Work with traumatized children has a profound effect on emergency personnel and other health care providers. It is hypothesized that work with seriously ill or injured children potentiates motivating factors in the helper's personality, brakes down natural defenses and leads to strong identification with the victims. In this paper various psychological effects on the rescuer are outlined.
Coping strategies used by health care personnel in the acute phase of an emergency are identified. Mental preparation, suppression of emotions, dirtancing from certain aspects of the event, and dehumanizing were frequently utilized coping strategies. Other coping mechanisms were regulating the amount of erposure, activities to restrict reflection, developing a sense of puvose, and selfreassuring comments. Postexposure response to child trauma include helplessness, fear and anxiety, existential insecurity, rage, sorrow and griefl intrusive images, self-reproach, shame and guilt, and changes in values. Emotional distancing and other self-protective strategies seem important at the scene; self-disclosure by talking about impressions and reactions is most helpful afierwards. However, carefully timed and executed interventions are necessary to break through the defensive bam*ers which are established by health care and other emergency personnel.