Grieving Childhood Grief

Bereavement and loss - The loss of a loved one such as a parent, sibling, grandparent or friend can turn a child’s world upside down. Grief can bring all sorts of emotions, upset, sadness, hurt and anger because they are gone and, fear because the child may be afraid of other loved ones dying too. A child can be affected by grief for a long period of time, and this may impact on their emotional and physical

Unplanned transition is the hardest for the children to cope with. As discussed by Stokes et al. (1999), a sensitive, responsive support needed more than ever when it was recognized that children and young people had experienced an unplanned transition such as bereavement. Whenever a child or adult is faced with traumatic life events, particularly the loss of a loved one, the ability to survive the emotional and physical pain associated with the event will be influenced by the individual’s level of personal resilience. Focusing entirely on their needs enables children to express their feelings, acknowledge their loss and develop skills to cope with their changed lives.

This paper examines the implications of grief, bereavement and disenfranchised grief. Grief in response to a loss is a unique experience and is expressed distinctively by every individual. It is helpful to have models that outline the stages of grief that need to be experienced in order to achieve acceptance. However, their utility is limited by the reality that grief is immeasurably complex and individualized. Veterans and children are two groups at risk of developing disenfranchised grief. Therefore, it will be important for nurses to be able to identify those suffering with disenfranchised grief or other forms of maladaptive grief so appropriate intervention may be employed.

Grieving parents say that their grief is a lifelong process, a long and painful process..."a process in which [they] try to take and keep some meaning from the loss and life without the [child]" (Arnold and Gemma 1983, 57). After a child's death, parents embark on a long, sad journey that can be very frightening and extremely lonely- a journey that never really ends. The hope and desire that healing will come eventually is an intense and persistent one for grieving parents.

The groups I helped co-facilitate focused on death-loss for children and their families. I would help children process their grief through checking-in with their feelings, reading stories, interacting with them in play, and engaging in conversations about these experiences. Many times I was surprised by the levels of understanding and

I chose the GriefShare support group because as nurses we will need to help our patients and their families with the grief process when a loved one passes away. On March 29, 2014, I met Claudette St. John, the group leader, at 6:45pm at Northwest Christian Church in Acworth, GA. Rick Baldwin also attended the meeting. The group meets from 7-8:30pm. Claudette shared that she has been doing grief support classes for the past 20 years and the past 3 years she has been doing GriefShare at Northwest Christian. She lost her teenage daughter in a car accident 20 years ago. She expressed that there really are not any rules, other than just respecting each individual. She tasks herself with keeping the meetings on track and has a democratic leadership style. GriefShare is a Christian based program consisting of 13 weekly session. Participants do not need to attend all 13 sessions, the sessions can also be done individually. A workbook is given to those that are participating in the program. GriefShare’s goal is to help those experiencing grief, work through the process and recognize the different aspects of grief that they may encounter.

Each year thousands of teenagers experience the death of someone they love. When a parent, sibling, friend, or relative dies, teens feel the overwhelming loss of someone who helped shape their -fragile self-identities. Caring adults, whether parents, teachers, counselors or friends, can help teens during this time. If adults are open, honest and loving, experiencing the loss of someone loved can be a chance for young people to learn about both the joy and pain that comes from caring deeply for others. There are many common reactions to trauma, grief, and bereavement among teens. First of all, shock and denial. Feeling numb, stunned and dazed are healthy and normal reactions. Often, it is difficult to “take in” information. The grieved may

Death is a universally experienced phenomenon. In the United States alone, over 2.6 million people die each year (Center for Disease Control and Prevention [CDC], 2015). For practitioners, it is of utmost importance to better understand the process of grief to develop better interventions for bereaved individuals.

1There is an identified need for a community level hospital intervention that will focus on adolescents dealing with grief and loss. The public health groups in hospitals are aimed at disease prevention and health promotion for adults and families who are at high-risk. These groups only focus on members who have high-risk health conditions and risky lifestyle behaviors, but they do not address the idea of death resulting from these high-risk behaviors. Clearly, these public health interventions do not target adolescents who share the commonality of grief and loss. These groups ignore the effects of death and the role it can play in determining one’s actions. Both the public health group and the grief and loss

Children who are grieving often struggle with life because they have lost a loved one. The loss may have been expected or unexpected, but the pain is still great. However, the way the person was lost and other factors surrounding the death, as well as the age of the child, can all affect how a counselor handles the child and his or her grief. Children can also grieve something other than a death, so there are many situations in which a child might need to see a grief counselor. Additionally, children who have been part of traumatic events where someone else has died may need more than just grief counseling because they will have survivor guilt and others issues which they will also have to face and work through. Empirical studies show that there are many different ways to provide a child with grief counseling, and that children can react very differently based on many characteristics. Counseling that is tailored to the child is the most significant way to help that child - and that is still not enough to convince every scholar that grief counseling actually has any benefit at all.

The Cokesbury United Methodist Church grief support group follows a thirteen-week curriculum from GriefShare, however, new members can join in at any time as each week has a “self-contained” lesson. The topic for the week I attendee focused on the “why” of losing a loved one. Through following this curriculum, the group seeks to equip members with “essentials to recover from the hurt of grief and loss.” (GriefShare, n.d.) The group focuses on helping members rebuild their lives after they experience tremendous loss and grief through facing the challenge together. (GriefShare, n.d.)

After interviewing the social workers Hope and Hodge (2006) found that they had observed similar patterns regarding the factors that affect the adjustment of children who lost a parent to death. Boys tend to show externalizing behaviors whereas girls tend to show internalizing behaviors due to the lost of a parent. They found that the cognitive level rather than the age of the child affects their adjustment more. Therefore younger children and preadolescents seem to have more difficulty adjusting to the death of a parent than adolescents. The results did not support earlier findings that sudden death present more difficulty adjusting than expected death. Most of the participants reported that sudden and expected death is equally traumatic to children. The participants also said that the adjustment of the caretaker is important for a positive adjustment for the children. The caretaker must be able to grieve while supporting the child’s need to grieve. This study shows that children of different ages and genders react different to the death of a parent.

This intervention benefits both children and parents with loss timelines. This intervention should not be used immediately after a loss. In addition, it is crucial that grief therapist review his or her own personal loss history before diving into this critical process with someone else. It is crucial the focus remain on the client. Loss Timelines works a bit differently for children and adults. For children losses can include moving to a new house or city, peer rejection, failing to make a team, the birth of a younger sibling, and the loss of grandparents. For adults their losses can include the start or treatment for an illness, fatal losses, romantic losses, financial losses, trauma, and relocation. The interesting aspect about this intervention

Nader and Salloum (2011) made clear that, at different ages, children differ in their understanding of the universality, inevitability, unpredictability, irreversibility, and causality of death. They believed, despite the increasing understanding with age of the physical aspects of death, a child may simultaneously hold more than one idea about the characteristics of death. However, factors that complete the determining nature of childhood grieving across different age groups may be a difficult task for a number of reasons including their environment in means of the support they have available, the child’s nature in terms of their personality, genetics, and gender, coping skills and previous experiences, the developmental age, grieving style, whether or not therapy was received, and the relationship to the deceased (Nader & Salloum, 2011). Crenshaw (2005) found that according to our current understanding of childhood traumatic grief and normal grief, thoughts and images of a traumatic nature are so terrifying, horrific, and anxiety provoking that they cause the child to avoid and shut out these thoughts and images that would be comforting reminders of the person who died. The distressing and intrusive images, reminders, and thoughts of the traumatic circumstances of the death, along with the physiological hyper-arousal associated with such re-experiencing, prevent the child from proceeding in a healthy way with the grieving process (Crenshaw, 2005). McClatchy, Vonk, and

In the future, sibling loss groups and other, more generalized grief groups will be established. Groups will be run primarily at GCC's planned counseling office, with an eye toward future expansion into public schools, health care centers, and senior citizen organizations. Groups in these community settings will be part of GCC's outreach program, and will be provided at no charge.