When Education and Humanitarian Families Witness or Experience Traumatic Events

Sahana Kanabar and Tanya Crossman
TCK Training’s 2021 survey on childhood trauma in globally mobile Third Culture Kids collected data from 1,904 Adult Third Culture Kids who experienced global mobility. While the initial data analysis focused on Adverse Childhood Experiences (published in our white papers Caution and Hope and TCKs at Risk) our latest white paper Sources of Trauma in International Childhoods: Providing Individualized Support to Increase Positive Outcomes for Higher Risk Families looks at potentially traumatic experiences occurring in the community. This article is part of a series of blog posts that looks a little deeper at certain sub-groups represented in the data.

When Education and Humanitarian Families Witness or Experience Traumatic Events

Part of TCK Training’s research on the well-being of Third Culture Kids (TCKs) looked at potential sources of trauma which might impact children. 150 TCKs from the Education and Humanitarian (IGO/NGO) sectors (abbreviated to Edu-NGO) took part in our 2021 survey. We learned some harsh realities through this research, such as that 1 in 3 Edu-NGO TCKs were impacted by a natural disaster, and 1 in 5 witnessed a traumatic human death. Exposure to various types of potentially traumatic events were also associated with higher ACE scores.

In this blog post, we go through data from our white paper Sources of Trauma in International Childhoods: Providing Individualized Support to Increase Positive Outcomes for Higher Risk Families that applies specifically to Edu-NGO TCKs. We hope to see this research used to support the well-being of Education and Humanitarian families globally – before, during, and after their time abroad.

What is a traumatic event?

‘Trauma’ describes an event that produces harm for an individual with lasting effects. ‘Big T’ trauma describes life-threatening situations including violence and disaster. ‘Little t’ trauma does not necessarily involve physical harm, but describes situations that create mental and emotional distress. All types of trauma negatively impact mental and physical health throughout life, increase risk-taking behaviors and suicidal ideation, and harm relationships. Traumatic childhood experiences that go unrecognized and unprocessed can cause these problems later in life. 

In this blog post, we discuss three categories of potentially traumatic events. These are events likely to cause either a ‘Big T’ or ‘little t’ trauma impact on the individual. In the “Sources of Trauma” white paper we discuss a research framework behind why such events can be traumatic, and how they can impact young people long term. 

  1. Small-scale events: localized to the household or local community
  2. Large-scale events: affect a wide area or large community as well as having personal impact 
  3. Witnessed events: when an individual sees something without necessarily being personally involved  

Small Scale Events

Medical Events

Multiple studies have connected serious medical issues, including chronic illness, with negative impacts on the patient’s family. Importantly, these stressors can impact the family’s long term emotional health. We asked about three categories of medical trauma: (1) medical crisis; (2) prolonged illness; and (3) death.

Medical crises affected over half (51%) of Education and Humanitarian TCK families. Edu-NGO TCKs who reported a household medical crisis were more likely to have a high-risk ACE score (28% compared to 19%). 1 in 4 Edu-NGO TCKs (23%) had experienced prolonged illness in their household; 37% of those had a high-risk ACE score. Medical trauma not only impacts the individual but the family as a whole. TCKs with these experiences were more likely to also report experiencing emotional abuse, emotional neglect, and household adult mental illness.

1 in 10 Edu-NGO TCKs (9%) reported that a member of their household died while they were a child; 5% reported the death of a non-residential caregiver. When Edu-NGO TCKs reported these experiences they had elevated high-risk ACE scores at 29% and 38% respectively (compared to 19%).
Violent Events

When violence is part of a family’s lived experience, it affects each family member. Our research illustrates how this experience increases the rates of ACEs like physical abuse, emotional abuse, emotional neglect, and mental illness of adults living in the home (such as parents).
Parents need to be educated on how to manage their stress, how to identify when the stress has reached a level where it’s negatively affecting their families, and what to do when that happens.
Violence can occur in many forms, and exposure to violence at a young age is known to impact development. (More information on this research can be found in the Sources of Trauma white paper). The types of violence asked about included: 
  • a household member suffering violent harm
  • a home invasion/break-in (while the person was home, or while they were away)
  • a violent incident occurring at their school while they were present
  • a violent incident occurring at another place while they were presenta violent incident occurring in a place they regularly went to while they were not present.

Half of Edu-NGO TCKs surveyed (46%) reported experiencing one of these violent events in their childhood. The most common event was a home invasion, experienced by 1 in 4 Edu-NGO TCKs (23%); 29% of these Edu-NGO TCKs had a high-risk ACE score. 1 in 7 Edu-NGO TCKs (14%) reported that a member of their household suffered violent harm. These Edu-NGO TCKs had a very high likelihood of a high-risk ACE score (62% compared to 19% overall).

Our survey also asked TCKs if they had been present during a violent incident (i.e. armed robbery) at their school or somewhere else in their community, or if such an event happened at a place they regularly went while they were not there. Edu-NGO TCKs were more likely to report a violent incident occurring in their absence (17%) than when they were present (15%). A violent event occurring in their absence corresponded with a doubled rate of high risk ACE scores (38% vs 19%).
Overall Impact

‘Small-scale’ events that affect TCKs directly in their homes and communities are not small in impact. They have an effect on ACE scores, and create conditions of stress for TCKs and their families. This emphasizes that trauma occurring at any scale can have a significant impact on well-being.

In addition to the small-scale events already mentioned, 1 in 3 Edu-NGO TCKs (33%) reported additional experiences of intense grief or fear. This also comes with an elevated ACE risk (24% compared to 19%).
Having a supporting adult to turn to during difficult times helps reset stress activation in children, and lacking that support leads to toxic continuous stress. Thus the presence of supportive adults is crucial for children living in stressful (or potentially stressful) situations.
4 out of 5 Edu-NGO TCKs (79%) experienced at least one of these potential sources of trauma. On the other hand, when Edu-NGOs reported none of these potentially traumatic experiences, only 3% had a high-risk ACE score (4 or more out of 10). This is one quarter of the ACE risk seen in the largest ever survey of ACEs (12.5% in the CDC-Kaiser study of 17,000 Americans).
On the other hand, when business TCKs reported that they had none of these potentially traumatic experiences, only 14% had a high-risk ACE score. This is half the ACE risk seen in business TCKs overall (14% vs 29%), and only slightly higher than the ACE risk seen in the largest ever survey of ACEs (12.5% in the CDC-Kaiser study of 17,000 Americans).

Large Scale Events

Political Disruption

Half of Edu-NGO TCKs (50%) experienced a type of political disruption during their time abroad.  While TCKs may consider political violence/corruption minor and thus hardly worth mentioning due to their high frequency (and therefore normalization), this environment contributes to a child’s perception of safety and who can be trusted in the world around them. Overall, there was only a minimal increase in high-risk ACE scores in this group (21% vs 19%).

War/Unrest

3 out of every 10 Edu-NGO TCKs (29%) reported being exposed to or impacted by war and/or unrest. This experience had no effect on overall ACE scores for Edu-NGO TCKs.

Natural Disasters

One third of Edu-NGO TCKs (31%) experienced a natural disaster, such as an earthquake or tsunami. Natural disasters had a larger effect on child maltreatment rates compared to political disruption and war, particularly when it came to emotional abuse and neglect.

Evacuation

Evacuation can occur due to any large-scale event, or even small-scale events such as medical emergencies/illness. 1 in 6 Edu-NGO TCKs (17%) experienced an evacuation. This experience had no effect on overall ACE scores for Edu-NGO TCKs.

Overall Impact


More than one third of TCKs from Education or Humanitarian families (35%) reported experiencing a large-scale traumatic event. In this sector, large-scale events had a minimal impact on ACE scores. For Edu-NGO TCKs that did not experience any of these large-scale events, 17% had high-risk ACE scores – a very small decrease from the overall average of 19%.

Witnessed Events

Extreme Poverty

TCKs from Education or Humanitarian families were more likely than other non-missionary TCKs to be exposed to extreme poverty. 69% of Edu-NGO TCKs reported they had witnessed extreme poverty at least once, and half (47%) said they witnessed this regularly. 1 in 4 Edu-NGO TCKs (25%) who regularly witnessed extreme poverty had a high-risk ACE score.

Regularly witnessing extreme poverty is worth acknowledging as it is a form of 'moral injury', defined by Foreign Policy as "perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations". Children who are being taught (often at a well funded international school, or in a very comfortable home) that all people are equal, and to treat others with respect and kindness, may struggle to integrate these messages with their lived reality of witnessing people living in extreme poverty.

Serious Traffic Accidents

On the surface, traffic accidents may not seem detrimental. Witnessing any serious traffic accident, however, is likely to cause an adrenal reaction as the body attempts to deal with a stressful situation. We have heard many stories from Adult TCKs who suffered mentally and emotionally from witnessing major injuries and even deaths due to traffic accidents as children. More than one third of Edu-NGO TCKs (37%) had witnessed at least one serious traffic accident, while 10% witnessed them regularly. Edu-NGO TCKs who witnessed serious traffic accidents regularly were twice as likely to have a high-risk ACE score (40% compared to 19% overall) while those who witnessed at least one had a less increased risk (25% were high-risk).
It’s important to understand that witnessing an incident that results in death or a life-changing injury – or even the potential for those things – can also lead to PTSD. A study from the American Academy of Pediatrics also showed that not only were child victims of road incidents at risk, but their parents too – even if they’d not directly been involved in the incident. 25% of the children in the study and 15% of the parents suffered diagnostic PTSD. It’s easy to see why road incidents are thought to be one of the leading causes of PTSD in the general population.
It’s important to understand that witnessing an incident that results in death or a life-changing injury – or even the potential for those things – can also lead to PTSD. A study from the American Academy of Pediatrics also showed that not only were child victims of road incidents at risk, but their parents too – even if they’d not directly been involved in the incident. 25% of the children in the study and 15% of the parents suffered diagnostic PTSD. It’s easy to see why road incidents are thought to be one of the leading causes of PTSD in the general population.
Violence

Witnessed violence combines experiences of armed conflict, human death, animal death, and physical violence. Half of Edu-NGO TCKs (48%) had witnessed a violent event, while nearly 1 in 5 (17%) witnessed these events regularly.
More than half of non-missionary TCKs who regularly witnessed armed conflict, traumatic death, or physical violence had a high-risk ACE score.
Physical violence was the most commonly witnessed event: 1 in 3 Edu-NGO TCKs (33%) witnessed at least one incident, and 9% saw these events regularly. When physical violence was witnessed regularly, ACE scores more than tripled (69% compared to 19%). 17% of Edu-NGO TCKs had witnessed armed conflict, which was also associated with an increased ACE score (27%). 4% witnessed armed conflict regularly. This group was a small sample, but demonstrated very high ACE scores (67%).

Almost 1 in 5 Edu-NGO TCKs (19%) reported witnessing a traumatic human death at least once, including 4% who witnessed a murder; 3% reported regularly witnessing traumatic human death. In this sector, witnessing traumatic human death was not associated with higher ACE risk.

We also asked about witnessing traumatic animal death, as we have worked with many TCK and ATCKs who had experienced this and needed to process it later down the line. 1 in 4 Edu-NGO TCKs (26%) had witnessed the traumatic death of an animal, with 9% witnessing this regularly. 31% of Edu-NGO TCKs who witnessed the traumatic death of an animal had a high-risk ACE score.
Overall Impact

3 out of 4 Edu-NGO TCKs (77%) witnessed at least one of these traumatic events, while nearly half of Edu-NGO TCKs (49%) witnessed potentially traumatic events regularly.

Fewer than 15% of Edu-NGO TCKs who did not witness any of these types of traumatic events had a high risk ACE score, a risk reduction of nearly 25%.

That said, ACE scores are not the only way to measure the impact of potentially traumatic events, and we anticipate that future research will help us learn more.

Where do we go from here?

This data can feel overwhelming. These numbers are sobering, and it is right and good to take time to reflect on them – and the people these numbers represent. So many children, teens, and families we know have been through these traumas. Some of them have received excellent support and are doing well. Some of them have not, and are not. We can and should grieve the occasions in which trauma was not well addressed. 

As we hold the weight of this, we ask the question: where do we go from here?

Potentially traumatic events threaten the mental health and stability of international families. When we recognize them as such, we can mobilize to acknowledge and debrief these events. These events cannot always be predicted; when changes in the environment threaten emotional/physical safety, especially through frequency of potentially traumatic events, the location’s suitability should be reassessed.
Childhood adversity and the presence of ACE scores does not inherently determine health and wellbeing in adulthood. In fact, the prevalence of certain protective factors can mitigate the risks associated with a high ACE score. Efforts that focus on building healthy families early in the life of a child are an effective means of preventing ACEs and reducing their damaging effects.
There are resources available to help those who were not helped effectively in the moment. Unstacking Sessions are a great resource to help Adult TCKs work through what happened in their childhoods and how this impacted their internal narratives. Unstacking Your Grief Tower is a short and inexpensive book that helps Adult TCKs work through this process on their own.

More than this, however, we want to see quality preventive care happen. 

Departmental Support is essential for Education, NGO and IGO workers and their families. This may be provided through their HR department, and/or specific family support workers. Budgeting for this support is essential to ensuring the families of educators and humanitarian workers thrive long term. Community organizations and informal staff networks can be a fantastic part of a family’s support network, but cannot on their own bear the burden of providing for all families’ emotional needs. 
Child protection is essential, and organization-level strategies should be put in place to safeguard children. Families need education to understand not only the rewards but also the risks for international life…Volunteer family organizations can be wonderful, but they also need institutional backing to provide the best care possible.
A great start for those working in family support is to learn more about TCKs and their needs. Support staff can also be trained to provide excellent care specific to the needs of global mobile families. This might include running a private training in Debrief Certification or Family Check-In Training, or getting certified in TCK care (either as a program leader through Pathways, or on-the-ground care in Groundwork).  

Quality pre-departure training for the international business family is essential. This service need not be offered in-house as there are options to out-source pre-departure training, debriefs, and other invaluable services. Parent Packages are a great way to support families by giving them access to resources that will equip them well. 

Debriefing is another incredibly powerful tool to help families work through the difficult parts of their journey in a way that also affirms the good things, while equipping parents to have ongoing conversations with their kids. We recommend that family debriefs occur annually, to catch things that aren’t noticed in the moment, with a full debrief every four years. A crisis debrief is a helpful tool when a particularly disruptive or traumatic event occurs. A great book for parents who want to incorporate emotional support into their TCK parenting is Raising Up A Generation of Healthy TCKs, or for a shorter and more debrief-centric reading, The Grief Tower.
When international schools, and even local schools, invite teachers to work outside their passport countries, they are also inviting risk into the lives of these teachers’ families. When humanitarian organizations, including NGOs, IGOs, and governmental charities, send their employees to live and work abroad, they put their employees’ children at higher risk. Therefore it is the responsibility of these sending and inviting organizations to implement protective measures, and provide education and training to their staff to help them do the same at home.
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