INTERVIEW

Surviving the unthinkable: A psychologist explains how to help kids recover after a school shooting

"Some will be dealing with this for the rest of their lives," says Dr. Philip J. Lazarus

Published March 28, 2023 9:01AM (EDT)

Children arrive at Woodmont Baptist Church to be reunited with their families after a mass shooting at The Covenant School on March 27, 2023 in Nashville, Tennessee. (Seth Herald/Getty Images)
Children arrive at Woodmont Baptist Church to be reunited with their families after a mass shooting at The Covenant School on March 27, 2023 in Nashville, Tennessee. (Seth Herald/Getty Images)

Monday's shooting at a Christian school in Nashville was a stark reminder of how frequently even young American children are exposed to gun violence. A Stanford study estimated that 100,000 schoolchildren in the U.S. attended a school at which a shooting occurred — and that was just in the two-year span from 2018 to 2019. The trauma of living through a shooting can last a lifetime: The same study found that students exposed to shootings at their school were less likely to graduate, less likely to be employed and had lower earnings in their mid-20s.

The Covenant School, where Monday's shooting occurred, is a private school that enrolls preschool through sixth-grade students and has about 200 students, according to a Nashville independent schools group. Now, after living through a shooting in which three of their peer students and three adults were slain, those students will face the social and psychological struggle of rebuilding their lives and their sense of security.

There have been so many school shootings in the U.S. that child psychologists and public health experts have developed a playbook for helping children who live through such tragedies. Dr. Philip J. Lazarus, an expert in school psychology and a professor at Florida International University, has spent decades studying school shootings and comforting the children who have lived through them.

Lazarus was the former president of the National Association of School Psychologists and helped co-found and chair the group's National Emergency Assistance Team, which leads crisis response in the aftermath of school shootings around the country. As a result, Lazarus not only has decades of experience studying and responding to school shootings, but also has observed school shootings became more common in the U.S. over the years.

Most students who bear witness to school shootings will have "at least some" of the symptoms of post-traumatic stress, Lazarus said. As for the psychological repercussions, "some will be dealing with this the rest of their lives." A child who experiences a school shooting firsthand may have issues concentrating, trouble sleeping, develop a fear of loud noises, experience mood swings, eating disorders or even "full-blown depression," he said.

Moreover, the impressionable young age of the children involved here — the three who died at The Covenant School were all reported as being 9 years old by the police — necessitates a slightly different counseling response, Lazarus noted.

Salon spoke at length with Lazarus about what happens to young children who experience a school shooting, how to help such children recover and how the demography of school shootings has changed over the decades.

This conversation has been edited for clarity and length.

I struggled to find data on school shootings that was separated by the grade levels of the school, but my sense is that elementary school shootings seem to have become more common.

When there were school shootings In the late 1990s to the beginning of the 21st century, it was often students coming to their own school and attacking their schoolmates, teachers, and administrators over issues related to bullying, grievance, anger, revenge, a desire to become famous — they wanted to enact their vengeful fantasies on people they felt tormented them. They wanted to make their tormentors pay a price and felt justified in their actions.

More recently, we are seeing adults who aren't part of the student population thinking, "this is the way I want to go out." Almost all these individuals are suicidal. They don't expect that they'll come out of this situation alive. In the aftermath of their rampage, they often kill themselves or it's suicide by cop. That is, they get killed by the police, which is what happened at the Nashville school shooting.  

You founded the National Emergency Assistance Team at the National Association of School Psychologists, which helps children and adults in the aftermath of shootings. What kinds of things did you do to help?

What's usually done first is to provide services and support to the administrators, because it is hard to take charge and lead when one is traumatized. Consequently, administrators may need a great deal of help and guidance. Because we have been engaged in this crisis work for so long, we understand the challenges and pitfalls in managing a school after a horrendous event. 

We advise the school to bring in at least one extra principal, so one principal can help run the school, while the other can deal with all the issues related to the crisis. We have parent meetings to enable parents to share what is happening to their families and provide psycho-education regarding how to help themselves and their children deal with trauma and grief. In a school shooting of this magnitude, we suggest bringing in outside resources as well as local mental health personnel into the schools. School psychologists from the surrounding community are often well trained in crisis response. It is best to bring in crisis responders who know the school and the culture.  [Editor's note: The National Association of School Psychologists publishes a resource on how to talk to children about violence, which you can find here.]

My concern in regard to this shooting [in Nashville] is that Covenant School is very small, Christian school — pre-K to 6th grade — and I'd surmise they don't have a school psychologist on staff, because of the size of the student body and funding required to provide on-site mental health professionals. The additional support they're going to need may have to come from the outside community, which may or may not know their students. 

"I expect all these students (or most) will have at least some post-traumatic stress symptomatology. As to whether or not it develops into post-traumatic stress disorder, well, some will definitely have that."

Crisis responders, working with school personnel, would  want to provide small group meetings with the youngsters that have been involved — in this case, probably everyone because it's such a small school — so these professionals would have private meetings with small groups of students, perhaps three to six students at a time. In these meetings, the mental health professional would give students the opportunity to express everything they're going through, provide them coping and stress reduction strategies, and give them factual information regarding what occurred. 

The professional would have the students express their feelings and/or reactions, validate their experiences, and answer their questions in age-appropriate ways. They would provide students with support in all ways possible. One way to help these students is to explain what may happen in the future — especially as it may deal with issues related to law enforcement presence,  funerals, community activities planned, memorial services, etc.  At this time, I don't know if or when the school may re-open. Because six people were killed, students and faculty may be too afraid or traumatized to go back to Covenant. Decisions will need to be made by the school community about what is best for students and families moving forward. 

In the aftermath of these horrific events, we try to give students structure and routine as best as possible. Because the school is now a crime scene, crisis counseling and stabilization will need to be done off campus. Triage will need to be done to determine which children are most vulnerable and at risk — which in this case would be the nine-year-old children in the victims' class, those who witnessed the killings of the students and adults, and the friends and family of the children that were killed. A determination would also need to be made regarding which children or adults need immediate help. 

Say I am a child who witnessed a shooting at my school. What kinds of mental health effects, what kinds of symptoms might I experience as a result?

I expect all these students (or most) will have at least some post-traumatic stress symptomatology. As to whether or not it develops into post-traumatic stress disorder, well, some will definitely have that — usually, 20 to 30 percent in this small community school would develop PTSD. I'd estimate that at least 80 to 90 percent will have symptoms. Whether or not it's full blown, or chronic, that's hard to say. Still, some children and adults will be dealing with this tragedy for the rest of their lives. 

Some might have anger problems, all kinds of fears, difficulty sleeping, nightmares, difficulty calming themselves down, become scared when they hear loud noises… many of them could have problems with focusing or concentration, challenges attending to school work or shutting down academically. They may have various kinds of mood swings, burst into tears when they're not anticipating it. They may have eating problems — eating too much or not enough. Many children and adults will have anxiety related issues, and some will experience full-blown depression and complicated grief. 

Do younger children who experience a shooting have different reactions compared to teens? I have a perception of younger children as particularly vulnerable.

Yes, younger children are extremely vulnerable. So much depends on how their parents deal with the situation. If their parents listen to their child and provide support and comfort — let their child talk, and don't discourage their children from dealing with the issues then the outcome will be better. With young children, parents have to reassure them that they're safe as best they can.

Of course, it's problematic to do that now. And it is hard to answer the question, "Why, why did this happen mommy? What made this person kill my friends, daddy?"  Yet the best thing parents can do is to listen and give their children time to talk. And let them talk and talk and talk about it. A parent has to be patient. They can't push their child to talk either. Sometimes children need to keep their feelings inside for self-protection and find it too scary to let their emotions come out. Some youngsters may prefer writing or drawing, some might want to engage in music or dancing or song, or hitting punching bags or even getting into fights to express their feelings. Young children may need concrete activities such as looking at picture books or engaging in imaginative play to help them identify and express their feelings. They're going to keep referring back to the tragedy and may emotionally regress, especially if they were very close to the shooting. 

"We as a society have normalized lock-down drills and have our children practice for a shooter on campus rather than legislate and enforce common-sense gun safety measures that even most gun owners now support."

I'll talk briefly about younger elementary-aged students versus older elementary youth. Younger elementary should be given brief information balanced with reassurance that their school is safe, and that adults are out there to protect and help them. An effective way to look at it is to ask what provides these children with safety. Sometimes it's just going to be being with their friends. Sometimes it's being part of a religious group, a sports team, or going to church, or just being with their family. A lot of children might just want to play games or engage in sports, or get on their tablets, read comic books, or watch super heroes defeat the bad guys. Pets are really helpful. In the aftermath of the Parkland shooting, assisted pet therapy was extremely popular. The kids really gravitated toward all sorts of support animals. Pets make no demands on children. 

So much depends on how adults around them manage the situation. Of course, adults are going to be concerned too. In this case, they may ask questions such as, "How will this affect my children graduating into the next grade? Are they even going to come back to school? What will happen to their learning? Should I home school my child or children? Is my child going to be significantly emotionally damaged by this tragedy?"

If students do end up going back to Covenant, the school needs to focus attention on their students' emotional well-being, as opposed to their academics. These youngsters are going to be emotionally banged up in so many ways. But kids can also be resilient and can recover from this tragedy, move their lives forward, and integrate this experience into the fabric of their lives. However, their lives will never be the same. They can grow from this, but it's not something that happens quickly. 

What about slightly older children who live through this? Is their psychology different?

Teenagers want to get solace and protection from their friends, and especially from those people that went through the experience with them. It's almost like a different type of psyche emerges in the students in the impacted school: "you don't know what this is about if you weren't at my school when the rampage took place. You might be 11 years old and on my baseball team and you're my buddy, but you have no idea what I really went through!" So sometimes kids will gravitate more towards fellow victims.  

You mentioned that female school shooters are very rare. Is there a social reason why that is?

Thus far, girls are not socialized to use gun violence to solve their problems.

Are there typical characteristics of school shooters? 

I worked with the FBI many years ago when they were looking into this, studying who school- age school shooters were. However, the Secret Service has done a more credible analysis. They studied youth — who were current students at the school they attacked — not older individuals (as in the Nashville shooting) who returned to schools to engage in a killing spree.

They found in preliminary analysis that in almost all cases, school shooters were males. Typically, perpetrators had recently experienced a major loss (we may find this to be the case with this particular shooter). They often had told someone about their intentions. They planned an attack in advance of carrying it out  — in other words, these aren't last-minute plans. Typically, they exhibited a history of suicidal thoughts or intents. If you're going to do this, you're not going to expect to live. I've evaluated school shooters before and they don't have an exit plan. They usually have some kind of grievance — we don't know exactly what — but we know this perpetrator went to Covenant School, and likely they had a grievance.

Also, usually school-age school shooters felt persecuted or bullied. Usually, they've experienced a loss of social status or major failures. I'll give you some numbers that are typically above 50 percent for school-age school shooters: demonstrated an excessive interest in violence; experienced a loss of a romantic relationship; and demonstrated excessive interest in weapons. Many of these people also had a previous diagnosis of a psychiatric disorder, but not all of them. And it doesn't mean they didn't have one, just that they weren't necessarily diagnosed. Also, school shooters who are part of the school-age population are different in important ways than older adults who go to schools to inflict carnage on our most vulnerable population.  

To conclude this interview, imagine, you are a 9-year-old child, and your best friend is killed and you see it all unfold in front of your eyes. You hear the screams, the cries, you see the blood, you witness the child's body being physically torn apart. That is hard, terribly hard, and no child should ever have to go through this type of grief. We as adults have failed our youth when it comes to preventing gun violence. Since I began this work 25 years ago, it has only become worse—especially after the federal assault weapons ban was repealed in September 2004. Gun violence has now become the leading killer of individuals from age 1 to 24. Now, we as a society have normalized lock-down drills and have our children practice for a shooter on campus rather than legislate and enforce common-sense gun safety measures that even most gun owners now support. 


By Keith A. Spencer

Keith A. Spencer is a social critic and author. Previously a senior editor at Salon, he writes about capitalism, science, labor and culture, and published a book on how Silicon Valley is destroying the world. Keep up with his writing on TwitterFacebook, or Substack.

MORE FROM Keith A. Spencer


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Child Psychology Covenant School Guns Interview Mental Health Parenting Psychology School Shooting Trauma