It has become the standard response to every school shooting: First come the sirens, and then come the grief counsellors.
That familiar tableau took shape in Toronto over the past two days as counsellors descended on C.W. Jefferys, the high school rocked by the fatal shooting Wednesday of 15-year-old Jordan Manners.
But with controversy brewing over the benefits of conventional grief counselling, the Toronto District School Board has turned to a newer approach. The school board favours a method called "psychological first aid," which emphasizes giving students space instead of pushing them to relive the event.
That's because conventional grief counselling may not be helpful and "might actually be hurtful," says Dr. John Ogrodniczuk, a psychiatry professor at the University of British Columbia.
School boards, colleges and corporations make a public show of summoning grief counsellors to reassure the public rather than to comfort the grief-stricken, say Dr. Ogrodniczuk and other critics. "It's become a social phenomenon," he says. "They're showing to the public that they care, that they're here to help - even if what they're offering is not really useful."
A study published just days before the one-year anniversary of the Sept. 11, 2001, terrorist attacks on New York showed that the 9,000 therapists who swarmed the city did little to prevent post-traumatic stress disorder or other psychological problems.
Much of the controversy centres on the conventional counselling method called critical incident stress debriefing.
Pioneered by U.S. paramedic Jeff Mitchell, the debriefing requires anyone involved in a traumatic incident to rehash the details of the event with a counsellor.
But reliving the trauma is now being questioned as a means of therapy.
"For some people, these cathartic interventions actually retard their ability to recover naturally," says Dr. Richard Gist, a public health psychologist with the Kansas City Fire Department, and a leading critic of conventional grief counselling.
In the past three years, Dr. Gist has helped develop a new form of counselling he calls psychological first aid.
It emphasizes giving victims enough space to deal with trauma on their own terms rather than making them endure the scripted line of questioning prescribed under the Mitchell method.
Dr. Gist's method is rapidly gaining disciples, the Toronto District School Board being among them.
Students at C.W. Jefferys will be allowed to opt out of counselling, and sessions will take the form of a discussion rather than the Mitchell method's questions.
"The literature has completely discredited the Mitchell approach," said Dr. Lynne Beal, a former chief psychologist for the Toronto school board.
"That approach has been replaced with psychological first aid. First aid doesn't put bandages on everybody. You look for those who are seeking assistance."
The value of trauma counselling depends in part on who's doing it, some say. Grief counsellors vary greatly in experience and education. Some are armed with psychology degrees. Others have simply graduated from a weekend course.
At C.W. Jefferys, students may find it tough to get on with their lives. Not only did they lose a classmate, but they also underwent an hours-long lockdown, and may never be able to regard the school as a safe place again, trauma experts say.
The Toronto District School Board employs a team of counsellors who help students and staff cope with death or calamity in all forms.
"The biggest issues will be shaking the sense that the school is an unsafe environment," Dr. Beal said. "It's something you take for granted, and now you've had an experience where there was a clear and present danger. It will be a very tumultuous time."
Sometimes, so early after a traumatic event, the term grief counsellor can be a misnomer.
At C.W. Jefferys, counsellors will no doubt be dealing with students who are still in a state of shock and distress. "They won't be dealing with grief at this point," said Pam Fitzgerald, a Toronto-area counsellor. "They're going to be in shock. They're going to be in fear."
In that case, counsellors assure students that thoughts of the shooting will eventually wane, even if they may be all-consuming at the moment.
"They may be sleepless," Dr. Beal said. "They may be irritable. They may have difficulty concentrating." That should all dissipate in a couple of weeks, she said. If not, then it may be time for parents to seek out counselling for them.
How schools responded
MONTREAL, SEPT. 13, 2006
Kimveer Gill shot one woman to death and wounded 20 other people before being killed by police. The night of the shooting, school administrators met with the head of psychiatric services at Montreal General Hospital, where the victims were treated, says Donna Varica, public relations director for the school. When classes resumed, 120 counsellors were on site. Library carrels became counselling stations, and Ms. Varica says hundreds of students lined up to talk.
W.R. MYERS HIGH SCHOOL
TABER, ALTA., APRIL 28, 1999
A 14-year-old boy shot one student and wounded another before being arrested. Students, parents and community members attended counselling sessions and public meetings. In a memorial service held before the school reopened, victim Jason Lang's family and friends walked to the spot where he died and prayed.
MONTREAL, DEC. 6, 1989
Marc Lepine killed 14 women and then shot himself. The school made about 25 therapists available for free counselling, and professors organized impromptu group-therapy sessions. About 400 students took advantage of the counselling.