Grief & Loss: The School Counselor’s Guide Lacee Tolliver We all experience pain, loss, death and grief in our life. It can seem especially difficult for children, we view them as more vulnerable, we have natural instincts to protect them from things of this nature Loss and grief affect the TOTAL lives of children- school, play, relationships with friends and family, physical, cognitive (thoughts about themselves) One of the things that makes grief a complicated issue is that parents often hugely impact the way a child grieves, it makes our role in the school that much more crucial

Objectives Common causes of childhood grief and loss Developmental factors Identify normal and complicated reactions to loss and bereavement Personal and cultural factors Role of the school counselor Interventions

Reflect Think about what you know already know about children & grief What are common messages we hear about children & grief? What questions do you have?

Definitions Loss Grief Bereavement Mourning The disappearance of something cherished, such as a person, possession or pet. Grief The normal, multifaceted response to a loss. Can include emotional, cognitive, physical, behavioral and social components. Bereavement The process of adjusting to a loss. Mourning The culturally structured response to grief.

Historical Perspective Kubler-Ross 5 stages of grief Berger’s 5 identities of griever Freud Bonanno’s 4 trajectories of grief Resilience- most common reaction Recovery-symptoms of intense grief for short period Chronic dysfunction-prolonged suffering Delayed grief-adjustment seems normal, but it then turns into recovery or chronic dysfunction after several months

The Statistics Of high school juniors and seniors….. 90% have experienced grief related to death 40% have experienced the death of a friend 20% have witnessed a death 1 in 20 children under the age of 15 will lose a parent Most will get information about death & dying from parents (Parent education)

Causes Individuals experience grief for many different reasons Death of a parent, grandparent, sibling, other family member or friend Death of a pet Parent’s divorce or move Do not delegitimize the student’s losses Can we brainstorm some other reasons that children might grieve or mourn? Throughout this presentation, we will be mainly talking of traumatic loss (death) for individual students, but we might think about how we could adapt this to non-traumatic loss or crisis response (larger group).

Emotional & Developmental age Influenced by… Social supports Circumstances Relationship Previous experiences Emotional & Developmental age Culture  The grieving process is influenced by many issues The impact of a death on a teen relates to a combination of factors including: * Social support systems available for the teen (family, friends and/or community) * Circumstances of the death - how, where and when the person died * Whether or not the young person unexpectedly found the body * The nature of the relationship with the person who died - harmonious, abusive, conflictual, unfinished, communicative * The teen’s level of involvement in the dying process * The emotional and developmental age of the teen  * The teen’s previous experiences with death

Varies across developmental stage Responses Varies across developmental stage Ages 4-7 Ages 7-11 Ages 12-18

Responses for 4-7 year olds Concept of Death: Reversible, personification of death. Feeling of responsibility because of wishes and thoughts. Common statements: “It’s my fault. I was mad and wished she’d die. Grief Response: More verbalization. Concerned with process. How? Why? Repetitive questioning. May act as though nothing has happened. General distress and confusion. Signs of Distress: Regression: nightmares, sleeping and eating disturbed. Possible violent play. Attempts to take on role of person who died Tend to see death as temporary and reversible Cartoons portrayal of death

Varies across developmental stage Responses Varies across developmental stage Ages 4-7 Ages 7-11 Ages 12-18

Responses for 7-11 year olds Concept of Death: Death seen as punishment. Fear of bodily harm and mutilation. This is a difficult transition period, still wanting to see death as reversible but beginning to see it as final. Do not think it could happen to anyone they know. Grief Response: Specific questions. Desire for complete detail. Concerned with how others are responding. What is the right way to respond? Starting to have ability to mourn and understand mourning. Signs of Distress: Regression: school problems, withdrawal from friends. Acting out. Sleeping and eating disturbed. Overwhelming concern with body. Death thoughts (desire to join one who died). Role confusion. More advanced view of death, though still do not think it could happen to them or anyone they know Others may expect them to provide light to the situation, pressure to do this

Varies across developmental stage Responses Varies across developmental stage Ages 4-7 Ages 7-11 Ages 12-18

Responses for 12-18 year olds Concept of Death: A more “adult” approach. Ability to abstract. Beginning to conceptualize death. Work at making sense of things. Grief Response: Extreme sadness. Denial. Regression. More often willing to talk to people outside of family and peer support. Risk taking. Traditional mourning. Signs of Distress: Depression. Anger often towards parents. Suicidal thoughts. Non-compliance. Rejection of former teaching. Role confusion. Acting out. Less likely to be their first experience with death and loss

Complicated Grief Complicated grief may require more intense counseling, outside referral Traumatic loss Intensity & Duration Functional decline Total denial PTSD type reactions Premature death • Increased risk for mental and somatic problems • Reduced functional capacity • Increase in suicide attempts • Higher levels of health risk behaviours • Reduced life-quality

Emotional & Developmental age Influenced by… Social supports Circumstances Relationship Previous experiences Emotional & Developmental age Culture For interventions to be effective, the need to be tailored  The grieving process is influenced by many issues The impact of a death on a teen relates to a combination of factors including: * Social support systems available for the teen (family, friends and/or community) * Circumstances of the death - how, where and when the person died * Whether or not the young person unexpectedly found the body * The nature of the relationship with the person who died - harmonious, abusive, conflictual, unfinished, communicative * The teen’s level of involvement in the dying process * The emotional and developmental age of the teen  * The teen’s previous experiences with death

Cultural Factors Mourning looks different from culture to culture Socio-cultural Ethnic Religious/philosophical Afterlife, burial rites, expected attitudes of loved ones, gender differences, how to tell children What can we do in the schools to be culturally aware or sensitive in times of student grief/loss? Some culturally accepted patterns of grieving could be seen as helpful adjustment in some cultures & harmful adjustment in others (example: China vs. Us “bonded” to deceased) How do your own cultural views

Exploring personal reactions Sensitive topic People often avoid thinking about it Must know our own attitudes and fears Consider how this might impact your work with grieving students

ASCA National Model IV-A-9. Providing responsive services, including grief and bereavement IV-B-3c. Demonstrates an ability to provide counseling for students during times of transition, separation, heightened stress and critical change IV-C-2. School counselors coordinate and facilitate counseling and other services to ensure all students receive the care they need, even though school counselors may not personally provide the care themselves Hard to be preventative, can do some parent education if there is a crisis

What is our purpose? Grief is a natural process Most will eventually be fine Current research focusing on limitations of grief counseling & potentially harmful effects Although we are not grief counselors, what can we do? Support the child at school

In the school... Before a student returns after a traumatic loss Talk with the student Talk with the parent, if possible Talk with the class Provide a way for students to reach out to their friend 1. Talk with the bereaved student before she returns. Ask her what she wants the class to know about the death, funeral arrangements, etc. If possible, call the family prior to the student’s return to school so that you can let her know you are thinking of her and want to help make her return to school as supportive as possible. 2. Talk to your class about how grief affects people and encourage them to share how they feel. One way to do this is to discuss what other types of losses or deaths the students in your class have experienced, and what helped them cope. 3. Discuss how difficult it may be for their classmate to return to school, and how they may be of help. You can ask your class for ideas about how they would like others to treat them if they were returning to school after a death, pointing out differences in preferences. Some students might like to be left alone; others want the circumstances discussed freely. Most grieving students say that they want everyone to treat them the same way that they treated them before. In general, they don’t like people being “extra nice.” While students usually say they don’t want to be in the spotlight, they also don’t want people acting like nothing happened. 4. Provide a way for your class to reach out to the grieving classmate and his or her family. One of the ways that students can reach out is by sending cards or pictures to the child and family, letting them know the class is thinking of them. If students in your class knew the person who died, they could share memories of that person. VIDEO of some kids responses

In the school... School wide Let teachers know what to expect & what they can do Be available for teacher support Encourage routine Provide both structure and flexibility Set and enforce limits Do not act as if nothing happened 5. Provide flexibility and support to your grieving student upon his or her return to class. Recognize that your student will have difficulty concentrating and focusing on school work. Allow the bereaved student to leave the class when she needs some quiet or alone time. Make sure that the student has a person available to talk with, such as a school counselor.

Ages 4-7 Art projects and drawings Balloon with a message Books: When Dinosaurs Die, Badger’s Parting Gifts

Varies across developmental stage Interventions Varies across developmental stage Ages 4-7 Ages 7-11 Ages 12-18

Ages 7-11 Acrostic poems Colleges GTI- supported by research, $28 Relaxation techniques

Varies across developmental stage Interventions Varies across developmental stage Ages 4-7 Ages 7-11 Ages 12-18

Ages 12-18 Wordle Journaling/letter writing Inside/outside art activity Books-for lots of situations When you get angry/sad cards

Remember… Grief and loss are unique for each individual School counselors role is to help support student at school, connect to resources, identify complicated responses to grief Questions, comments, discussion?

Resources http://www.childrengrieve.org/ http://childgrief.org/childgrief.htm http://www.dougy.org/ https://www.childrengrieve.org/sites/default/files/C7%20Clinical%20Grief%20Activities%20booklet%20handout.pdf