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Children and Grief (page 3)

By — NYU Child Study Center
Updated on Jul 9, 2010

Coping tasks

We know that children, as well as adults, grieve in their own way, that feelings change over time, and that the bereavement process goes on throughout life. There can be an ebb and flow to emotions and situations that trigger new thoughts and ways of thinking about the person who has died and one's life without the person. Rather than believe in a set series of stages that one must pass through, the work is conceptualized as different tasks with which one must cope or which one must resolve. The tasks of mourning for children 5 have been modeled on the tasks identified for adults 6 as follows:

  • Adults need to accept the reality of the loss. Children need to understand the person has actually died: Understanding can involve believing the death has occurred, understanding the feelings about it, and accepting the accompanying changes. A child may need to accept that dad doesn't braid hair as well as mom or that the family needed to get a new nanny because mom had to start working to earn money after dad died.
  • Adults need to work through the pain of grief. Children must also cope with the pain of loss and are faced with future occurrences of feelings related to loss: Experiencing rather than avoiding feelings is a necessary step. Experiencing and facing difficult feelings allows one to manage and move beyond them. As children get older, their understanding and feelings about the person who died may change and these feelings must also be addressed Unaddressed feelings at any time can lead to physical symptoms and emotional difficulties, or exert more force later on. A child may need to tell his mother he will never be as good a baseball player as his older brother who just died.
  • Adults adjust to the environment in which the person is no longer there. Children are faced with the task of investing in new relationships and developing a new identity based on the loss: Realization and understanding occurs over time as a death shapes life in new ways. Children face everyday concrete changes in routine as well as changes in responsibilities and role. Coming to terms with the differences encourages active control rather than passive avoidance. Whereas a wife may need to take over the family finances, a teenage boy may need to get a part time job as well as develop a strong bond with a coach as a male role model and guide.
  • Adults must emotionally relocate the person who has died to move on. Children accomplish this task by reevaluating the relationship, keeping an internal sense of the person, and continuing on with normal developmental tasks: Gradually, as days and months pass, the intense emotional focus and feelings become less prominent as balance is restored in life and memories are reinforced. There is a re-investment of physical and emotional energy in other aspects of life. This can be seen when a young teen continues to forge strong peer relationships, when a family enjoys a Thanksgiving celebration with talk about happy memories of past holidays, and when children are comforted by realizing they have incorporated qualities of a parent who has died into their own personality or life.

How to help

Children and teens can be helped with coping tasks in a variety of ways. Whereas the particular issues and specific content discussed must be varied and adapted to the age of the child and the situation, it is helpful for parents and adults to: 7

    1. Tell the truth. The alternative -- hiding information -- causes children to feel confused, unable to turn to adults for help, and mistrustful of other information. Avoid any unnecessary information.
    2. Be simple and direct. Use correct words and language. Although this may be difficult for adults, saying someone has died is preferable to potentially confusing euphemisms such as "he went to sleep," "he passed on," and "we've lost him."
    3. Reassure children they are not to blame.
    4. Model appropriate responses. Do not hide emotions. Explain feelings as a way to help children understand their own, but keep expression of strong, dramatic feelings for private times with other adults.
    5. Find ways for the child to be involved with family if at all possible. Participating in hospital routines or funeral rituals in whatever way they feel most comfortable can demystify events for children and provides closure.
    6. Encourage the child to talk and ask questions. Find out what a child thinks and feels and correct any misconceptions or misinformation.
    7. Become attuned to and respond to the child's own pace for revealing feelings. Offer opportunities for comfort by being available whenever the child/teen is ready or is experiencing some strong emotion.
    8. Allow and encourage expression in private ways, e.g. use of journals, art.
    9. Acknowledge and affirm children's expressions. Accept and normalize their response.
    10. Have more than one conversation. A child's familiarity, interest, and questions about difficult situations change over time. Be available and look for teachable moments or opportunities for further exploration.
    11. Provide understanding, support, and extra guidance or assistance with school assignments, social obligations, and home chores as necessary over time.
    12. Explore their feelings about the situation or death. Understand their beliefs and how being confronted with death can stimulate related personal feelings.
    13. Realize children may make comparisons; they may comment on and wish for things to be the way they used to be, compare times before and after events, compare the surviving parent to the one who has died, or their life to that of others.
    14. Talk to and enlist the support of other adults (such as teachers and coaches) who are in contact with the children.
    15. Become familiar with cultural and religious beliefs and practices. Being sensitive to specific rituals and customs is important for understanding how to respond, how to tailor comfort, what is within the realm of expected behavior, and how to prepare and involve classmates.
    16. Monitor a child's response over time and check out any concerns with a mental health professional.
    17. Encourage and help the child to collect keepsakes and construct and maintain memories.
About the Author

Robin F. Goodman, Ph.D. , is a clinical psychologist specializing in bereavement issues.

References

1. Statistical Abstract of the United States (119th edition) (1990) Washington, DC. U.S. Bureau of the Census.

2. Goodman, RF (1990). Development of the concept of death in children: the cognitive and affective components (Doctoral Dissertation, Adelphi University, 1989). Dissertation Abstracts International . 4405.

3. Christ, GH (1999), Healing Children's Grief . NY: Oxford University Press. Wolfelt, AD (1996). Healing the Bereaved Child . CO: Companion Press.

4. Del Zappo, P.M. (1993) Pastoral Bereavement Counseling: A Training Program for Caregivers in Ministry to the Bereaved . Archdiocese of NY. Weller, RA, Weller, EB, Fristad, MA, Bowes, JM (1991) Depression in recently bereaved prepubertal children. American Journal of Psychiatry , 148 (11), 1536-1540. Wolfelt, AD (1996) op cit.

5. Beker, JE, Sedney, MA , Gross, E (1996) Psychological tasks for bereaved children. American Journal of Orthopsychiatry , 62, 105-116. Oltejenbruns, KA Developmental context of childhood grief. In MS Stroebe, RO Hansson, W Stroebe, H Schut, Handbook of Bereavement Research . Washington, DC: American Psychological Association. 169-917.

6. Worden, JWW (1991) Grief Counseling and Grief Therapy . NY: Springer Publishing Co.

7. Goodman, RF (in press). Using art as a component of grief work. In Helping Bereaved Children , Second Edition. NB Webb (Ed.) NY: Guilford. Formanek, R & Gurian, A (1980) Why: Children's Questions . NY: New American Library. 129-133.

 

About the NYU Child Study Center

The New York University Child Study Center is dedicated to increasing the awareness of child and adolescent psychiatric disorders and improving the research necessary to advance the prevention, identification, and treatment of these disorders on a national scale. The Center offers expert psychiatric services for children, adolescents, young adults, and families with emphasis on early diagnosis and intervention. The Center's mission is to bridge the gap between science and practice, integrating the finest research with patient care and state-of-the-art training utilizing the resources of the New York University School of Medicine. The Child Study Center was founded in 1997 and established as the Department of Child and Adolescent Psychiatry within the NYU School of Medicine in 2006. For more information, please call us at (212) 263-6622 or visit us at www.aboutourkids.org.

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