Children and Bereavement How Do Healthcare Professionals,

Children and Bereavement

How do healthcare professionals, psychologists and others help a child transition to a life without its mother or father? What are the best support methods for children when they are dealing with bereavement? This paper sheds light on the best practices -- and the less-than-ideal practices -- when helping a young person or a child get through this painful experience in their lives.

A scholarly article in the Journal of Child and Adolescent Psychiatric Nursing uses the results of several studies to emphasize that children grieving the death of a parent that committed suicide tend to experience "…even higher rates of anxiety, depression, poor school adjustment" than children who lost a parent resulting from natural causes (Mitchell, 2006, pp. 130-31). When a child is forced to deal with the suicide death of a parent, that child is not only asked to try to understand why the parent died by suicide, but also that child must now cope with the "stigma that society places upon a suicide death" (Mitchell, 131).

Of course children experience certain emotions during bereavement like anger, shame, guilt, sadness, relief and even acceptance, Mitchell explains. But for a child whose parent died by suicide, about six months after the death, the child tends to transition into more serious symptoms, including depression and shame, Mitchell goes on (131). A study by Pfeffer and associates indicates that a child whose parent committed suicide experiences "anxiety" immediately after the death, followed six months later by "anger" and by "shame" one year later. Moreover, the Pfeffer study suggests that about eighteen months after the suicide death of a parent, a child will have begun to experience "significantly more severe depressive symptoms" (Mitchell, 131).

There will likely be long-term psychological and social adjustments necessary for a child in this situation, Mitchell explains. Hence, identifying the child's psychological needs at an early time in the grieving process, and offering "therapeutic intervention" will be "crucial to prevent the development of negative health outcomes…" (Mitchell, 131). Another ramification for the child and for the family of a parent that died because of suicide is the possibility that the "true cause of death" may be concealed. In that event, the family is attempting to hide the "shame and guilt" associated with a death by suicide through creating a myth about the death. This secrecy and falsification of true facts -- along with a lack of "open communication" -- can result in "interminable mourning," Mitchell continues on page 133.

The authors suggest in strong terms that being coy about the fact that the parent is dead -- for example, saying dad has "gone somewhere" or has "gone to sleep" -- can lead to a very young child hoping the parent will wake up, or show up, at some point in the future. Keeping communication open and honest, and making the cause of death as "clear and honest as possible" is the best strategy, Mitchell concludes (135).

Meantime, in the Journal of Mental Health Counseling the authors offer suggestions to counselors that will be working with children after a member of the family has died from natural causes. The authors emphasize that very young children (those in preschool, for example) often do not comprehend the "permanence of death" and as a result, they may ask "repeatedly" when that deceased family member is coming home (Morgan, et al., 2010, p. 207). Very young children are apt to use "magical and egocentric thinking," Morgan explains, and they may believe that they "somehow caused the death because of their inability to differentiate between thoughts and deeds" (207). Typically, a very young sister might think her brother died because in the past the sister was very angry at him, Morgan continues (207).

For children aged 7 to 11, they might experience a sense of guilt because they believe that they should have been able to do something to prevent that death (Morgan, 208). The authors suggest that counselors should encourage young people to express thoughts and feelings through drawings; through the act of drawing, a young child is "externalizing" memories of that deceased person which can be "a bridge for discussing unarticulated thoughts and feelings about death" with a professional counselor. Support groups are also important for young people; it allows them to come together in a safe place where they can honestly and openly share their thoughts with others that have lost someone recently (Morgan, 210). Still another idea for helping young people transition into a life without their missing loved one is "bibliotherapy," the practice of using books for therapeutic reading. This can stimulate conversation about death, and especially for children that are traumatized, sharing well-written, sensitive literature can help them realize "that others share their situation" (Morgan, 212).