supporting bereaved teenagers
Winstons Wish
ISBN: 0955953952

Out of the blue
Julie Stokes and Paul Oxley
ISBN: 9-781903-458716

Teaching about death and bereavement in the curriculum

When a pet dies
Fred Rogers
ISBN-13: 978-0698116665

Waterbugs and Dragonflies
Doris Stickney
ISBN-13: 978-0829816242

What's happening – Death
Karen Bryant-Mole
ISBN-13: 978-0750213790

Life's End
Cath Senker
ISBN: 978-0750249775

Lifetimes
Bryon Mellonie and Robert Ingpen
ISBN: 978-0-553-34402-8

Grief, Bereavement and Change
Penny Cadagli and Francis Gobey
Daniels Publishing

How can I deal with when people die
Sally Hewitt
ISBN: 978-0-7496-7090-0

The tenth good thing about Barney
Judith Viorst
ISBN-13: 978-0689712036

Helping children think about bereavement
Heather Butler
ISBN: 978-0-415-353685-1

What does dead mean
Caroline Jay and Jenni Thomas
ISBN: 978-1-84905-355-6

Talking with children and young people about death and dying
Mary Turner
ISBN: 978-1-84310-441-4