Day Four: Counseling Grieving Children and Adolescents

"Often times children are the ones getting left behind." 

~ Mary Pat Warner, MFT 

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 Children grieve differently than adults

• Experience of grief depends on cognitive development
• Children act more than speak
• Children mourn in "doses" - they do not grieve in predictable patterns or stages
• Children are at the mercy of those around them for care
• Children, particularly teens, may resist open mourning because they do not want to be different from their peers

Six manifestations of grief in children

1. Physical
2. Emotional
3. Mental
4. Social and Familial
5. Behavioral
6. Spiritual and Existential

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Infants are NOT to young to grieve

• Infants detect changes in emotional atmosphere 
• Infants can recognize the absence of a family presence
• Infants experience insecurity - they protest - changes in sleeping and eating - regressive behavior - apathy, detachment, and withdrawal

Children Age 2-5 years

• May seem unaffected by news of death
• Approach and avoid 
• Perceive death as temporary and reversible
• Magical Thinking
• Somatic complaints

Children Age 6-9 years

• Approach and avoid
• Better understanding of permanence of death
• Difficulty expressing and answering questions
• Strongly attuned to emotional state of key adults
• Fear of other attachment figures dying
• School phobias and separation anxiety
• Parentification

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Children Age 10-12 years

• Good understanding of permanence
• School phobias and separation anxiety
• Somatic complaints
• May stop expressing grief to "protect" others or appear "in control"
• Tend to identify strongly with deceased and adopt their habits, mannerisms, and interests
• Grief complicated by puberty
• Parentification

Adolescents

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• Complicated by challenges of adolescence
• Ability to think abstractly allows for greater understanding of death and spiritual issues
• Fear of unknown mortality
• Risk of developing maladaptive behaviors to self-soothe
• Decrease in school performance
• May experience depression, guilt, and concerns about things said or unsaid
• Anger, tantrums, defiance, and withdrawal
• Parentification

Six Reconciliation Needs of Children

1. Acknowledge the reality of the death
2. Move toward the pain of the loss while being nurtured physically, emotionally, and spiritually.
3. Convert the relationship with the person who has died; from the one of presence to the one of memory
4. Develop new identity without the person who died
5. Relate the experience of death to a context of meaning
6. Experience a continued supportive adult presence in future years

Helpful Hints

• Accept all feelings and emotions
• Careful not to judge or criticize
• Provide safe place
• Reassure death is not their fault
• Be open about the grief process
• Communicate with children about death - differentiate between sickness and terminal illness
• Avoid euphemisms like: "Eternal rest" or "Rest In Peace" or "Went Away"

Recommended Reading List from Bo's Place Website:

Professionals:

• Children and Grief: When a Parent Dies by J. William Worden
• Companioning the Bereaved: A Soulful Guide for Counselors & Caregivers by Alan D. Wolfelt
• Grief as a Family Process: A Developmental Approach to Clinical Practice by Ester R. Shapiro

Adults:

• Guiding Your Child Through Grief by James P. Emswiler and Mary Ann Emswiler
• Healing Your Grieving Heart by Alan D. Wolfelt
• Healing a Child’s Grieving Heart by Alan D. Wolfelt
• Understanding Your Grief: Ten Essential Touchstones for Finding Hope and Healing Your Heart by Alan D. Wolfelt

Grieving Children:

• Don't Despair on Thursdays!: The Children's Grief-Management Book (The Emotional Impact Series) by Adolph Moser (Author) and David Melton (Illustrator)
• The Fall of Freddie the Leaf by Leo Buscaglia
• Healing Your Grieving Heart: For Kids by Alan D. Wolfelt
• How I Feel: A Coloring Book for Grieving Children by Alan D. Woolfelt, Ph.d
• Lifetimes: The Beautiful Way to Explain Death to Children by Bryan Mellonie (Author) and Robert Ingpen (Illustrator)
• Sad Isn't Bad: A Good-Grief Guidebook for Kids Dealing With Loss (Elf-Help Books for Kids) by Michaelene Mundy (Author) and R. W. Alley (Illustrator)
• Tear Soup by Pat Schweibert, and Chuck DeKlyen, Illustrated by Taylor Bills
• When Dinosaurs Die: A Guide to Understanding Death by Laurie Krasny Brown and Marc Brown
• When Someone Dies by Sharon Greenlee

Grieving Teens:

• Fire in My Heart, Ice in My Veins: A Journal for Teenagers Experiencing a Loss by Enid Samuel Traisman, MSW
• You Are Not Alone: Teens Talk about Life after the Loss of a Parent by Lynne B. Hughes
• Healing Your Grieving Heart: For Teens: by Alan D. Wolfelt, Phd
• Straight Talks About Death for Teenagers: How to Cope with Losing Someone You Love by Earl A. Grollman