Wednesday, November 23, 2005

Helping Children Cope with Loss, Death and Grief:Response to a National Tragedy

The security and safety that was a hallmark of our American society was shattered by the events of September 11th. Never before in our nation’s history have so many lives been lost in a single day. Communities are impacted by multiple losses that stretch their capacities to cope. It is difficult to predict how students, adults and schools will be able to deal with the harsh realities of life in the coming weeks, months and years. Children who have experienced the loss of one or both parents, siblings, other relatives, friends, or neighbors are now suffering from profound grief. How can caring adults help these children deal with loss of this magnitude? How can we begin to understand and respond to the depths of their suffering? One thing we do know is that this will be an extremely difficult and painful task. Children and adolescents will need all the support they can get and they will require a long time to recover. Life may not be the same for anyone in this country, but those youngsters who have sustained personal losses may require significant assistance from trained, caring adults.
Expressions of Grief
Talking to children about death must be geared to their developmental level and their capacity to understand the related facts of the situation. Children will be aware of the reactions of significant adults as they interpret and react to information about death and tragedy. The range of reactions that children display in response to the death of significant others may include:
Emotional shock and at times an apparent lack of feelings, which serve to help the child detach from the pain of the moment;
Regressive (immature) behaviors, such as needing to be rocked or held, difficulty separating from parents or significant others, needing to sleep in parent’s bed or an apparent difficulty completing tasks well within the child’s ability level;
Explosive emotions and acting out behavior that reflect the child’s internal feelings of anger, terror, frustration and helplessness. Acting out may reflect insecurity and a way to seek control over a situation for which they have little or no control;
Asking the same questions over and over, not because they do not understand the facts, but rather because the information is so hard to believe or accept. Repeated questions can help listeners determine if the child is responding to misinformation or the real trauma of the event.
Helping Children Cope
The following tips will help teachers and parents support children who have experienced the loss of parents or loved ones. Some of these recommendations come from Dr. Alan Wolfelt, Director of the Center for Loss and Life Transition in Fort Collins, Colorado.
· Allow children to be the teachers about their grief experiences: Give children the opportunity to tell their story and be a good listener.
· Don’t assume that every child in a certain age group understands death in the same way or with the same feelings: All children are different and their view of the world is unique and shaped by different experiences. (Developmental information is provided below.)
· Grieving is a process, not an event: Parents and schools need to allow adequate time for each child to grieve in the manner that works for that child. Pressing children to resume "normal" activities without the chance to deal with their emotional pain may prompt additional problems or negative reactions.
· Don’t lie or tell half-truths to children about the tragic event: Children are often bright and sensitive. They will see through false information and wonder why you do not trust them with the truth. Lies do not help the child through the healing process or help develop effective coping strategies for life’s future tragedies or losses.
· Help all children, regardless of age, to understand loss and death: Give the child information at the level that he/she can understand. Allow the child to guide adults as to the need for more information or clarification of the information presented. Loss and death are both part of the cycle of life that children need to understand.
· Encourage children to ask questions about loss and death: Adults need to be less anxious about not knowing all the answers. Treat questions with respect and a willingness to help the child find his or her own answers.
· Don’t assume that children always grieve in an orderly or predictable way: We all grieve in different ways and there is no one "correct" way for people to move through the grieving process.
· Let children know that you really want to understand what they are feeling or what they need: Sometimes children are upset but they cannot tell you what will be helpful. Giving them the time and encouragement to share their feelings with you may enable them to sort out their feelings.
· Children will need long-lasting support: The more losses the child or adolescent suffered, the more difficult it will be to recover. This is especially true if they lost a parent who was their major source of support. Try to develop multiple supports for children who suffered significant losses.
· Keep in mind that grief work is hard: It is hard work for adults and hard for children as well.
· Understand that grief work is complicated: When death results from a terrorist act, this brings forth many issues that are difficult, if not impossible, to comprehend. Grieving will also be complicated by a need for vengeance or justice and by the lack of resolution of the current situation: Perpetrators may still be at large and our nation is at war. The sudden nature of death and the fact that many individuals were considered missing rather than dead further complicates the grieving process.
· Be aware of your own need to grieve: Focusing on the children in your care is important, but not at the expense of your emotional needs. Adults who have lost a loved one will be far more able to help children work through their grief if they get help themselves. For some families, it may be important to seek family grief counseling, as well as individual sources of support.
Developmental Phases in Understanding Death
It is important to recognize that all children are unique in their understanding of death and dying. This understanding depends on their developmental level, cognitive skills, personality characteristics, religious or spiritual beliefs, teachings by parents and significant others, input from the media, and previous experiences with death. Nonetheless, there are some general considerations that will be helpful in understanding how children and adolescents experience and deal with death.
Infants and Toddlers: The youngest children may perceive that adults are sad, but have no real understanding of the meaning or significance of death.
Preschoolers: Young children may deny death as a formal event and may see death as reversible. They may interpret death as a separation, not a permanent condition. Preschool and even early elementary children may link certain events and magical thinking with the causes of death. As a result of the World Trade Center disaster, some children may imagine that going into tall buildings may cause someone’s death.
Early Elementary School: Children at this age (approximately 5-9) start to comprehend the finality of death. They begin to understand that certain circumstances may result in death. They can see that, if large planes crash into buildings, people in the planes and buildings will be killed. However, they may over-generalize, particularly at ages 5-6 - if jet planes don’t fly, then people don’t die. At this age, death is perceived as something that happens to others, not to oneself or one’s family.
Middle School: Children at this level have the cognitive understanding to comprehend death as a final event that results in the cessation of all bodily functions. They may not fully grasp the abstract concepts discussed by adults or on the TV news but are likely to be guided in their thinking by a concrete understanding of justice. They may experience a variety of feelings and emotions, and their expressions may include acting out or self-injurious behaviors as a means of coping with their anger, vengeance and despair.
High School: Most teens will fully grasp the meaning of death in circumstances such as the World Trade Center or Pentagon disasters. They may seek out friends and family for comfort or they may withdraw to deal with their grief. Teens (as well as some younger children) with a history of depression, suicidal behavior and chemical dependency are at particular risk for prolonged and serious grief reactions and may need more careful attention from home and school during these difficult times.
Tips for Children and Teens with Grieving Friends and Classmates
Many children and teens have been indirectly impacted by the terrorists’ attacks. They have learned of the deaths of people close to their friends and classmates - parents, siblings, other relatives and neighbors. Particularly in areas near the World Trade Center or Pentagon, it is not unusual to find several children in a given classroom who lost a family member - or even multiple family members. Additionally, all over the country, children have been impacted by the death of a family member at either the attack site or on board one of the four hijacked planes. Seeing their friends try to cope with such loss may scare or upset children who have had little or no experience with death and grieving. Some suggestions teachers and parents can provide to children and youth to deal with this "secondary" loss:
Particularly with younger children, it will be important to help clarify their understanding of death. See tips above under "helping children cope."
Seeing their classmates’ reactions to loss may bring about some fears of losing their own parents or siblings. Children need reassurance from caretakers and teachers that their own families are safe. For children who have experienced their own loss (previous death of a parent, grandparent, sibling), observing the grief of a friend can bring back painful memories. These children are at greater risk for developing more serious stress reactions and should be given extra support as needed.
Children (and many adults) need help in communicating condolence or comfort messages. Provide children with age-appropriate guidance for supporting their peers. Help them decide what to say (e.g., "Steve, I am so sorry about your father. I know you will miss him very much. Let me know if I can help you with your paper route...") and what to expect (see "expressions of grief" above).
Help children anticipate some changes in friends’ behavior. It is important that children understand that their grieving friends may act differently, may withdraw from their friends for a while, might seem angry or very sad, etc., but that this does not mean a lasting change in their relationship.
Explain to children that their "regular" friendship may be an important source of support for friends and classmates. Even normal social activities such as inviting a friend over to play, going to the park, playing sports, watching a movie, or a trip to the mall may offer a much needed distraction and sense of connection and normalcy.
Children need to have some options for providing support - it will help them deal with their fears and concerns if they have some concrete actions that they can take to help. Suggest making cards, drawings, helping with chores or homework, etc. Older teens might offer to help the family with some shopping, cleaning, errands, etc., or with babysitting for younger children.
Encourage children who are worried about a friend to talk to a caring adult. This can help alleviate their own concern or potential sense of responsibility for making their friend feel better. Children may also share important information about a friend who is at risk of more serious grief reactions.
Parents and teachers need to be alert to children in their care who may be reacting to a friend’s loss of a loved one. These children will need some extra support to help them deal with the sense of frustration and helplessness that many people are feeling at this time.
Resources for Grieving and Traumatized Children
At times of severe stress, such as the trauma of the terrorist attacks on our country, both children and adults need extra support. Children closest to this tragedy may very well experience the most dramatic feelings of fear, anxiety and loss. They may have personally lost a loved one or know of friends and schoolmates who have been devastated by these treacherous acts. Adults need to carefully observe these children for signs of traumatic stress, depression or even suicidal thinking, and seek professional help when necessary.
Resources to help you identify symptoms of severe stress and grief reactions are available at the National Association of School Psychologist’s website - www.nasponline.org.

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