Only individuals who have been directly involved in terrorist attacks in Israel and have reported to an emergency room within a relatively short proscribed time limit are recognized as victims of terror by the healthcare system in Israel and therefore receive on-going free medical treatment for all related disorders.
Other family members, particularly children, may be deeply affected by what they have witnessed or experienced in their own homes as a result of the attacks. Often their symptoms of post traumatic stress may only become apparent over time and, since they do not meet the eligibility criteria, they will not receive state funded care for the post traumatic stress disorders that they suffer. Their only options are to pay for their own private treatment or to wait to receive treatment from the general psychiatry clinics, which are neither trained nor equipped to deal with them.
Sadly, many of the families who are affected and unable to cope are immigrants who have no network of family or community to help them in a crisis. The ripple effect can be devastating; first on the individual who was injured, then the disruption to the entire family, economic hardship sets in or is exacerbated, marital problems ensue and the whole fabric of the family can start to fall apart. Unfortunately, these are the very individuals who are unable to afford to pay for the care they need.
Children are extra vulnerable to trauma. They dont only react to the event but also to the way their parents deal with it. Children can become very clingy and start to have recurring nightmares. They may become withdrawn and distracted or aggressive, acting out what they have seen or how they interpret events. They can also develop somatic symptoms; nausea, aches and pains, fainting fits. The most important factor for children in these circumstances is the presence of an adult, providing reassurance, stability and security. For parents, who are themselves recovering from loss, injury or a post traumatic stress disorder, this can prove to be impossible.
One to One is committed to helping to identify individual children needing specialist support and to funding their treatment for as long as it is necessary.
One to One are also supporting the Israel Centre in expanding counselling and screening programmes into schools across Israel through the National Schools Intervention Programme (NISP). The project has three elements. Firstly, NISP is helping to educate and prepare teachers, school principals, guidance counsellors and school psychologists for crsis, disaster, trauma and trauma recovery.
Over 200 kindergarten teachers will have participated in a pilot training study by the end of 2003, impacting on 9000 kindergarten age children and then 500 high school teachers will be next. The focus is on developing and improving their skills in helping the children to explore their feelings and reactions to trauma and helping them with relaxation and other therapeutic techniques to overcome trauma in the classroom setting.
The second element of the programme is the screening of 4 - 18 year olds for symptoms of post traumatic stress; exposure, depression, anxiety, somatic responses and poor academic function. Over 1100 high school students have already been screened in the Jerusalem area. Screening will be taking place shortly in Eshkol, Afula, Hadera and Nazareth.
The final element has been designed to treat those identified in the screening process. Depending on the severity of the symptoms a child will either attend a six week school based intervention group lead by school mental health professionals or, for the more severely traumatised, group sessions run by specially trained trauma treatment psychologists. One to One is providing funding for some of the training and supervision of the trauma counsellors and teachers.
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