How to help a child after a traumatic event

A car accident. A house fire. A frightening medical stay, a sudden death in the family, violence at school or at home. When something scary happens to a child, parents often ask me the same two questions: “Is what I’m seeing normal?” and “What do I do now?”

The honest answer to the first question is usually “yes, for now.” The second question has a longer answer, and it’s one you can start on today.

What reactions are common after a traumatic event?

Children don’t always show distress the way adults expect. How they react depends a lot on their age.

Young children (roughly 5 and under) may cling to you, cry more, or go back to things they had outgrown, like bed-wetting, thumb-sucking or not wanting to sleep alone. The National Institute of Mental Health lists these among the common reactions. Some little ones play out the event over and over. The National Child Traumatic Stress Network (NCTSN) describes this “traumatic play” as more repetitive and less imaginative than ordinary play.

School-age children may worry a great deal about their own safety and the safety of people they love. They may feel guilty about what they did or didn’t do, retell the story again and again, sleep badly, have trouble concentrating, or complain of stomachaches and headaches (NCTSN). Some become afraid to go to school or pull back from friends (SAMHSA, 2023).

Teenagers are often self-conscious about their feelings and may hide them, even from themselves. They may withdraw, feel ashamed, or take more risks than usual. NIMH notes that some teens turn to alcohol, drugs or tobacco after a trauma.

Which reactions usually ease, and which need more help?

Here is the part I most want you to hear: most children do recover. SAMHSA’s guide for parents puts it simply: “Most of the time they get back to feeling okay soon after a trauma.” NIMH says many of these reactions “are normal and will lessen with time.”

Time on its own isn’t the whole story, though. Children recover best with steady, caring adults around them. And some children need more than that.

Consider reaching out for professional help if:

Strong reactions are still there after a few weeks. SAMHSA suggests more help if behaviors last more than 2 to 4 weeks; NIMH says to contact a health care provider if symptoms last more than a month.
Reactions show up later, weeks or months after things seemed to settle. SAMHSA notes that this happens too.
Your child has flashbacks, a racing heart and sweating, jumps at small noises, seems emotionally numb, or is very sad or depressed (NIMH).
Daily life is getting harder: school refusal, losing friends, sleep that isn’t improving, or big changes in eating.
Your teen is using alcohol or drugs, taking serious risks, or talking about hurting themselves.

It’s also a good idea to let your child’s pediatrician know what happened. They can rule out physical causes for sleep or stomach problems and help you think through next steps.

If your child is in danger or talking about suicide, call 911 in an emergency, or call or text 988. In Washington County you can also call the crisis line at 503-291-9111. You’ll find more numbers on my resources page.

What can I do at home to help my child?

You don’t need special training to make a real difference. Children look to the adults around them to decide whether the world is safe again. NIMH puts it this way: how adults respond to trauma “can strongly influence” how children react.

Bring back routine. Predictable days tell a child’s nervous system that things are steady again. NIMH suggests sticking to things like bedtime stories, family dinners and games. The American Academy of Pediatrics recommends keeping regular times for meals and bed and explaining changes to the schedule ahead of time (HealthyChildren.org, 2026).

Offer safety and reassurance. Tell them, often and plainly, that they are safe now and that you are taking care of things. Physical comfort and one-on-one time matter, especially for younger children (HealthyChildren.org).

Listen more than you talk. Let your child talk, draw or play about what happened if they want to. Don’t push for details, and don’t stop them either. Answer their questions honestly in words that fit their age. If they’ve got the facts wrong, or they believe it was their fault, gently correct that (NCTSN).

Limit news and social media. Repeated images of a frightening event can keep fear going. NIMH advises limiting children’s exposure to repeated news reports about traumatic events. With teens, watch or read together so you can talk about it.

Help them calm their body. Slow belly breathing, stretching, and tensing and releasing muscles can help a child settle, and they’re easier to learn when things are calm (HealthyChildren.org).

Look after yourself too. This isn’t a luxury. NIMH notes that when caregivers take steps to support their own ability to cope, “they can provide better care for others.” SAMHSA encourages parents to model self-care: regular meals, sleep, exercise and slow breaths. If the event affected you as well, you may need support of your own. I work with adults after trauma too, and you can read more on my trauma and PTSD page.

How does therapy for children after trauma work?

Therapy after trauma isn’t about making a child relive the worst day of their life. It’s about helping them feel safe, understand what happened, handle their feelings, and slowly get back to being a kid.

Trauma-focused CBT. The most studied approach for children is Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). NCTSN describes it as an evidence-based treatment for young people aged 3 to 18. Parents have their own sessions alongside the child’s, plus joint sessions. It has been tested in 25 randomized controlled trials and usually takes 8 to 25 sessions. A 2023 meta-analysis of 33 studies found large improvements in post-traumatic stress symptoms that were still there at the 12-month follow-up. Children’s and caregivers’ reports of those improvements largely agreed (Thielemann et al., 2023). It doesn’t help every child, but it has strong support.

Play therapy for younger children. Young children often can’t explain in words what frightened them, but they can show it. In my playroom there are toys, art materials, a sand tray and games. A child might build a scene in the sand, act out an accident with toy cars, or draw a house over and over. Play gives them a safe distance from the memory, and we work with it at their pace. Play is how young children naturally make sense of their world, and it’s where I meet children aged 3 to 12.

Talking therapy for teens. Most teens would rather talk. I use CBT and mindfulness with them, to help them notice unhelpful thoughts, manage panic and sleep, and feel more in control.

You are part of it. Whatever the approach, parents matter. I begin by meeting with you on your own to hear what happened and what you’re seeing. I keep you updated on themes and progress, and I give you ideas to use at home. You know your child better than anyone, and your calm presence is one of the strongest supports they have.

If you’re wondering whether your child needs a therapist or just some time, my child and teen therapy page explains how I work.

A quick checklist for the weeks after

Keep meals, bedtime and school as normal as you can.
Tell your child they are safe, and show them with your presence.
Let them talk, draw or play about it without pushing.
Turn off the news around young children.
Watch for reactions that last more than a few weeks or show up later.
Tell your pediatrician what happened.
Look after your own sleep, meals and support.

Talk it through with me

If something frightening has happened to your child and you’re not sure what’s normal or what to do next, you don’t have to work it out alone. I offer a free phone consultation. We can talk about what you’re seeing and whether therapy might help. My office is in King City, a few minutes from central Tigard. Call me at 503-495-5072 or send me a message.

Sources

National Institute of Mental Health. Helping Children and Adolescents Cope With Traumatic Events. https://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-disasters-and-other-traumatic-events
Substance Abuse and Mental Health Services Administration (2023). Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A Guide for Parents, Caregivers, and Teachers (PEP23-01-01-012). https://library.samhsa.gov/sites/default/files/tips-help-children-cope-disaster-pep23-01-01-012.pdf
National Child Traumatic Stress Network. Age-Related Reactions to a Traumatic Event. https://www.nctsn.org/sites/default/files/resources/age_related_reactions_to_traumatic_events.pdf
American Academy of Pediatrics, HealthyChildren.org (2026). Childhood Trauma: 3 Ways to Help Kids Cope. https://www.healthychildren.org/English/healthy-living/emotional-wellness/Building-Resilience/Pages/Childhood-Trauma-3-Ways-to-Help-Kids-Cope.aspx
National Child Traumatic Stress Network. Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). https://www.nctsn.org/interventions/trauma-focused-cognitive-behavioral-therapy
Thielemann, J. F. B., Kasparik, B., KÃ¶nig, J., Unterhitzenberger, J., & Rosner, R. (2023). Stability of treatment effects and caregiver-reported outcomes: A meta-analysis of trauma-focused cognitive behavioral therapy for children and adolescents. Child Maltreatment, 29(2). https://doi.org/10.1177/10775595231167383