Developing services for bereaved children: A discussion of the theoretical and practical issues involved

Lost support, lost skills: Children's cognitive outcomes following grandparental death

OBJECTIVE

This study examines the implications of grandparental death for cognitive skills in middle childhood.

METHOD

This study uses data from the Future of Families and Child Wellbeing Study (N = 2479) to estimate ordinary least squares regression models of the associations between grandparental death and subsequent cognitive skills among children in middle childhood.

RESULTS

Experiencing a grandparental death between ages 5 and 9 is associated with boys' lower reading, verbal, and math scores at age 9, with associations most notable for Black and Hispanic boys; grandparental death before age 5 has minimal influence on boys' cognitive skills at age 9. There is little indication that grandparental death adversely affects girls' cognitive skills.

CONCLUSION

The numerous and persistent implications of grandparental death for boys' cognitive skills merit greater recognition of grandparental death as a source of family instability, stress, and ultimately inequality in child development.

Mothers Coping With Bereavement in the 2008 China Earthquake: A Dual Process Model Analysis

The purpose of this study is to explore the grief experiences of mothers after they lost their children in the 2008 China earthquake. Informed by the dual process model, this study conducted in-depth interviews to explore how six bereaved mothers coped with such grief over a 2-year period. Right after the earthquake, these mothers suffered from intensive grief. They primarily coped with loss-oriented stressors. As time passed, these mothers began to focus on restoration-oriented stressors to face changes in life. This coping trajectory was a dynamic and integral process, which bereaved mothers oscillated between loss- and restoration-oriented stressors. This study offers insight in extending the existing empirical evidence of the dual process model.

Towards a model of loss navigation in adolescence

Researchers today consider childhood bereavement one of the most traumatic experiences that can befall a child. Nevertheless, most models of bereavement currently limit themselves to dealing with adult grief and primarily explores the internal processes associated with recovery. Based on a study which conducted focus groups with 39 Danish adolescents (aged 9-17), this article presents The Model of Loss Navigation in Adolescence. Centered on the three factors-Being Different, Being in Control, and Being in Grief-the model highlight the social conventions children have to navigate and how these influences both their day-to-day lives and their road to recovery.

Mothers Coping With Bereavement in the 2008 China Earthquake: A Dual Process Model Analysis

The purpose of this study is to explore the grief experiences of mothers after they lost their children in the 2008 China earthquake. Informed by the Dual Process Model, this study conducted in-depth interviews to explore how six bereaved mothers coped with such grief over a 2-year period. Right after the earthquake, these mothers suffered from intensive grief. They primarily coped with loss-oriented stressors. As time passed, these mothers began to focus on restoration-oriented stressors to face changes in life. This coping trajectory was a dynamic and integral process, which bereaved mothers oscillated between loss- and restoration-oriented stressors. This study offers insight in extending the existing empirical evidence of the Dual Process Model.

The dual process model of coping with bereavement: a decade on

The Dual Process Model of Coping with Bereavement (DPM; Stroebe & Schut, 1999) is described in this article. The rationale is given as to why this model was deemed necessary and how it was designed to overcome limitations of earlier models of adaptive coping with loss. Although building on earlier theoretical formulations, it contrasts with other models along a number of dimensions which are outlined. In addition to describing the basic parameters of the DPM, theoretical and empirical developments that have taken place since the original publication of the model are summarized. Guidelines for future research are given focusing on principles that should be followed to put the model to stringent empirical test.

Setting up a support group for children and their well carers who have a significant adult with a life-threatening illness

St Richard's Hospice provides care and support for adults with a life-threatening illness and their families. Children and adolescents who are facing the loss of a significant adult are often encountered as part of its work. Whereas in the past children and young people have been supported primarily through one-to-one interactions after the adult has died, the expansion of the hospice's facilities has recently enabled it to provide an increasing amount of pre-death support, including the launch of a pre-death child and family support group. This article reflects on the benefits and challenges of setting up and running such a group and the journey the hospice has gone through so far. It is hoped that by sharing experiences, some of the benefits of group work for children and adolescents facing the loss of a significant adult can be demonstrated, and that others in the worldwide palliative care community who are considering running or are already providing such a service will be encouraged.

Service and science in times of crisis: developing, planning, and implementing a clinical research program for children traumatically bereaved after 9/11

September 11, 2001 was a tragedy unparalleled in the United States, resulting in the largest number of parentally bereaved children from a single terrorist incident. The event necessitated swift and sensitive development of programs to meet the needs of bereaved children and their families, and it offered a rare opportunity to investigate the symptoms of, and intervention for, traumatic bereavement. Progress is being made in evaluating assessment and treatment services for traumatically bereaved children and their caregivers. However, attention must be paid to how programs are created in order to carry out the work. This article reports on the methods used to develop and deliver a clinical research program in the aftermath of 9/11. The specific challenges following a crisis, the decision-making process and lessons learned are highlighted, and future program development recommendations are presented.

Are we getting it right? Parents' perceptions of hospice child bereavement support services

OBJECTIVE

To determine parents' experiences and perceptions of a support service for families with bereaved children, provided by a UK charity for cancer patients in seven hospices in the UK.

METHOD

Individual interviews with 25 purposively selected parents.

RESULTS

Parents used the service for: advice and reassurance; support for their children while they grieved; and advice on ameliorating behavioural difficulties at home and school. Non-service users did not think formalised support was necessary or had other sufficient support. Nevertheless, important to parents in both groups was that the service existed so their children's needs were being or could be addressed. Children and their parents benefited from talking to a non-family member, and being involved in social events that reduced feelings of isolation.

CONCLUSION

The hospice child bereavement service was offered as an integral part of palliative cancer care support. Future research could explore collaborative work between counsellors and other professionals.

Program interventions for children at the end of life and their siblings

An analogy may be drawn between readying a family for the birthof a child and readying a family for the death of a child. Both ex-periences bring about an intense fusion of the emotional, physical,and spiritual realms for those bearing witness. Preparation, com-munication, and collaboration are essential to provide optimalsupport for the children at the end of life, the parents, and thebrothers and sisters.

Pilot of a workbook for children visiting a loved one in a hospice

A palliative care counsellor developed a workbook for use by children aged 5 to 14 years visiting a loved one in a hospice. This article reports the findings of a small qualitative pilot study exploring how children used the workbook, their views on it and the views of their families and hospice staff. The seven children in the study all enjoyed having the workbook. It provided opportunities for them to interact and build relationships with the staff and to become more involved in their visits to the hospice. Nurses and staff thought the workbook had the potential to help nurses and parents respond to questions or to stimulate discussion. Children used the workbook in different ways, highlighting the need for a flexible approach. It is essential when using such a tool that individual and family needs are respected. The study also raised issues regarding the need for training and emotional support for staff.

Grief and bereavement

Bereavement support is an integral part of palliative care. Grieving after loss is a normal process; however, some grief reactions become complicated and may seriously compromise the health of an individual. Routine bereavement care helps identify people at risk of complicated grieving. The burden of grief can last for years, sometimes indefinitely. People caring for the bereaved need to pay special attention to cultural differences, the burden of caring for dying children, and the special support needs of bereaved children and adolescents. Excellent resources to assist in grief management, including the expertise of palliative care teams, are readily available.