Grief in Children and Adolescents
Common reactions:
Somatic: irritable bowel, stomachaches, vomiting, headaches, difficulty breathing, and panic attacks
Executive Functioning: remembering to complete tasks, staying on task, following directions, planning, coordination, misplacing items, making simple errors and struggling with fine motor skills, like handwriting
Emotional Regulation: difficulty controlling and managing fears/worries, tearfulness, overwhelmed “big feelings,” irritability and anger, depression and internalization or externalization
Developmental Considerations: depending on the personal meaning and significance of the loss, the individual may experience the loss differently throughout life when encountering personally significant events (ex. graduations, holidays, academic/community events, etc.)
Considerations:
It is encouraged to answer all of a child or adolescent’s existential questions honestly, including questions regarding death and the end of the relationship, when possible using developmentally considerate language (ex. “his blood stopped working, it’s like falling asleep but you don’t wake up, etc.”)
Losses early in life can serve to function as a template for handling many important life experiences, involving death, endings, losses, spiritual beliefs and attachment to other people
Parents often serve as a model for coping with grief and loss. Unfortunately this often occurs during times when parents are most in need of their own self-care and healing. Parents are strongly encouraged to seek their own care (ex. therapy, support groups, or any relevant healing activities) during times of grief in order to have the capacity to model grief responses for their children
Treatment:
Diagnosis: there is no “right way” to grieve, and as such it is important to identify the nature of the individual’s grief as well as the meaning behind the loss
Interdisciplinary Care: treatment may involve communication with the child or adolescent’s school to offer recommendations
Referrals: common referrals include support groups following at least six weeks of individual therapy, to ensure that the individual is prepared to cope with the many unique experiences of grief in a group setting
Psychotherapy: existential therapy is an evidenced based treatment for exploration of grief. It involves understanding the unique meanings behind the individual’s loss and offers a reparative relationship by a therapist who is outside of the child or adolescent’s immediate world. This allows for a space in which the child or adolescent can process authentically. When relevant, family members may be involved in treatment There are always exceptions to these recommendations, depending on the needs of the child, adolescent and family
