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Understanding and Supporting the Process Of Grief and Loss in Children and Youth.
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Understanding and Supporting the Process Of Grief and Loss in Children and Youth Being separated from loved ones and being torn from home and everything familiar is devastating for children and youth. The resulting experiences of loss and grief are profound and lasting. Because children usually have no choices in this experience, the impact for them is more severe than that for the adults in similar events. Beverly Kyer Educator and Public Speaker 2011 925.709.3300 Beverly Kyer, MSW; ACSW
Learning Objectives • Recognizing and examining grief as a natural process in children and youth • Increasing understanding and awareness of the stages and reactions to grief in children • Building empathy to shift away from pathologizing grief responses in children • Building comfort to talk about Loss with children • Learning techniques for helping children manage and move through Grief • Honoring grief triggers that surface for us during the work • Understanding that healing is an ongoing process Beverly Kyer, MSW; ACSW
Grief is a Journey to be Shared with Children of all ages No matter the nature of the loss, the grief process forever shapes the internal working model and resultant behaviors for the child. Our role as caretakers and providers will be to help the child process, cope and eventually integrate the overwhelming and persistent feelings they are struggling with. Beverly Kyer, MSW; ACSW
To Support the Grief Journey of Others, Recognize Our Own. INTRODUCTIONS AND SHARING • My Mother [my first real horrifying shock] • My Grandparents • My Husband left for Vietnam [I just gave birth] • I was a late life child; many losses • Children with cancer [an all consuming battle] • Almost Fiancée [a tear in the fabric of my soul] • Veteran patients [I couldn’t save them] • My daughter’s Mother • My Father; [my collapse] • Two suicides [the guilt and the why persist forever] Beverly Kyer, MSW; ACSW
How Can We Manage Grief; Ours and Theirs Concurrently? • Recognize what comes up for you. • Do not flee from it; honor and allow it. • Recognize that the child needs you more right now. • Your tears (if they come) are just fine. (Say to the child crying is good for the soul, spirit, body) (Say to the child that you feel for their sadness) While we may be in distress how can we suspend our own needs and stay with the child’s needs at the moment the child begins to release their grief? Beverly Kyer, MSW; ACSW
The Casualty of Relying on Resilience Beverly Kyer, MSW; ACSW
The Casualty of Relying on Resilience • According to Childhood Grief Expert Darla Henry, “Children grieve and adults must understand their intensely painful responses to trauma and loss (Rando, 1993). • Many children in the child welfare placement system experience non-resolution of their losses. Beverly Kyer, MSW; ACSW
The Casualty of Relying on Resilience • As a result, there is an increasing intensity of their unexpressed feelings and behaviors, deepening depression and the progression of protest into anger and ultimately rage. • Children who do well in foster or adoptive placements may do so because of the conscious or unconscious ability of those parents to assist children in grieving their losses.? Beverly Kyer, MSW; ACSW
An Exercise in Empathy Bella’s story • I will read the story • You will imagine being Bella and respond as Bella • Given these experiences, how could you be helped to grieve, or should you be expected to out grow it. Beverly Kyer, MSW; ACSW
GRIEF IS A NATURAL PROCESS Handout “A” Beverly Kyer, MSW; ACSW
Grief as a Natural Process The Handout “A” • Overview • How to help the child • Common mistakes • Taking care of yourself • Children’s understanding of death (Developmental implications & Common Responses) Beverly Kyer, MSW; ACSW
Elizabeth Keubler-Ross • Shock/Denial • Bargaining • Anger • Depression/Despair • Understanding/Acceptance These stages do not operate as a linear process Handout “B” Beverly Kyer, MSW; ACSW
The Stages Operate the Same When the Loss is not Related to a Death. • The protest [struggle get back the parent (s)/family] • Anger as a defense [protects from facing loss; saying what hurts; source of fear; guilt] • Despair/deep sorrow [helplessness or loss of hope for return] Beverly Kyer, MSW; ACSW
Assessing Grief It is important to understand the nature of the loss experienced by the child. Natural Death (old age; illness) Traumatic Death (Violence in or near the home; car accident) Loss of family (Incarceration; removed for abuse) Ambiguous loss (Are we reunifying? If not, what is the relationship) Beverly Kyer, MSW; ACSW
Shock Intensifies the Pain Beverly Kyer, MSW; ACSW
Shock Intensifies The Loss & Grief Experience • Strong sense of unreality • Feelings of intense guilt and rage • Extreme need to blame someone • Strong sense of helplessness • Real & imagined unfinished business with the deceased can cause feelings of frustration and betrayal • The “why” need is dramatically increased Beverly Kyer, MSW; ACSW
Understanding Feelings and Behavior Beverly Kyer, MSW; ACSW
Understanding Feelings and Behaviors • Feelings are Common and Normal [children need to know this is normal; there are no short cuts. Hurting & crying are part of the healing process] • Feelings are a Priority [The child’s feelings and concerns must take priority. Stop everything and focus the very second they attempt to open up] • Feelings Exist [Allow anger, guilt, shame, fear, etc to be expressed. Show authentic empathy, respect and support] Beverly Kyer, MSW; ACSW
Understanding Feelings and Behaviors • Respect Differences [Do not norm the Child’s experiences, timing/duration and reactions. Accept and validate each emotion just as it is and as it occurs] • Witness [Remember that children most often just want someone to bear witness to their pain] Beverly Kyer, MSW; ACSW
Understanding Feelings and Behaviors • Support [If the child seems to be playing up grief for attention, this is a signal that some other need is likely not being met] • Disclosure/Share [Loss happens to everyone. Learning that you are not alone in the experience lessens some of the fear and brings one out of isolation] Beverly Kyer, MSW; ACSW
Supporting the Tasks of Mourning Beverly Kyer, MSW; ACSW
Supporting the Tasks of Mourning • The Four Tasks: by Maria Trozzi • Understanding what caused the loss • Grieving/experiencing the painful feelings associated with the loss • Commemorating [Symbolic ceremonies] • Going on with life Beverly Kyer, MSW; ACSW
Supporting the Tasks of Mourning • The Helpful Caregiver/Provider • Foster an open and honest relationship • Provide a safe and secure place for the child to mourn • Listen, listen, listen, listen • Help preserve the memory of the lost • Be a role model of healthy mourning Beverly Kyer, MSW; ACSW
Just When You Think Things are Getting Better Beverly Kyer, MSW; ACSW
After the Sunshine Comes the Storm • Many children are only able to release deeply suppressed grief after they feel secure in your unconditional love. • The wounds in the hearts of children need to begin to heal. The child will then need to express their grief through words. • Listen ……… Bella’s Story, by Clark & Post Beverly Kyer, MSW; ACSW
Creative Tools and Outlets for the Child • Life books [Pictorial stories about the loved one. Allow the child to adorn the book with color and design] • Letters to Heaven or the Universe [Allow the child to send a message of what they want to say to the deceased person. This is a powerful intervention (bury/float/balloon] • Rituals to say goodbye [a planned goodbye mitigates the unfinished business that complicates the grief that follows loss: A gathering of special people] Beverly Kyer, MSW; ACSW
Creative Tools and Outlets for the Child • Creative Art Play [Art allows for expression of overwhelming non verbalized pain. Poetry can bring comfort. Clay can be cathartic; Books express the universality off death and loss] • Journal Writing [Suggest topics: what I remember most about..; what I wish I could say; If I could talk to God; How is … still with me?; what I learned from… that I can take into the future} • Vision a Future [Where do I go from here?; what’s next? What is the meaning and purpose for my life?] Beverly Kyer, MSW; ACSW
Cited Works • Dr. Bruce Perry, MD,., Ph.D. Preeminent Trauma Neuroscientist • Darla L Henry, Social Worker, Consultant and Author of the 3-5-7 Model • B Bryan Post, Ph.D. & Nancy Clark, MFT Co-Authors of “The Forever Child” series Beverly Kyer, MSW; ACSW
Cited Works Alexander, 1999; Aust, 1981; Backhaus, 1984; Fahberg, 1991; Fahberg & Jewett, 1978Keck & Kulpecky, 1995; McInturf, 1986; McMillan & Weiner, 1988; Rycus & Hughes, 1998 all emphasized the importance and value of the Life Story book for all foster children. Beverly Kyer, MSW; ACSW