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Child bereavement occurs when a child loses someone of importance in their life. There is substantial research regarding
grief Grief is the response to loss, particularly to the loss of someone or some living thing that has died, to which a bond or affection was formed. Although conventionally focused on the emotional response to loss, grief also has physical, cogn ...
in adults, but there is less focus in
literature Literature is any collection of written work, but it is also used more narrowly for writings specifically considered to be an art form, especially prose fiction, drama, and poetry. In recent centuries, the definition has expanded to inclu ...
about grief among children.Melhem, N. M. (2011). Grief in Children and Adolescents Bereaved by Sudden Parental Death. Archives of General Psychiatry, 68(9), 911 Children will experience instances in their life that could involve losing a parent, sibling, or friend through
suicide Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and ...
, unintentional injury,
homicide Homicide occurs when a person kills another person. A homicide requires only a volitional act or omission that causes the death of another, and thus a homicide may result from accidental, reckless, or negligent acts even if there is no inten ...
, or
natural causes In many legal jurisdictions, the manner of death is a determination, typically made by the coroner, medical examiner, police, or similar officials, and recorded as a vital statistic. Within the United States and the United Kingdom, a disti ...
. The levels of grief and bereavement differ among children, including uncomplicated and complicated bereavement.Worden, J. W. (1996). Children and grief: When a parent dies Unlike adults, children may experience and express their grief and bereavement through
behaviors Behavior (American English) or behaviour (British English) is the range of actions and mannerisms made by individuals, organisms, systems or artificial entities in some environment. These systems can include other systems or organisms as we ...
, and are less likely to outwardly express their
emotions Emotions are mental states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioral responses, and a degree of pleasure or suffering, displeasure. There is currently no scientific ...
.Osterweis, M., Solomon, F., & Green, M. (1989). Bereavement: reactions, consequences, and care. Washington, D.C.: National Academy Press The children who experience bereavement and grief can receive treatment involving group intervention,Pfeffer, C. R., Jiang, H., Kakuma, T., Hwang, J., & Metsch, M. (2002). Group Intervention for Children Bereaved by the Suicide of a Relative. Journal of the American Academy of Child & Adolescent Psychiatry, 41(5), 505-513.
play therapy Play therapy refers to a range of methods of capitalising on children's natural urge to explore and harnessing it to meet and respond to the developmental and later also their mental health needs. It is also used for forensic or psychological as ...
,Fiorini, J., & Mullen, J. A. (2006). Counseling children and adolescents through grief and loss. Champaign, IL: Research Press. and
cognitive behavioral therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (su ...
.Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents. New York, NY: The Guilford Press. Different forms of treatment for children experiencing bereavement and or grief can help to reduce symptoms of
anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil Turmoil may refer to: * ''Turmoil'' (1984 video game), a 1984 video game released by Bug-Byte * ''Turmoil'' (2016 video game), a 2016 indie oil tycoon video ...
, depression, social adjustment, and
posttraumatic stress Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
. Research has shown that it is important to be aware of the difficulties in predicting how losing a closed one can impact a child’s emotionality and how their coping abilities will differ across ages and
cultures Culture () is an umbrella term which encompasses the social behavior, institutions, and norms found in human societies, as well as the knowledge, beliefs, arts, laws, customs, capabilities, and habits of the individuals in these grou ...
.


Background

Across cultures the loss of a parent is consistently rated as one of the most difficult experiences that a child will endure.Yamamoto, K., Davis, O.L., Dylak, S., Whittaker, J., Marsh, C., & Westhuizen, P. C. van der. (1996). Across six nations: Stressful events in the lives of children. Child Psychiatry and Human Development, 26(3), 139-150. In western countries, 5% of children will experience the loss of a parent.Currier, J. M., Holland, J. M., & Neimeyer, R. A. (2007). The effectiveness of bereavement interventions with children: A meta-analytic review of controlled outcome research. Journal of Clinical Child and Adolescent Psychology, 36(2), 253–259US Bureau of Census. Suicide Deaths and Rates. Washington, DC: National Center for Health Statistics; 2012:87-97 Across the world, the loss of a parent is seen as a significant life event for a child. However, the process of grieving can look different for each child based on their age, the quality of the relationship with the deceased parent, and the characteristics of the death. An individual’s culture is an important factor that will influence the bereavement process. What one culture believes to be
maladaptive In evolution, a maladaptation () is a trait that is (or has become) more harmful than helpful, in contrast with an adaptation, which is more helpful than harmful. All organisms, from bacteria to humans, display maladaptive and adaptive traits. ...
, another culture may view as healthy; there is no universally accepted view of the bereavement process Carter, S. L. (1989). Themes of Grief. Nursing Research, 38(6), 354


Bereavement

There are two categories of bereavement that children experience after the loss of a parent; complex bereavement and uncomplicated bereavement. Uncomplicated bereavement is the normal process that most children will experience. Children who experience uncomplicated bereavement and receive adequate parenting following the death of a parent appear to not be at risk of developing a mental health condition in the future.Worden, J. W. (1996). Children and grief: When a parent dies. Complicated bereavement occurs when an individual fails to return to their pre-bereavement emotional and behavioral functioning Cutcliffe, J. R.1998. Hope, counselling and complicated bereavement reactions. Journal of Advanced Nursing, 28(4), 754-761 The precise definition and duration of the bereavement process has been a source of controversy over the decades.Wakefield, J. C., & First, M. B. (2012). Validity of the bereavement exclusion to major depression: does the empirical evidence support the proposal to eliminate the exclusion in DSM-5? World Psychiatry, 11(1), 3–10Kendler, K. S., Myers, J., & Zisook, S. (2008). Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events? American Journal of Psychiatry, 165(11), 1449–1455 According to the
DSM-V The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...
, Persistent Complex Bereavement Disorder, requires that the child lost someone that they had a close relationship with; and during a 6 month period the child must experience on more days than not, one of the following symptoms: a yearning for the deceased individual, sorrow or emotional pain for the dead, preoccupation with the death, or preoccupation surrounding the circumstances around the death.American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders: DSM-5(5th ed.). Arlington, VA: American Psychiatric Association Additionally, six more symptoms must be experienced on more days than not that are related to reactive distress to death or social/identity disruption.


Development considerations

Children can be vulnerable to life events following loss. The vulnerability is due to developmental immaturity and the lack of developed coping abilities. It is common to assume children will grieve in a similar fashion to adults, but their symptoms and duration of grief following loss appears differently. This may include children repeatedly asking questions about death for reassurance that nothing has changed and reenacting the death or funeral activities. Additionally, children’s emotions may be expressed differently than adults; adults may express their grief through sadness, but children may misbehave or have outbursts. Research emphasizes the importance of being cognizant of and not to expect children to display their emotions outwardly like adults, but rather that their behaviors could indicate their internal distress. It is important to note that grief reactions in children are varied, wide ranging and unique to each individual.https://theparentvine.com/child-grief.html


Treatment

A large portion of children may experience loss and bereavement at some point during their childhood. After these losses occur, there are a variety of types of treatment techniques that can be implemented, including Play Therapy, Group Therapy, and Cognitive Behavioral Therapy. Play therapy for loss during childhood uses activities like drawing or games that aid in having the children talk about their feelings. Another effective form of therapy is Group Therapy tailored for loss during childhood, where a group of peers, similar in age, share and talk about their feelings and the bereavement process with a facilitator leading the group. Lastly, Cognitive Behavioral Therapy for loss during childhood includes using cognitive techniques to assist the child in changing their behavior and using more effective coping techniques. The different forms of treatment aiming to assist children in coping with loss and bereavement also help to reduce their symptoms of anxiety, depression, adjustment issues, and posttraumatic stress. By using empirically driven forms of therapy for children who have experienced loss, children can reduce their symptoms and will be less likely to drop out of treatment by focusing on the feelings and reaction they have to the death or suicide of someone close.


References

{{Reflist Childhood Developmental psychology Grief