Grief Loss and Change Helping Children Manage difficult life transitions
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Grief Loss and ChangeHelping Children Manage difficult life transitions
Gregory Lubimiv www.lubimiv.ca firstname.lastname@example.org
Studies confirm that adults who were unable to move through the tasks of grieving as children are at significant risk for developing depression and anxiety In our society today it is still difficult to speak about death openly, yet, by age 16 the majority of children will have experienced the loss of a loved one
Sudden Death (ex. Accident)Capacity to cope is diminishedLoss is disruptive so recovery is almost always complicatedCannot comprehend what has transpiredTry to reconstruct the death in our minds to allow for some anticipationGrief symptoms tend to persist longerAnticipatory Death (ex. Disease)Have opportunity to say goodbyeIf healthy anticipation of death will have a better bereavement experienceThree time frame losses; past, present and future
Death is only one form of loss which stimulates the grieving process.
What are some other forms of loss/change which children can be exposed to?
Distinction between the 3
Sleep disturbanceSeparation difficultiesConcentration and memory problemsIntrusive thoughtsTalking with parentsTalking with peersHeightened alertness to dangersFears
(W. Yule. Brief Interventions with bereaved children OUP 2005)
Children do not grieveChildren experience few lossesChildren recover quickly from griefPredictable stages of grief children go throughChildren who experience bereavement will become maladjusted adultsChildren should not attend funerals
Children may not verbalize feelings more likely to act out through behaviour and playLosses doesnt always refer to deathAdults may not have the energy and knowledge to help children cope with lossAdults want to protect childrenGrief is intertwined with developmental processNo two people are alikeChild who receives compassionate care and early interventions can heal and grow from bereavementFunerals provide structure for people to comfort one another, can mourn openly and mourn deceased
Worden(2002) suggests thinking of mourning in terms of tasks instead of stages:Accept the reality of the lossWork through the pain of griefAdjust to the new environment in which deceased is missingTo emotionally relocate the deceased and move on with life
Sadness, fear, guilt, regretAngerHypersensitivityFatigue,headaches, nauseaCrying,withdrawal, lack of concentration, overachieving, risky behavioursOngoing restlessness, hyperactivity,superalertnessStrong reactions to potential separationsRegressing to behaviour of less mature child on regular basisOngoing symptoms of depressionTaking on parental of adult rolesSelf-destructive behaviourChronic anger/hostilityOngoing signs of traumaNarrowed range of emotionsOngoing physical complaints with no causeSuicidal thoughts
Increase Child Self EsteemIncrease adaptive Control BeliefsImprove Coping SkillsSupport Adaptive Expression of EmotionFacilitate Positive Parent-Child RelationshipParental WarmthParent-Child CommunicationEffective DisciplineReduce Parental DistressIncrease Positive Family InteractionsReduce Exposure to Negative Life Events
To accept the reality of the loss developmental age is a major factor
AgeReality3 5lack of understanding of finality of death5-9Death is personified and can be avoided or controlled9+Understand permanency as well as own vulnerability-everyone dies
Experiencing the emotions Being able to express feelings, worries, fears, etc. related to the loss is critical.Children age 5 9 at highest risk for issues as they are beginning to understand the permanency of death, but lack thesocial/emotive skills to deal with the intensity of feelings attached. Prone to phobias, nightmares, separation anxiety, etc.
To adjust to the world without the deceased.
Impacted by:The stability of the remaining caretaker If the surviving parent is the motherThe amount of environmental change due to the lossThe degree to which life style changes.
To find a role for the deceased person in ones life and to find ways to remember:
Being allowed to have memoriesBeing able to talk about the person who diedHaving rituals/ceremonies which include the person who died
Young children often re-experience mourning process as they move through different developmental stages or life events. Such as:PubertyAdditional lossesCan conceptually understand deathReminder of person/thing lost
. The risk of major depression is 7 times greater for early adolescents after the death of either parent than for their non-bereaved peers (Gersten, Beals, Kallgren, 1991)
The risk of depressive symptoms for bereaved adolescents 12 to 15 years of age was found to be twice that of children 8 to 11 years, with girls at twice the risk of boys, (Gersten, Beals, Kallgren, 1991) About one third of the bereaved children experienced serious emotional and/or behavioural difficulties at some point during the 2 years following a major loss.
Most children returned to the same level of functioning pre-death (83%) without interventionThose who didnt often had a series of additional stressors after or at the time of the deathBereavement itself was less stressful than theattending events e.g. poverty, moving, mental illness, change of financial status.
Nearly all children who attended (the funeral), felt good about what had gone on at the funeral. ( Child Bereavement Study)
57% of children maintain a connection by speaking with their deceased parent, dropping to 39% in the first anniversary (Child Bereavement Study)
74% of children reported the deceased parent was in heaven (Child Bereavement Study)
94% of children thought about their dead parent several times a week 4 months after the loss. After 2 years this was still at 65% (CBS)
How available are support systems at the time the death occurred?How open is the family communication?How much is the home able to provide the essential environmental conditions?SafetyUnconditional Love/AcceptanceConsistency and PredictabilityBelongingOpportunity
How easy is it for family members to express their feelings with each other?How easy is it for members to talk about death and the person who died?How reliant were family members on the deceased person?
How much will the life situation change because of the death?What other life circumstances follow the death? (other deaths, move, change of schools, etc.)
It has been found that the most effective coping tool is communication and expressing the thoughts and feelings related to the death. The better the communication within the family the more healthy.When surviving parent is mother, children tend to be able to talk about feelings more. As well, there tends to less change of routines and daily living patterns. When the surviving parent is the father it is helpful to consider supporting these two areas.
There are several common questions that children ask/worry about.1. Why did the person die?2. Was it my fault?3. What will happen to me/us now?4. Will I die? 5. Did my parent know I love them?
Lying Not being emotionally presentNot validating feelingsUsing words to soften death
Avoidance of childAvoidance of the deathNot noticing warning signs of need for helpNot giving timeGiving too much timeTreating the child differently than others
Fear and anxieties are addressed to know they will be cared forReassurance they are not to blameActive ListeningLabeling and validation of their feelingsAssisting with overwhelming feelingInvolvement and inclusionContinued routine activitiesModeled grief behaviorsOpportunity to remember the deceased person
Providing wrong informationWithholding information about the eventNot relating the facts as more information becomes availableNot explaining certain factsNot answering childrens questions about an eventHiding feelings or not explaining feelings for childrenNot talking about or signaling to the child that they should not to bring up the event in conversationsExcluding children from rituals and (re) visiting the scene of the event(ACCP Paper No.17. Dyregrov A. 2001)
Give timedont rushSupport use of a transitional objectCreate a memory bookGo through photos, videosRemember events, funny storiesConfirm that they will be okayTell the truthValidate all feelingsHave similar expectationsAsk if they are okay (over 10 years)
Help to identify/label feelingsUse puppets to talkHave a ceremonyPlant a treeVisit the graveyardPut a message in a helium balloonCreate a prayer Celebrate birthday, anniversary, Christmas and other important days
There are many tools and activities that can be used to assist in the Bereavement Process.
Use a ball or balloon that you are able to write on.Using an indelible ink pen write a number of questions related to death and bereavement.Add about 6 fun or easy things to do.Throw the ball. Whatever question the catchers right thumb is closest to they can read out and answer.
Create set of cards with questions , (Talk, Story, Wish, Problem Solving, Feelings)Using a game have a card drawn each time a person talks a turn.
Create a Feeling Wheel with the child/youth or familyHave at least 4 feelings if children are 5 and under. Generally take the average age of the children to a maximum of 12 feelings. Have the children/family decorate the wheel and use to help identify and talk about feelings.
Felt Boards can be purchased or created very easily. Have the