TEEN GRIEF: A VIEW THROUGH THEIR EYES

1. RACHAEL GARRETT, MA, ALC, NCCGRIEF COUNSELORDUSTY SIVLEY, MA, ALCGRIEF COUNSELORTHE AMELIA CENTERWWW.AMELIACENTER.ORG TEEN GRIEF: A VIEW THROUGH THEIR EYES

2. LEARNING OBJECTIVES • At the completion of this discussion, participants will • have the ability to recognize 3 normal teenage responses to grief. • recognize the difference between healthy teen grief and unhealthy teen grief. • be able to demonstrate 3 effective techniques for grief support groups that can be accurately applied to grieving teenagers.

3. BEING A TEENAGER IN TODAY’S WORLD • IDENTITY VERSUS ROLE CONFUSION • Search for Identity -“Who am I and where do I fit in?”. • “Just being a teenager is a painful and uncertain time of life”. • TRANSITION FROM CHILDHOOD INTO ADULTHOOD • Trying to make good decisions regardless of peer pressure and surrounding temptations. • “Hormones are raging and expectations are high”. Teen Grief Relief: Parenting with understanding, support and guidance by Dr’s. Gloria & Heidi Horsley

4. BEING A GRIEVING TEENAGER IN TODAY’S WORLD • “WHO AM I AND WHERE DO I FIT IN?” • Feelings of isolation due to their experience. • Mood swings can be more frequent or intense. • TRANSITION FROM CHILDHOOD INTO ADULTHOOD • Can be expedited depending on who died. • Many teens find that they have to grow up quicker and take on adult roles after a caregiver dies.

5. WHAT’S NORMAL?

6. NORMAL SYMPTOMS OF TEEN GRIEF • Anger • Shame • Guilt and Regret • “Regrets are wishes. Guilt, on the other hand, implies action of some sort. It stems from something that you did or something hurtful you said.” • Feeling the need to tell and retell their story • Intense mood swings • Change in eating or sleeping patterns • Desire to connect with the person who died (specific places, items of clothing, objects they owned, etc.) *The Grieving Teen: A guide for teenagers and their friends by Helen Fitzgerald

7. NORMALSYMPTOMS OF TEEN GRIEF • Feelings of isolation • “No one understands what I’m going through” • Inability to verbalize or express feelings • Inability to concentrate • Poor grades • Lack of interest in social life and activities for a short period of time • Worrying about health issues or death of themselves or family • Idealizing person who died • Talking about funeral *The Grieving Teen: A guide for teenagers and their friends by Helen Fitzgerald

8. WHAT’S CAUSE FOR CONCERN • Overly preoccupied with death and dying • Bullying or becoming class clown • Completely stopping social life or activities for an extended amount of time • Giving possessions away • Acting out behaviors (drugs, alcohol, promiscuity) • Inability to function on a daily basis • Suicidal ideations • Self harm

9. CASE STUDIES • Female, 17 years old, father died by suicide when she was 13. • Struggles with feelings of self worth. Hard time accepting that people value her friendship. • Feels no one understands her. • Feels neglected/abandoned by mom. • Borderline Personality Disorder. • Techniques – • Acceptance, Staying present, Validating. • Show that I am a constant while also creating boundaries.

10. CASE STUDIES • Female, 14 yr old whose father died of cancer. • Client went into a depression where she stopped eating. • Had to quit dance and school due to the weight loss. • Techniques • Allowed her time to tell and retell her story. • Validated and Normalized. • Used grief as motivation to succeed instead of an excuse to fail. • Built on her faith.

11. CASE STUDIES • 18 year old teen girl, her mom died from cancer when she was 17. • She struggles with feeling like a burden to others when she voices her feelings. • She struggles with guilt/regret related to her mom’s death. • Techniques • I do a lot of normalizing and validating her feelings. • We work on helping her feel more comfortable with asking for help when she needs it. • We work on her learning the difference between guilt and regret and how to deal with each of those feelings.

12. CASE STUDIES • 16 year old teen girl. • Her dad died from cancer after battling it for 6 years. • She is very quiet and has a difficult time opening up. • She was very close to her dad and feels like no one understands what she is going through. • Techniques • I help her develop healthy coping skills. • I help her learn ways of communicating her feelings to her mom.

13. TEEN GRIEF SURVEY

14. TEEN SURVEY RESULTS • 6 Male/ 6 Female • Ages- 12-17 • Who died? Mom, dad, stepdad, grandfather, grandmother • How long ago did the death occur? 4 months-7 years • What has been the hardest part for you? • Opening up to someone about my feelings. • Accomplishing things and him not being here to see, being forced to live with my mom.

15. TEEN SURVEY RESULTS • What has been the hardest part for you? (cont…) • When my little brother gets in the way and mom’s not there to help. • Dealing with them not being around, not getting to visit with granddad or make pie with him. • Living without her being in my life and not seeing her on a daily basis. • Not having her here, being able to talk to her and tell her stuff, not coming/being at soft ball games, her being at the house cooking dinner, etc. • Focusing at school. • Going to their home and them not being there.

16. TEEN SURVEY RESULTS • What has been the most helpful thing another person has done for you, or said to you? • Having them listen and comfort me (close friend). • Just listened when I needed them to. • A friend’s letter that they gave to me. • That they’ll be there for me- and proving it (best friend). • Counselor giving me tips and guides on how to deal with my death. • Receiving signs through friends that my mom is watching over me. • Doing something to help me get what happened off my mind. • Thinking about my loved one.

17. TEEN SURVEY RESULTS • What do you suggest well meaning people avoid doing or saying to a grieving teen? • Telling them to “toughen up” or “you’ve got to grow up”. • Saying “it’s okay” because at the time it is isn’t okay. Saying “it will be okay one day” would make me feel better . • Don’t say “I know how you feel” unless you’ve had a similar thing happen like a parent die. • “I know how you feel” or putting themselves in the same place as the one who’s experienced the loss. • Saying “you have to forget about it and move on”.

18. TEEN SURVEY RESULTS • What do you suggest well meaning people avoid doing or saying to a grieving teen? (cont…) • Try to get them to talk about it. • “She is in a better place”, “It wasn’t your fault” (or family’s fault), “She is still with you”, “Everything is going to be ok”.

19. TEEN SURVEY RESULTS • What has been your most helpful coping tool? • Exercise • Talking • Talking to close friends • Running • Reading • Art • Writing • Crying • Playing softball for me and my mom • Being with family • Playing sports to get out the grief and anger

20. TEEN SURVEY RESULTS • What advice can you give to other grieving teens? • Don’t bottle it up. Find a person who is close and trustworthy to talk about how you feel. • Be positive, patient, and persistent. • Keep going and have your friends around to help you out. Don’t try to cope alone. • It’s okay to cry and think about that person. Continue to keep doing and accomplishing the goal you set before that person died. • Know you’re not the only one. It’s hard to go through and God is still with you and loves you.

21. TEEN SURVEY RESULTS • What advice can you give to other grieving teens? (cont…) • Find a hobby to get things off your mind. • Talk to a counselor. • It’s hard but keep your eyes open and someone special will enter your life.

22. VIDEO • A teen client shares her grief story

23. INDIVIDUAL SESSION TECHNIQUES • Rapport building • Let the teen tell (and retell) their story • Validate their feelings and normalize their grief • Remain present • Introduce healthy coping skills (writing, talking, crying, exercise, hobbies, art, poetry, music) • Active listening skills • No judgment – (They already have parents/guardians, they don’t need another person passing judgment) • Poker face

24. INDIVIDUAL SESSION • Benefits: • Allows self-disclosure in a more private setting. • Groups are not for everyone. • Provides an unbiased outlook on their grief journey. • Allows for intentional therapy on specific/current issues. • There is no set timeline of counseling (a person can come as long as it is beneficial to them). • There is no set curriculum.

25. ACTIVITIES: MEMORY STONE

26. ACTIVITIES: GRIEF CAVE

27. ACTIVITIES: JOURNAL, MEMORY BOX, PICTURE BOX

28. ACTIVITIES: GOODBYE GAME

29. GROUP SESSIONS • Name, who it was that died, how long ago. • Rapport building within the group by allowing each teen to tell their story. • Benefits: • Newfound identity through connecting with others who have faced similar experiences. • No longer feel isolated. • Finally feel understood. • New support system.

30. GROUP SESSION TECHNIQUES • Active listening • Reflecting • Clarification • Open-ended Questioning • Provide direction but encourage group to discuss among each other (ex: leader’s eye contact) • Linking others by pulling from one members experience and relating it to another members experience • If members interrupt each other, interject and politely refocus (ex: hand stop)

31. TEEN FACTS • 40% of teens report that the most helpful person in dealing with their loss was a peer. • 76% of teens involved in support groups reported feeling that they felt understood by their peers after their loss. * Responding to Teen Grief by Linda Goldman

32. TEEN GROUP ACTIVITIES • Past/Present/ Future Self activity- write down what member was like right after the death, write down who they are now, write down who they want to be in the future (-Shocked, -Scared/ Unsure, -Sad/ Happy, -Hopeful) • Garbage Thoughts activity – thoughts that haunt them that they throw away after discussing (“I could have done more”, “if only”) • Legacy activity – write down lasting legacies from the loved one (kindness, laughter, sharing, love for education, desire to help others) * Johnson, S. (2000). Teen Grief Groups: An eight-week curriculum. http://griefed.wordpress.com/

33. TEEN GROUP ACTIVITIES • Letter to the deceased, Letter from the deceased • Future Fears – (Who will walk me down the isle? Will I ever want to go fishing again?) -group members suggest ways to help their peers experiences be less painful. • Question Basket – basket full of questions for each member to draw from. (Before the death my biggest responsibility was____, now it’s ____. Before the death I was most afraid of_____, now I’m most afraid of_______.) * Johnson, S. (2000). Teen Grief Groups: An eight-week curriculum. http://griefed.wordpress.com/

34. TEEN GROUP ACTIVITIES • Variation of Question Basket- Group members write on an index card “I used to be _______. Now I’m______”. Go around the room and share. • Draw a favorite memory and a more difficult memory. • Scrapbook activity- supply items for scrapbooking such as paper, magazines, stickers, markers, etc. Group members choose items that remind them of their loved one and create a scrapbook page. Members can also bring pictures of their loved one to this group to include in their activity. * Johnson, S. (2000). Teen Grief Groups: An eight-week curriculum. http://griefed.wordpress.com/

35. WHAT YOU CAN DO TO HELP • Listen

36. WHAT YOU CAN DO TO HELP • Be present • Avoid passing judgment • Avoid telling the teen “you should” do or say anything • Provide examples of healthy coping skills (talking, writing, exercising, etc.) • Be encouraging

37. TEEN GRIEF RESOURCES:WEBSITES • Tragedy Assistance Program for Survivors • http://www.taps.org/magazine/print.aspx?id=6740 • Information providing common signs of teen grief and how to support grieving teens. • Hospice of the Valley • http://www.hov.org/teen-grief-support • Various articles directed at teens and adult who are helping teens. • The Dougy Center • http://www.dougy.org/grief-resources/how-to-help-a-grieving-teen/ • Teen grief information adapted from the book Helping Teens Cope with Death, Written by The Dougy Center • Comfort Zone Camp • http://comfortzonecamp.org/grief-resources/teens • Information about teen grief, but also allows teens to submit questions to be answered by peers or professional counselors.

38. TEEN GRIEF RESOURCES:BOOKS • Fitzgerald, H. (2000). The Grieving Teen: A guide for teenagers and their friends. New York, NY: Simon & Schuster. • Grollman, E.A. (1993). Straight Talk About Death for Teenagers: How to cope with losing someone you love. Boston, MA: Beacon Press. • Horsley, G. & Horsley, H. (2007). Teen Grief Relief: Parenting with understanding, support and guidance. Highland City, FL: Rainbow Books, Inc. • Wheeler, J.L. (2010). Weird is Normal When Teenagers Grieve. Naples, FL: Quality of Life Publishing Co.

39. REFERENCES • Fitzgerald, H. (2000). The Grieving Teen: A guide for teenagers and their friends. New York, NY: Simon & Schuster. • Goldman, L. (2012). Responding to Teen Grief. Taps Magazine, 17,3. Retrieved October 25, 2012, www.taps.org/magazine/print.aspx?id=6740. • Grollman, E.A. (1993). Straight Talk About Death for Teenagers: How to cope with losing someone you love. Boston, MA: Beacon Press. • Horsley, G. & Horsley, H. (2007). Teen Grief Relief: Parenting with understanding, support and guidance. Highland City, FL: Rainbow Books, Inc. • Johnson, S. (2000). Teen Grief Groups: An eight-week curriculum. http://griefed.wordpress.com/.