Episode 105 | How Child Life Specialists Help Kids and Families After Disasters

Podcast Show Notes

Today’s 12 minute talk became a 20+ minute talk, and Cara Smith and I discussed how parents can connect with their children after a disaster. Cara is an amazing pioneer in the child life field, and she has valuable tips both for child life specialists as well as for parents in the wake of a natural disaster, a pandemic, or any other stressful event.

In this episode, we talk about…

[1:41] Cara’s background

Cara Smith has been a child life specialist for 16-17 years. She started at Children’s Mercy Hospital in Kansas City, and she covered a number of different unites. Her first official unit was the emergency room and their urgent child abuse center, then she moved for the bulk of her career into trauma and burns, and she ended in the pediatric intensive care unit. After about eight years of that, the opportunity came along for her to jump into the academic world.  She took that plunge, and she has been working as a clinical instructor at Missouri State University for about nine years.  Taking on that position also allowed Cara to take on some work outside of the hospital world, which is an area she is super passionate about as far as child life is concerned.  

Cara currently works with the Police Athletic League, which is an organization that exists throughout the country. She works with the league in Kansas City, bringing together cops and kids to help build meaningful and healing relationships in the community. Cara is a member of their wellness and resiliency team, helping to meet some of the kids’ psychosocial and emotional needs and also doing some training with the police officers to provide a more trauma-informed approach to the great work that was already being done there.

In addition to this work, Cara was able to dive into child life work in disaster relief. She was able to go to the Bahamas after Hurricane Dorian and provide services there. That is when her eyes were really opened to just how meaningful the skillset and the role of child life can be in the disaster world. She got involved in some of the local work they were doing in the country as a program manager, helping to build relationships in the community, and then she became their trainer and educator. Cara is now mostly responsible for their webinar series that trains people to deploy to disaster zones as well as for general education for child life specialists.

[4:18] Burnout as a child life specialist

Cara’s first eight years in the field were very intense, and she thinks she reached a state of burnout. She doesn’t think it was burnout from the populations she was working with, because she really loved that work. The burnout, however, seemed to come from the administrative piece of child life. Also, as an individual Cara tends to feel like once she has conquered something she is ready to move on. There were some changes going on in her department, and she felt drawn to continue to work with more challenging populations in different ways.

[6:44] Cara’s experience working with children in the wake of a traumatic event

When Cara first went to the Bahamas, she traveled with two other child life specialists from Florida. They were given a letter from the Ministry of Health saying that they were child life specialists and should be allowed to do their work. There were wonderful people on the ground to provide housing and transportation, but essentially they showed up with this letter in hand and were taken to a huge gymnasium filled with people.

They walked in with their backpacks full of toys, and they were suddenly thrown into this environment without a clear plan. They had training, but until you’re in the situation with the sensory overwhelm and the kids running at you, it’s all hypothetical. It was an opportunity to go back to their roots of being a child life specialist and create that space for kids to feel safe and make connections.

In the wake of a disaster, there is so much uncertainty. That ability to pause, take a deep breath, and connect to your core as a child life specialist, reminds you that you have the skills and abilities within you. You don’t even need your backpack or your stuff. You are capable of walking into this environment and creating a safe space for kids to feel connected, safe, and able to open up.

There were moments when Cara was letting girls braid her hair, and they just started talking about their experiences. Cara didn’t ask, but they felt safe enough to open up on their own. One of the big things they talk about in their disaster relief training is that asking kids to talk about the stress immediately after the traumatic event can actually cause more long-term damage. Instead, they just create the space for child-directed play and connection. As they begin to open up and tell their stories, they are signaling that they are ready to process what they have gone through. Conversations can emerge organically, just as they evolve while sitting around the hospital playroom table. As a child life specialist, you are there to hold space as they process.

At another time, Cara was sitting by herself with a bunch of blocks in front of her. The kids had gone to lunch, and it was a rare moment of peace. A 12-year-old boy walked by and looked at her, and Cara asked him if he wanted to play. He sat down and began building, explaining that he was building his house. He talked about what his house looked like, and then went on to build a bridge. Cara gave him space, and he eventually came back around to sharing his experience with the hurricane and using the blocks to build parts of his story along the way.

He built the church that they had to run to so they could escape the water, and he described being scared of the wind. He built the boat they were rescued on, and he talked about how the driver wasn’t very good and what it smelled like as everyone was throwing up. Trauma is a multisensory experience and he was giving a full explanation of his experience. He brought Cara all the way to the shelter and then talked a little bit about the dreams he had been having. Cara didn’t have to do anything except be there and hold space for him. Creating the space for play allowed him to share his experiences and process his story. When he was done, he got up and went on his way. She never worked with him again, but they would share a connecting glance whenever they saw each other.

[14:13] Supporting caregivers after a disaster

Of course, in the hospital parents are experiencing the trauma of their children being ill or injured. In the disaster world, however, you are working with a whole community that has experienced trauma. The support systems that are normally there for parents to rely on aren’t necessarily there anymore.There is a greater level of chaos in the environment and parents are focused on the physical and primary needs of their families. They recognize the emotional needs of the kids and all the stress and trauma, but it’s a lot happening at once.  

This can also feel super overwhelming as a helper. One of the doctors they first met in the Bahamas talked about the “circle of concern”. She made a big circle with her arms, her fingers touching her head. She then made a smaller circle with her hands that she called our “circle of control”. As helpers, we have to recognize the difference between what we are going to see that is our concern and what we can control. We need to focus our attention on what we can control, and trust that other people are taking care of some of the other things.

There were some moments that allowed Cara to connect with parents. For example, one day she was working in the clinic that was readministering vaccines so children could go to school (since they no longer had proof they had been vaccinated). There was a terrified 4- or 5-year-old who was just screaming, and her mother was holding her. In that moment, Cara just went over and held the mother’s hand. There wasn’t much else to do. The kid was stressed. The family was stressed. Cara just held space, and afterwards the mother stood up with tears in her eyes and gave Cara a hug.

It is so difficult to know that you can’t take away the stress of these traumatic experiences for families. What you can do, however, is hold space for them to feel what they need to feel. In that moment, that mother felt helpless and Cara was able to step in and go through it with her. When it comes to parents, that is most important. Support comes from knowing you can’t fix it, but you can be with someone. That is probably all they can offer their children, as parents, in those moments as well. They can create a safe space to feel and share emotions.

One day, it was really windy in the gym. The child life specialists could tell this was creating a lot of anxiety, as a lot of kids talked about the wind being really scary during the hurricanes. A couple of the other child life specialists took the kids and a lot of the parents outside, where they got out their bubble wands and created tons of bubbles. Everyone was laughing and playing in the wind with the bubbles, and it was such a healing moment for everyone. The scariness of the wind turned into something playful and fun, and it wasn’t just for the kids.

Cara saw this in the hospital, and she saw it even more in the disaster world. Often parents will come in and play, because they need to process what they don’t have words for yet. Maybe they want to do an art project or play with something because it allows them an opportunity to pause. They need to recognize what they have been through and create that space for healing.

[21:39] Giving children the tools to be resilient

We hear over and over again that kids are resilient. Absolutely, kids are resilient. They’re also, however, more at-risk for long-term negative effects of trauma from disasters. They are resilient, but they are resilient when they are given the tools to be resilient. They will be fine, if we can support them. Research has identified five essential needs of kids after a disaster.

  1. Safety – We need to not only create a safe environment, but we also need to help kids feel safe within that environment. They need to allow their brains to relax and to turn off some of that hypervigilance for potential threats.
  2. Connections – Taking those moments to connect are critical, which is why play is so important. We need to help kids feel connected to others around them, as well as to nature.
  3. Self-regulation – This is where we need to remember we are not there to fix things. We aren’t there to make them chill out, but we are there to help them feel safe and feel connected while providing opportunities for them to regulate their emotions. As a child life specialist or helper in the field, Cara tells people that is the number one thing to work on before going into disaster work – you have to be able to regulate yourself in the midst of a crisis.
  4. Self-efficacy – It is important for children to feel like they are contributing to the healing within their environment. We need to help them feel like they have some control over what is going on and give them ways to help rebuild their community.
  5. Hope – We have to be careful with hope, in that we don’t want to provide hope before kids are ready for it. We don’t want to come in with a silver lining like, “At least you still have your family.” Rather, we need to recognize as the kids start to reflect and become more hopeful on their own. We can process that and highlight the positive moments or outcomes with them.

If we can help kids feel safe and connected, support them as they regulate their big feelings, give them a sense of control, and provide opportunities for hope, that is the nuts and bolts of what we need to do to support kids as parents, as caregivers, and as educators.

[24:29] Learning more about working as a child life specialist in disaster relief

If you want to learn more, there is information available on the Child Life Disaster Relief website. There is a ‘Get Involved’ button, and they also offer webinars and training. They cannot deploy and do the work they do if they don’t have the funds to support the people who are going, so fundraising is an appreciated way to get involved as well. The website also offers resources, and they always need people to help them develop new ones.  Cara would love to connect with anyone who is interested in learning more.

Connect with Cara:




Have you heard? The Child Life On Call mobile app for parents, kids and their care team will be available in 2022. Sign up to stay informed here

Child Life On Call is a community of parents and professionals that share ideas, stories and resources to help YOU navigate your child’s unique experiences. We give you strategies to support yourself and your family through life’s challenges. We are so glad you are here.

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