"People tend to think children are just fine, which doesn’t help, or think they’ll be just fine," Christ says. "We found that children’s grief is very different from adult grief, and that has implications for how to help them."
Part of the problem stems from the ways in which children express grief. Very young children, for example, are unable to express sustained grief (or any emotion) for an extended period. Children might experience periods of sadness or anger, and then go off and play with friends, says Christ. Their ability to play and laugh often leads adults to think that children are not grieving when, in fact, they are.
"Children this age, between six and eight, are capable of ‘joyous remembering’ much sooner than adults. These memories are very comforting to a child—but can be very distressing to an adult," says Christ. "Very young children cannot compartmentalize."
Slightly older children "want to talk about facts, not feelings," says Christ. For nine to eleven year olds, such fact-finding is part of their developmental stage. Adolescents have a different set of problems, torn between developmental tasks of separating from their parents and the reality of a parent’s death.
Christ found that children’s anticipatory grief was actually more stressful to them than the parent’s death. "Children had a higher level of depression before the death than in the period immediately after," Christ says. "That period of time, when a parent is ill, is time for intervention."
The intervention must target the child’s age or developmental stage. Christ suggests that caregivers help children over the age of twelve cope with their emotional reactions. For younger children, facts about death and dying can be helpful. Very young children, she says, can be frightened by not knowing what death is.
What helps grieving children most? According to Christ’s study, an intervention that guides parents on how to help their children before and after death seems to be most helpful. "It is hard to overestimate the importance of giving children information at all stages," she says.
Families that did best in the study (those that returned to a normal level of functioning) attended children’s support groups, read about children’s grief, and participated in individual and group counseling.
A key variable in how well a child adjusts is the relationship with the surviving parent. "More active coping and less depression are attributes of surviving parents that contribute to the better functioning of children after a parent’s death," she writes. Other attributes include the parent’s warmth and the cohesiveness of the family.
Christ’s work has a universal appeal. As a senior faculty leader for the Project On Death in America, she recently traveled to Slovenia where physicians and others were interested in how to help traumatized children there and throughout Eastern Europe. Although Christ’s book does not focus on traumatic loss, she believes that the information provided can be useful in many situations. "There are many different ways to handle grief, a lot of ways to work it out well. It helps to hear what others are doing. My book does not give methods, but it does give ideas."
Professionals and lay readers will find the book’s recommendations very helpful in addressing children’s needs. Recommendations focus on specific age groups and address dealing with the terminal illness, death and family rituals, and bereavement and recovery.
Christ leads PDIA’s Social Work Leaders project, which has granted 14 two-year awards worth almost $1 million. Projects include several on advance practice education for social workers, who face problems familiar to other professional caregivers: a lack of formal training in end-of-life care. Christ and others hope to develop programs that improve education and develop leaders in the field.
For more information, visit Christ’s website, www.childrensgrief.com
School of Social Work
622 West 113 Street
New York, NY 10025
212.222.1829 or [email protected]
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