Children and young people's experience of UK childhood bereavement services

Supporting Childhood Bereavement Through School-Based Grief Group

With 7.3% of children under the age of 18 experiencing the death of a parent and more who experience a loss of a loved one bereavement is a common experience in the lives of children and youth. The current study sought to evaluate the effectiveness of an 8-week, school-based grief group treatment program in reducing symptoms of grief, dysregulation, and improving social support. A total of 296 children and youth (age 11-18) participated in the grief programming provided by a local hospice agency. With a retention rate of 76% the researchers identified a significant reduction in grief symptomology, frequency of emotion dysregulation, and a significant increase in perceived social support from pre- to post-8-week school-based grief programming. A reduction in intensity of dysregulation was not significant. Implications for school personnel and parental support of children and youth experiencing loss are discussed.

"I Don't Know What to Say": Teachers' Perspectives on Supporting Bereaved Students After the Death of a Parent

This qualitative study examined teachers' experiences dealing with bereaved students following the death of a parent. The researchers conducted in-depth, semi-structured, face-to-face interviews with 25 teachers in Israeli schools who had counseled one of their students after the death of a parent. The interviews were recorded and transcribed and underwent content analysis. Analysis of the findings revealed that the teachers felt helpless, confused, overloaded emotionally and anxious when counseling students who had lost a parent. In addition, the teachers discussed the complex nature of their relationship with the remaining parent, ranging from a desire to support the family through avoidance for fear of hurting the parent to fears of being overwhelmed by the child's problems. Many teachers mentioned their need for support from school officials.

Unity strengthens and inhibits development: A focus group interview with volunteer adults in support programs for bereaved children and their family

This article illuminates (inter)actions and group dynamics of adult volunteers in programs for bereaved children and parents. A focus group interview with seven volunteers in Swedish was conducted. A latent, thematic analysis was conducted, inspired by Braun and Clarke, and Goffman. Two themes were constructed: Personal despair as a motivation for establishing and consolidating voluntary involvement and The volunteers acted as an extended family. Group dynamics within the group contributed to uphold volunteers' adherence to formal and informal guidance related to the program. Strong engagement among volunteers and internal recruitment strategies contributed to uphold and consolidate the program's implementation.

Reflecting on parental terminal illness and death during adolescence: An interpretative phenomenological analysis

There has been little consideration of how adolescents experience parental terminal illness (PTI) and death and any continuing impact it may have on their lives. In particular, limited attention has been given to this group’s perceptions and experiences of support during this period. This study explores the retrospective experiences of six individuals who had a parent diagnosed with a terminal illness (TI) during late adolescence. Their experiences are qualitatively explored in terms of their understanding, processing and adjustment to their parent’s TI and death; both as an individual, and in the context of their wider family and social setting. Interpretative Phenomenological Analysis was employed to analyse participant data. Participants were individuals who had a parent diagnosed with a terminal illness aged 16-18. Four superordinate themes emerged from the data. These were: changing family dynamics, grappling with adolescence and adjustment to loss, barriers to feeling/being supported and living with the consequences. Participants relate the profound impact that PTI during adolescence has had and continues to have on their lives. Study findings provide clinically useful information for healthcare professionals working with bereaved young people and those presently experiencing PTI. Implications are discussed in terms of service provision and design, including therapeutic recommendations for counselling psychologists and other professionals working with this group.

When a parent dies - a systematic review of the effects of support programs for parentally bereaved children and their caregivers

BACKGROUND

The death of a parent is a highly stressful life event for bereaved children. Several studies have shown an increased risk of mental ill-health and psychosocial problems among affected children. The aims of this study were to systematically review studies about effective support interventions for parentally bereaved children and to identify gaps in the research.

METHODS

The review's inclusion criteria were comparative studies with samples of parentally bereaved children. The focus of these studies were assessments of the effects on children of a bereavement support intervention. The intervention was directed towards children 0-18 years; but it could also target the children's remaining parent/caregiver. The study included an outcome measure that dealt with effects of the intervention on children. The following electronic databases were searched up to and including November 2015: PubMed, PsycINFO, Cinahl, PILOTS, ProQuest Sociology (Sociological Abstracts and Social Services Abstracts). The included studies were analysed and summarized based on the following categories: type of intervention, reference and grade of evidence, study population, evaluation design, measure, outcome variable and findings as effect size within and between groups.

RESULTS

One thousand, seven hundred and-six abstracts were examined. Following the selection process, 17 studies were included. The included studies consisted of 15 randomized controlled studies, while one study employed a quasi-experimental and one study a pre-post-test design. Thirteen studies provided strong evidence with regards to the quality of the studies due to the grade criteria; three studies provided fairly strong evidence and one study provided weaker evidence. The included studies were published between 1985 and 2015, with the majority published 2000 onwards. The studies were published within several disciplines such as psychology, social work, medicine and psychiatry, which illustrates that support for bereaved children is relevant for different professions. The interventions were based on various forms of support: group interventions for the children, family interventions, guidance for parents and camp activities for children. In fourteen studies, the interventions were directed at both children and their remaining parents. These studies revealed that when parents are supported, they can demonstrate an enhanced capacity to support their children. In three studies, the interventions were primarily directed at the bereaved children. The results showed positive between group effects both for children and caregivers in several areas, namely large effects for children's traumatic grief and parent's feelings of being supported; medium effects for parental warmth, positive parenting, parent's mental health, grief discussions in the family, and children's health. There were small effects on several outcomes, for example children's post-traumatic stress disorder (PTSD) symptoms, anxiety, depression, self-esteem and behaviour problems. There were studies that did not show effects on some measures, namely depression, present grief, and for the subgroup boys on anxiety, depression, internalizing and externalizing.

CONCLUSIONS

The results indicate that relatively brief interventions can prevent children from developing more severe problems after the loss of a parent, such as traumatic grief and mental health problems. Studies have shown positive effects for both children's and remaining caregiver's health. Further research is required including how best to support younger bereaved children. There is also a need for more empirically rigorous effect studies in this area.

The Shared Experience Help the Bereavement to Flow: A Family Support Group Evaluation

When a family member dies, a bereavement period is taking place for all family members. The death of a parent during childhood is a highly stressful event. This study evaluates families' experiences of family support groups when a parent has died. Families were participate in groups for children, teenagers, young adults, and parents in seven sessions. The same topic which was discussed in all groups. The support groups were evaluated qualitatively and quantitatively. The participants were satisfied with the groups and experienced that the shared experience facilitated bereavement to proceed. The results indicate that families' experiences is being more open about feelings in their own family. A support group can be one possibility to help the whole family in the bereavement.

'Being a presence': The ways in which family support workers encompass, embrace, befriend, accompany and endure with families of life-limited children

Children with life-limiting and disabling conditions are surviving longer than previously, and many require palliative and supportive care, usually at home. Home-based care can put family life under considerable strain, as parents care for their child's complex, often unpredictable, continuing care needs. Rainbow Trust Children's Charity aims to bridge gaps in services for children with life-threatening or terminal conditions by providing family support workers (FSWs). The study used a range of methods (surveys, interviews and ethnographic observation) approach to explore key aspects of the work of the FSWs. The target population for the surveys was families with a child having complex, life-threatening or terminal conditions receiving care from FSWs. The participants included 55 families (12 bereaved) and 39 children aged 2-18 years. Thematic analysis revealed how the FSWs became a presence in families' lives in three main ways: (1) encompassing and embracing families through supporting needs and promoting resilience; (2) befriending and bonding through developing knowledge, trusting relationships and a sense of closeness; and (3) accompanying and enduring by 'being with' families in different settings, situations and crises and by enduring alongside the families. The study demonstrated the fundamental importance of workers who are able to provide aspects of support that is usually not provided by other services.

Young people living with parental bereavement: Insights from an ethnographic study of a UK childhood bereavement service

The purpose of this two-year ethnographic study was to explore the experiences of parentally bereaved young people who sought support from the Rocky Centre (a pseudonym), a childhood bereavement service in the United Kingdom. Data were generated from extended periods of participant observation and semi-structured interviews with both staff and service users. In this article we focus specifically on the interviews with 13 young people to elucidate the factors that helped them to live with parental bereavement. Of these participants, four had been recently bereaved and nine had experienced the death of a parent over ten years ago. Seven key themes emerged from the analysis of the interview data: expressing emotion, physical activity, positive adult relationship(s), area of competence, friendships/social support, having fun/humour and transcendence. These themes are discussed in turn, and implications for research and practice are addressed.

Behavioural and emotional problems in Iranian children four years after parental death in an earthquake

BACKGROUND

Although previous research has established a direct impact of natural disasters on child mental health, there is limited knowledge on the underpinning mechanisms, particularly when there has been the loss of a parent.

AIMS

To establish: (a) the rates of behavioural and emotional problems of school-aged children who had lost their parents in the 2003 earthquake in Iran, compared with children from intact families who attended the same schools; (b) the relationship between the psychopathology of the surviving parents' and children's behavioural and emotional problems; and (c) whether this relationship was compounded by socioeconomic factors.

METHODS

Eighty six children of 7-13 years who had lost a parent in the earthquake four years earlier were compared with 80 matched children from intact families. The teacher and parent versions of the Strengths and Difficulties Questionnaire (SDQ) were used as measures of behavioural and emotional problems. Parents' psychopathology was established by the Self Report Questionnaire (SRQ).

RESULTS

Behavioural and emotional problems were significantly higher in children who had suffered parental loss than in the control group. There was a significant association between parent-rated SDQ and SRQ scores. Parental death was found to interact with socioeconomic variables in predicting children's behavioural and emotional problems and surviving parents' mental health problems.

CONCLUSIONS

After natural disasters, bereaved children and their surviving parents are at risk of developing mental health problems, and social adversities increase this risk.