1. Young People Facing Loss 29 November 2006 Isobel Bremner Candle Project

2. Young People, Bereavement and Loss Ribbens McCarthy  Wide ranging review of research and literature  Majority of young people (e.g. 82%) experience some form of bereavement (death of a close relative or a friend). 4-6% death of a parent  Bereavement can be a source of difference (major/traumatic) and/or continuity (life’s rich tapestry)  Jane Ribbens McCarthy and Julie Jessop 2005  Summary on Joseph Rowntree website

3. Issues that may be affected by significant bereavement Death of a parent and sibling researched:  Educational and employment status  Leaving home early  Early sexual and partnering activities  Criminal and disruptive behaviours  Depression short and longer term  Self concept and self esteem

4. Complex and contradictory evidence Resources and stressors  Individual  Family and social relations  Class, material circumstances, culture, gender  Bereavement and multiple losses more likely to be experienced by young people who are already disadvantaged and with less organised support  Known link between premature death and inequalities related to geography and social class

5. Implications  Bereavement may be a relevant issue in the life history of particularly troubled and vulnerable young people  A range of services which are integrated and co- ordinated are needed including phone contact, individual and family interventions, peer group support  Death education needs to be systematically included in schools given most young people experience a bereavement  Young people’s views need to be listened to and respected

7. The Grief Process and What Helps There is much debate about the nature of grief; for example, whether it helps individuals to “let go” or to “hold on”, whether models of grief for men and women should be different, and whether grief is a universal experience. Key concepts:-  Grief is a process, not an event  Grieving takes time – usually longer than expected or hoped  Grief is energy consuming and exhausting  Facing and avoiding our grief are both helpful

8.  Often, but not always there are common “phases of mourning”: – initial shock, numbness and disbelief; intense and overwhelming pangs of grief (sadness, guilt, pining, searching, anger, fear, anxiety and panic); disorganisation, despair, depression and loss of meaning; finally reorganisation and adjustment (Parkes)  Bereaved individuals need times when they face their grief, and times when they look to the future and avoid it. Both too much and too little grief can be harmful (Stroebe and Schut)

9. Time spent between grief work and activities which are about getting on with life LOSS ORIENTATED  Grief work  Intrusion of grief into everyday life  Avoidance of changes RESTORATION ORIENTATED  Denial/avoidance  Distraction from grief  Doing new things Dual Process Model To avoid grief all the time OR to face grief all the time can have serious consequences

10.  Four “tasks of mourning” have been identified – recognising the reality of the loss, experiencing the pain of grief, adjusting to an environment in which the deceased is missing, and emotionally relocating the deceased (Worden)  The grief process can be facilitated if the dead person is collectively remembered (Walters)  The “continuing bonds” that bereaved people have with the dead can be comforting and helpful (Klass et al)

12. Adolescence  Adolescence is a time of fluctuation and change  Developmental tasks characterised by loss and growth  Finding own identity  Separating  Developing relationships involving sexual intimacy  Managing strong emotions  Needing the security of having trusted adults around

13. Young People Facing Bereavement  Adolescence and grief. A potent mixture  Young person left very vulnerable  Ambivalent nature of relationship with adults  Difficulty acknowledging dependency needs  Foremost concern becomes that of connecting with the young person

14. Making a Connection  Engage with the frightening turmoil that they may be experiencing  To shy away from this says their world is unbearable and unsafe  Difficulties may result in us: believing we are incompetent or believing that the young person is fine  Making a connection involves tenacity, courage and openness

15. Why Does It Feel So Difficult?  Our Envy  Our own adolescence  Their feelings of being unbearably unattractive  Their sensitivity and self-consciousness  Their confident self appearance  Their apparent lack of sensitivity about you  Their difficulty putting feelings into words We may feel helpless, inadequate, clumsy, extremely self-aware and embarrassed

16. Control and Vulnerability  Young people may need to appear to be in control & independent  Difficult to acknowledge vulnerability & ask for help  We need to :- acknowledge vulnerability demonstrate processing vulnerable feelings not expect to be asked for help directly

17. Lack of Positive Feedback and Response  No feedback let alone positive feedback can feel very unrewarding  Change our expectations  Absence of a strong negative response can mean a wish for help  Do not collude with avoidance of painful issues  Be sympathetic about this impulse

18. Self Esteem  Grieving young people need positive feedback  Stigma of the death of a significant other

19. Young People In The Family  We may avoid discussions about death and dying with intention of protecting the young person  Young people may become isolated, as well as scared and sad  Expectation to become adult and independent virtually over night  Sometimes less sympathy than an adult in the same situation

20. Connect with young people by  giving choices within limits  giving them clear and truthful information about facts and feelings  suggesting ways of expressing and controlling feelings  being direct and transparent about our concerns  giving positive feedback  finding support from others if needed  encourage responsibility and self respect

22. Grace Christ (2000) Healing Children’s Grief  88 families followed in 20 months before and after death of a parent  Most young people returned to the same level of functioning pre- death (83%)  Those who didn’t often had a series of additional stressors after the death  Bereavement itself was less stressful than the attendant events eg. poverty, moving, mental illness  Most important finding: “Surviving parents can grieve deeply but can still be available to their children, can support them and can make it possible for them to continue with the tasks of ongoing development.”

23. Young Peoples Responses To Terminal Illness Developmental age 12-14  Adamant optimism  Ambivalence about seeing dying parent  Denial and avoidance of feelings  Muted anticipatory grief  Symptoms and behaviours often very demanding  Need to feel in control of emotions  Can be challenging to supportive adults

24. Young Peoples Responses After a Death Developmental age 12-14  Need to participate in ceremonies  Many do not discuss thoughts and feelings  Avoid crying  Moments of intense grief  Very influenced by peers  New relationship with surviving parent

25. Young Peoples Responses To Terminal Illness  Developmental age 15-17  Less egocentric, more thoughtful  Fear of future  Externalising behaviours more common e.g. alcohol and drugs  Peer relationships and other supports deeper  More control of emotions  More able to “put things on hold” e.g. through exams

26. Young Peoples Responses After a Death Developmental age 15-17  Timing of grief similar to adults  Intense grief  Test limits, displace anger  Self doubt about abilities  Process of re-negotiation with surviving parent  Internalise dead parent and want to “live up to them”

28. Started 1998 and offers….  Counselling to children, young people and families in the South East London area.  Group sessions for: children young people bereaved parent/carers  Advice and support to parents/carers and other professionals  and also support to a parent/carer user group  Training to other professionals eg. police, schools, health.

29. To Conclude  Grief is not an illness, it is a normal process  Most young people are very resilient  Growth and creativity possible if supported  Making a connection involves tenacity and courage No matter how risky or uncomfortable it feels to us, almost any attempt to communicate and involve the young person is better than exclusion and silence