Helping Grieving Students:

1. Helping Grieving Students: Resources for School-Based Professionals Dr. Carolyn H. Suppa Licensed Psychologist School Counselor K-12 Coordinator, Human Services Cluster WVDE csuppa@access.k12.wv.us

2. The 3R's of School Crises and Disasters: Readiness, Response, and Recovery A way to think about your school's level of preparedness is to measure what you have done to address the 3R's of School Crises and Disasters. • Readiness: Readiness is the level at which a school is prepared to respond to a crisis or to an emergency if the crisis or disaster were to happen today. • Response: Response is the sum total of the school's resources and skills to take decisive and effective action when a crisis situation has occurred. • Recovery: Recovery is the process of restoring the social and emotional equilibrium of the school community.

3. 4-step model found in some research: • Mitigation • Preparedness • Response • Recovery

5. Mitigation Mitigation is the action(s) schools and districts take to eliminate or reduce the loss of life and property damage related to an event(s) that cannot be prevented

6. Session Objectives To focus on resources for counselors to: • Evaluate and assist with school READINESS programs • Assist in the development of school RESPONSE strategies • Develop personal toolbox of RECOVERY strategies/resources related to grief reactions

7. READINESS • Because schools vary widely in their geographic locations, physical grounds, student body, number of teachers and staff, and available resources, each should craft strategies that match its own needs. • For all schools, cooperation among school staff, community resources, and mental health providers is the most important element of a successful readiness, response, and recovery process. • During the Readiness Phase, the school must establish effective relationships with law enforcement, emergency responders, health and mental health community agencies, and local religious institutions. With solid preparation and dedicated partnership, recovery, while always challenging, can be promoted effectively. • The first step in creating relationships is to reach out to partners in the community.

8. Each county school system is required to have a crisis management plan in place under the federal Safe Schools Act. The WVDE is encouraging all West Virginia schools to review their crisis management plans and will provide technical assistance related to such plans. These plans are customized to each county school system and explore items such as school security and actions to take in the case of a bomb threat or an intruder entering the building. (WVDE, 10/11/07) • The county plan must encompass the needs of the entire county and be reviewed and revised regularly. Additionally there must be a school-specific plan for each school. The county is strongly encouraged to keep all plans from every school within the county office. • http://www.connectlive.com/events/edschoolsafety/ • http://www.connectlive.com/events/depteduphilly0207/ (OSDFS Emergency Management Webcasts)

9. CurrentStatus of School Emergency Management Plans Most schools and school districts have emergency management plans; however, the plans are not always: • Comprehensive • Practiced regularly • Coordinated with the community • Always discussed with families, staff, and students • Based upon sound factual data and circumstances • Regularly updated or … • Used!

10. Key Components of School Emergency Management Plans The goal is for all school districts and schools to have emergency management plans that: • Address all phases of emergency management • Are developed collaboratively with community partners • Are based upon sound data and information • Are practiced on a regular basis • Are continually reviewed and updated • Are living documents • Include command structure • Are tailored to conditions of individual schools • Take an “all hazards” approach

11. All-Hazards Approach • Natural – Earthquakes, tornados, floods • Technological – Power outages, nearby nuclear plant • Infrastructure – Roads and bridges, utilities • Nonstructural – Portable room dividers, bookshelves, suspended ceilings and light fixtures • Man-made – Hazardous materials release, terrorism • Biological – Pandemic flu, contaminated food • Physical well-being – broken bones on playground, suicide • Student culture and climate – bullying, drugs, violent behavior

12. There are many resources for not only developing a school readiness program but also for assessing its effectiveness. This is just one review plan offered by, John Dudley, the author of the book When Grief Visits School: Organizing a Successful Response. http://www.schoolcrisis.org/publication.htm FREE*CRISIS PLAN REVIEW As the old saying goes, "People don't plan to fail, they fail to plan." Most schools have a plan to assist students, staff, and parents during times of crisis. But when was the last time you had your school crisis plan reviewed? Is it up to date on the latest techniques to deal with the media, students, staff and parents? As a service to schools, Dr. Dudley has volunteered to review and critique your school crisis plan FREE. Simply send a copy of your crisis plan to: Crisis Management7320 South 96th CourtLincoln, NE 68526 * Please enclose $15 for return shipping and handling.

13. Checklist for School Personnel • http://www.nctsn.org/sites/default/files/assets/pdfs/Challenger_Newsletter_Checklist-final_sw_rvsd.pdf Emergency Planning Guidelines • http://www2.ed.gov/admins/lead/safety/emergencyplan/index.html

15. RESPONSE AND RECOVERY

16. RESPONSE Response is the sum total of the school's resources and skills to take decisive and effective action when a crisis situation has occurred.

17. A Response Resource Aid: Responding to Crisis at a School is available from: The UCLA School Mental Health Project http://smhp.psych.ucla.edu

18. RECOVERY The Recovery phase is designed to assist students, staff and their families in the healing process and to restore educational operations in schools. The key components of recovery are: • Physical/structural • Business/fiscal • Academic • Psychological/emotional

19. Crisis Response, Recovery and Prevention Intervention Outcomes • Crisis Team Response and Aftermath Intervention • School Environment Changes and School Safety Strategies • Curriculum Approaches to Preventing Crisis Events (Personal and Social) a. Violence Prevention b. Suicide Prevention c. Physical/Sexual Abuse Prevention

20. Types of Crisis Aftermath Reactions • Reactions regarding Suicide • Reactions to Disaster • Reactions to Violence and Trauma • Grief Reactions

21. How do these types of aftermath reactions differ? And, more specifically to our session, what is the difference between grief and trauma reactions?

22. Disaster Reactions • Sense of unreality • Panic/feeling out of control • Anxiety/uncertainty • Disorientation • Despair • Anger • Generosity toward others • Cooperation/team work

23. Suicide: A Whole Other Session!http://www.google.com/search?q=wv+youth+suicide+rate&sourceid=ie7&rls=com.microsoft:en-us:IE-SearchBox&ie=&oe= (Good PowerPoint) But please remember three things: WV’s suicide rates for all ages are among the highest in the country. More students seriously consider suicide than most people want to think. (Take it all seriously.) Talking about suicide doesn’t make it happen. (Know and teach the signs.)

24. Violence and Trauma Reactions • http://www.tlcinst.org/griefandtrauma.html (The National Institute for Trauma and Loss in Children) • http://www.challiance.org/vov/publications/Common%20Reactions%20brochure.pdf (general brochure)

25. About Grief Reactions

26. There are a minimum of fifteen different terms describing grief, and mourning. Further complicating our understanding of grief and mourning is the concept of trauma. http://www.tlcinst.org/griefandtrauma.html

28. Grief and Trauma:The Confusion - The Difference

29.  As our understanding of trauma has improved, new terminology has emerged to describe new findings in the field of grief and trauma -- yet older terminology lingers. Terms are used interchangeably sometimes appropriately but also, at times, inappropriately. The meaning of some of the older terms can be narrowly and vaguely defined. This transition between old and new can be confusing at times.

30. The questions many now ask are: • “What is the difference between grief and bereavement and grief and trauma? • What is the difference between Traumatic Grief and PTSD? • What are the disorders most often associated with ongoing Traumatic Grief?”

31. Grief and Bereavement Grief and bereavement are terms often used interchangeably when in fact there is one major difference between the two. Bereavement is reserved specifically for the response to the death of a significant other whereas, grief can be the result of incidents of loss not involving death such as loss of job, loss of a limb, loss of status, etc.

32. The definition of Bereavement and its criteria has remained one of the more constant classifications. However, criteria related to other than normal bereavement and criteria related to mourning has changed considerably. Traumatic Grief is now becoming the term of choice over other terms used in the past to define other than normal bereavement.

33. Why the term “Traumatic Grief?” The classification of Traumatic Grief accomplishes several objectives as follows: • Avoids confusion with previous terminology such as pathological grief, neurotic or morbid grief, complicated grief, etc. • Succinctly defines a mourning process that can be traumatic without being triggered by a traumatic death. • Delineates traumatic grief from PTSD which can coexist with traumatic grief. • Requires that criteria be present for two months thereby giving individuals time to process traumatic aspects of the actual death prior to moving too quickly in assigning their reactions/responses as problematic.

34. Childhood Traumatic Grief Educational Materials - For School Personnel • The National Child Traumatic Stress Network • http://www.nctsn.org/products/childhood-traumatic-grief-educational-materials-school-personnel-2004 • For Educators • Childhood Traumatic Grief Educational Materials - For School Personnel

35. Posttraumatic Stress Disorder has also become a more familiar classification which is now evaluated for its presence following death of a traumatic nature. PTSD and Traumatic Grief do share common reactions yet each classification stands alone. At the same time both classifications can coexist with or without additional disorders.

36. Bereavement and Mourning Bereavement and mourning are also sometimes used interchangeably when in fact a distinct difference also exists between these two classifications. Bereavement identifies the specific reactions experienced following the death of a significant other whereas, mourning speaks to the way the individual displays his/her grief.

37. Complicated Mourning & Pathological Grief Complicated Mourning and Pathological Grief both refer to a description of the normal mourning process that leads to chronic or ongoing mourning. Psycho-analytically, mourning refers to the conscious and unconscious processes and behavior related to:a) development of new tiesb) adapting to the loss (the internal process of redefining one’s view of self and the world) andc) adaptation to the loss (the external process of relating to the world, people, one’s roles, responsibilities etc.)  It has been in this area of complicated mourning and pathological grief that numerous terms came into existence to further clarify different factors of complicated mourning or pathological grief. As stated previously many of these terms were narrowly defined and no longer considered current.

39. GRIEF RECOVERY

40. WVDE Web Grief Resources • http://wvde.state.wv.us/counselors/documents/grief_resources_what_to_say.pdf • wvde.state.wv.us/counselors/documents/Divorce9-122.doc • http://wvde.state.wv.us/counselors/group-lessons.html “Let’s talk about these. I have issues with the concepts of stages and closure.”

41. Coping with Death Important qualities for assistance include: • Courage to acknowledge the loss • Willingness to talk; “Keep the door open” • Good listening skills • Ability to empathize • Offer ongoing care and support • Regular, healthy routines and structures • Boundaries, limits, and accountability • Spiritual perspective/insight

42. COPE Model Problem-Solving Motivational Approach • Creativity – to overcome obstacles, manage problems and to see problems and solutions in a new way • Optimism – to face other’s expectations re the problem-solving process; need realistic optimism to recognize seriousness of problem yet see that solutions are possible • Planning – to implement treatment goals and objectives and address the emotional challenges associated with tasks • Expert Information – to encourage a sense of control and confidence when managing physical and emotional problems due to loss (adapted from Houts, 1996)

43. Six Basic Concepts of Grief • Grief is a natural reaction to change, loss, or death. • Each person’s grieving experience is unique. • There are no “right” or “wrong” ways to grieve. • All individuals walk through the grieving process in their own timeframes and in their own ways. • Grief comes in waves—times of great intensity followed by times of relief. There is no reasoning or pattern and it can hit with little warning. • Grieving never ends. It is something the person will not permanently “get over.”

44. Integration vs. Recovery, Closure, Etc. • Resolution (Not so much) • Recovery (Not so much) • Completion (Not so much) • Closure (Not so much) • Instead consider using . . . • Adaptation • Accommodation or • ** Integration (Current Preference in Literature)

45. Helping Grieving Children at School by Alan D. Wolfelt, Ph.D. Dr. Alan D. Wolfelt is a noted author, educator and practicing grief counselor. He serves as Director of the Center for Loss and Life Transition in Fort Collins, Colorado and presents dozens of grief-related workshops each year across North America. Among his books are Healing Your Grieving Heart: 100 Practical Ideas and The Healing Your Grieving Heart Journal for Teens. For more information, write or call The Center for Loss and Life Transition, 3735 Broken Bow Road, Fort Collins, Colorado 80526, (970) 226-6050 or visit their website, www.centerforloss.com.

46. Learn About Grief To help your students cope with death and grief, you must continually enhance your own knowledge of childhood grief. While we will never evolve to a point of knowing "everything there is to know about death," we can always strive to broaden our understanding and degree of helpfulness. Take advantage of resources and training opportunities as they become available. Another part of learning about grief involves exploring your assumptions about life and death. Think about your own personal losses. Who close to you has died? What did their deaths mean to you? Were you a child when someone you loved died? If so, how did you feel? How did the important adults in your life-including teachers and counselors-help you with your feelings of grief? Thinking about these issues will help you better help your students.

47. Adult Reactions to Grief and Loss • Denial • Difficulty finding consolation • Irritability and mood swings • Sleep difficulties • Change in eating habits • Low motivation • Difficulty problem solving • Fear of being alone • Use of substances to medicate • Vulnerable immune system • Other reactions?

48. Important Points re Grieving Children & Youth • They tend to go in and out of grief reactions. • Their developmental stage will influence their reactions. • All cannot talk openly about their loss and feelings. • They may not seem to be affected at all (external vs. internal responses or “survival mode”). • Play is one way in particular they make sense of the changes in their world. • It is not unusual for them to experience physical reactions. • They need to grieve any significant loss/change/death at all developmental stages for healthy resolution.

49. What are the differences between these two lists? Child/Adult Grief

50. Guidelines for Helping Grieving Children Be a good observer. A bereaved child's behavior can be very telling about her emotions. Listen. Let each child teach you what grief is like for him. And don't rush in with explanations. Usually it's more helpful to ask exploring questions than to supply cookie-cutter answers. Be patient. Children's grief isn't typically obvious and immediate. Be honest. Don't lie to children about death. They need to know that it's permanent and irreversible. Don't use euphemisms that cloud these facts. Use simple and direct language. Be available. Bereaved children need to know that they can count on the adults in their lives to listen to them, support them and love them.