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Associated Press
Molly Delaney, left, holds her 11-year-old daughter, Milly Delaney, during a service in honor of the victims who died a day earlier when a gunman opened fire at Sandy Hook Elementary School in Newtown, Conn., as people gathered at St. John's Episcopal Church , Saturday, Dec. 15, 2012, in the Sandy Hook village of Newtown, Conn.
You become like a shaken soda bottle. You've got all this carbonation, and if you don't let that pressure off — by talking, talking, talking — you'll explode and damage relationships. —Liz Carlston

Images of terrified children being led away from Sandy Hook Elementary Friday — eyes closed, clinging arm-to-shoulder — add depth to the misery of the worst primary school shooting in U.S. history. These are victims, too, though we will not learn their names.

Few can imagine the road ahead for Sandy Hook's young survivors. Liz Carlston is one who can. Carlston was a 17-year-old student listening to a lecture in her trigonometry class when the shooting started at Columbine High. She remembers being escorted to temporary safety outside the school, only to join a panicky stampede of students when one of the shooters sprayed gunfire from a school window. Her sister was still in the school.

"There was fear, panic, uncertainty and a loss of innocence," Carlston remembers. "My world had been shattered."

Carlston's sister survived but was devastated by the scenes of mayhem she witnessed in the school. The two teenagers slept together in the bedroom they shared as children that night — reverting, as survivors often do, to a more innocent time. There, Carlston comforted her sister through night terrors and bouts of weeping. Meanwhile, she sorrowed over the deaths of classmates and of her basketball coach, Dave Sanders, who died helping students escape.

In the coming days, Carlston found solace for her grief through a support group formed for Columbine survivors at her church. There, she felt safe to cry. She remembers that she and her friends were reluctant to use school and community counseling resources, "because that would mean we were crazy."

She realizes now that she needed an outlet desperately, and is grateful for the practical and spiritual support her church associations brought.

"You have to talk and share what's inside you," Carlston said. "You become like a shaken soda bottle. You've got all this carbonation, and if you don't let that pressure off — by talking, talking, talking — you'll explode and damage relationships."

Talking to children

For children, even hearing about mass shooting incidents can be disturbing, and those have increased in recent years. That this event happened at a school — the most familiar place next to home — makes it even scarier for kids.

There are no right or wrong ways to talk to children about school shootings and other community tragedies, wrote psychiatrist David Fassler, in a paper for the American Academy of Child and Adolescent Psychiatry.

Fassler tells parents to be honest with their children without telling all they know. Keep comments appropriate to age and developmental level.

 Remember that children are likely to personalize situations and worry about their own safety. So, limit television viewing of frightening images and violent news. If a child becomes overly fearful about safety, ask a school counselor or pediatrician for a referral so the child can be evaluated by a mental health professional, Fassbender wrote.

Sorrowful lessons learned

School counselor Sandra Austin was on the scene at Colorado's Columbine High School when two students killed 12 students and a teacher and injured 24 other students in 1999. The paper she wrote about lessons learned for the American School Counselors Association helped Jefferson School District create new crisis protocols that became a model for schools around the nation.

Austin's paper details the confusion faced by survivors of the Columbine crisis. Students who had escaped from the locked-down school were taken to a nearby school's gymnasium, where they waited for parents to pick them up. Lists of schoolmates taken to hospitals went up on walls, but the fate of students inside the school wasn't known for many hours.

Conflicting reports, the descent of the national media and communication problems between various law enforcement groups added to the aura of fear and chaos.

 Counselors worked to calm terrified students and to help families whose children were still in the school. As the school siege lengthened, counselors offered each family the services of a victim advocate who would stay with them in their homes that night as they awaited word about their children's fates.

As was the case in Newtown, Conn., a drop-in crisis center was established near the school the day after the Columbine shootings, staffed with mental health professionals from the school district and community.

Austin, a counselor at Colorado's Lakewood High School, said that since the Columbine shooting, school districts typically have pre-determined plans for dealing with the community-wide trauma that follows such horrific events, and for the more commonplace tragedies most schools will face — including accidental death of a teacher, student or a suicide. She laid out a typical plan for helping grieving students:

When a tragedy happens, a call goes out to previously identified members of a district's crisis team — selected counselors, psychologists and social workers from schools throughout the district. The team rushes to the affected school to assist its own counselors, whose familiarity in the school community make them best suited to lead the response and work most closely with students. In the case of major events, professional mental health care providers from the community might be called in, too.

Austin said it is typical for a room in a safe zone to be prepared as a "triage" area where counselors can meet with groups of students. In Newtown, a nearby fire station was chosen.

"We have kids go there while we figure out their needs," Austin said. "Some will be obviously upset, wailing and crying. We get them with an individual counselor right away."

In massive tragedies like the one at Sandy Hook, parents will be notified immediately — robo-calls notified the Newtown parents when the school went into lockdown. In the case of lower-profile events, such as a teacher's death, parents are notified immediately if a student is being seen for grief counseling. Usually, the parent comes to take them home, Austin said. The counselor will offer resources for additional care, and arrange for follow-up at school.

While working with groups of students, counselors try to help them process what has happened in whatever way suits them best. Many benefit from talking about what has happened, what they liked best about a friend who died, and why they will miss them.

"Sometimes kids don't want to talk about it at all, and we are sensitive to that," Austin said. "Sometimes it's difficult to talk, but you can draw or write, and that helps kids to process things."

There are natural limits on the role of school counselors and other first responders to grief and trauma, Austin said. They can help bereaved families find other resources, check in with grieving students at school over coming days, and perhaps work with teachers to meet academic needs of grieving students. But their role will dwindle long before the grief does. Ongoing professional counseling grief support groups can help children over the long term, Austin said. 

Finding support and healing

"Grieving children are very different than adults, especially younger children, who don't have words to express what they are feeling inside," said Carrie Moore, who co-founded the Bradley Center for Grieving Children and Families in Salt Lake City after her husband died in a plane crash, leaving her three children fatherless.

Bereaved children don't believe adults can understand what they are going though and can be reluctant to talk, Moore said. Directed play and creative activities help, as does support from families in similar circumstances.

There is no timeline for the grief process, and survivors of events like school shootings don't really "get over" what happened, Carlston said. In the first years after Columbine, she thought about the tragedy almost constantly, and used it as a crutch — an excuse for personal failures. Recovery was slower than she could have imagined, but she has progressed.

"Columbine, or some other tragedy, can't define you," Carlston said. "What defines you is how you react to it, and how you are going to move forward."

Email: cbaker@desnews.com