HFA Teleconference - 2008 Segment Summaries
Living with Grief: Children and Adolescents
Segment 1 - How Do Children and Adolescents Grieve
Children experience a wide range of losses in their lives. These losses can be compounded by the death of a significant person. In addition, often there may be secondary losses, such as relocation or other life changes, as result of the death of a significant person. Some of these losses experienced, such as the adolescent’s loss of a friend, can be disenfranchised by others.
In cases of life-threatening illness, children and adolescents experience anticipatory grief as well other reactions. Children and adolescents need a safe environment to explore their questions, anxieties, and responses.
Children and adolescents are continuing to develop cognitively, emotionally, behaviorally, and spiritually. The child or adolescent’s response to loss will be affected by their development and differ according to that development.
Children and adolescents grieve in ways similar to and different from adults. The grief of children and adolescents will be affected by the type of loss as well as the developmental level of the child and other social, psychological, spiritual, and cultural factors. For example, in dealing with the adolescents’ loss of a friend or sibling, the loss may be complicated by the fact that it is sudden – the result of an accident, homicide, or suicide.
Children and adolescents’ grief may be manifested in a number of ways including physical reactions, poor academic performance, absenteeism, acting out and other disruptive behaviors, and substance abuse. Teachers, guidance counselors, and school nurses should be educated to recognize, validate, and support grieving students. Other supportive adults, such as clergy, coaches, and other persons significant in the child or adolescent’s life, can provide additional and critical support.
Current grief theory emphasizes as that children and adolescents as well as adults maintain a continuing bond with the deceased and also acknowledges the role of post-traumatic growth.
While many children or adolescents are resilient, they still may need developmentally appropriate, family-centered support. Often the functioning of the family after a loss is a major factor in the adjustment of children.
A certain percentage of children and adolescents, perhaps near 20%, may need more intensive intervention as they try to cope with loss and consequent anxiety. Careful and continued screening of children and adolescents is essential as it may take a few years to fully ascertain the way that the child copes with the loss. Certain behaviors such as self-destructive acts or acts destructive of others require immediate intervention.
- Within a family, there may be significant differences in the ways that family members cope with loss. For example, siblings will respond in different ways according to their developmental levels. Families need to learn to respect and negotiate these differences.
Segment 2 - How Can We Help Children and Adolescents Cope with Loss
Rituals, such as funerals and memorials, are vitally important events and ways for individuals to cope with loss. Children and adolescents need opportunities to decide the ways they wish to participate in rituals and memorialization. In making such choices, children and adolescents need information, options, and support.
Adolescents and older children may look to the Internet for information, peer support, and memorialization. Parents and other supportive adults should open dialogues with their children about what they are doing and learning on the Internet.
Children will do best when their families are coping effectively. Interventions should be designed to support families – in some cases by educating families or by empowering extended families or intimate networks to assist.
There should be a range of interventive settings and techniques. Hospices, bereavement centers, schools, faith-based organizations, and other community organizations may be appropriate settings for support. There should be a range of options to help children cope, including individual counseling, bibliotherapy, support groups, grief camps, or expressive therapies such as play, music, drama, or art.
Schools can have a significant role in supporting grieving children and adolescents. Administrators, guidance counselors, teachers, and other school personnel may need education to offer effective support to students and to help enable peer support.
Schools should have protocols for prevention, intervention, and postvention for problematic deaths such as suicide or other self-destructive deaths.
Schools also should strategies to deal with local traumatic events and other public tragedies. Educational organizations can partner with a variety of local organizations, including hospices and bereavement centers, so that schools can draw upon the expertise of qualified grief counselors.
Hospices have a unique role in supporting grieving children through illness, loss, and death. Hospices should envision a role as a resource center to schools and other child-centered, community organizations, both during the course of an illness and after a death.
Persons who deal with dying children and adolescents including health care professionals, counselors, clergy, and funeral directors, need debriefing opportunities, adequate support, and strategies for self-care.
